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laser treatment for toenail fungus and dystrophic toenails in SeattleAre discolored, thick, brittle, crumbly, or misshapen fungal toenails making you self-conscious about your feet? If you're like most people who struggle with this condition, you probably want to rid yourself of it as quickly as possible, so you can get back to showing off your feet and participating in the activities you enjoy.

However, toenail fungus isn't just a cosmetic issue. Caused by a highly-contagious fungal infection, known as onychomycosis, fungal toenails can spread in families, become painful over time, they can spread to other parts of the body including hands and groin, and triple diabetic patients' risk of developing limb-endangering complications like slow-to-heal foot ulcers. Even more frustrating: fungal toenail infections can come back again and again, despite conservative treatments.

Expert Care for Fungal Toenails in Seattle's North End

Practicing proper foot hygiene, choosing the right footwear, routine podiatry care, and seeking prompt treatment for fungal toenails can help keep infections at bay. Fortunately, you've come to the right place for assistance. At Foot and Ankle Center of Lake City, we offer a broad range of effective treatment options for fungal toenail issues, and our highly-skilled podiatrist, Dr. Rion Berg, has four decades of experience helping patients resolve this stubborn and potentially dangerous condition.

Fungal Toenails (Onychomycosis) Causes and Prevention

locker rooms and pools are breeding grounds for toenail fungus in SeattleFungus is everywhere and, as a result, just about anyone can get a fungal toenail infection under the right (or, rather, the wrong) conditions. Thankfully, when you understand what causes fungus to thrive, you can take the appropriate steps to make your feet—and shoes—a less hospitable environment for it. Here's what you need to know.

  • Fungus loves warm, moist, dark areas. The most common cause of fungal toenail infections is chronic use of tight, non-breathable shoes along with cotton or wool socks that retain moisture. Avoid overly tight hosiery and restrictive shoes; instead, choose synthetic-fiber socks that wick away moisture, and supportive, well-fitting shoes made of breathable materials.
  • Proper foot hygiene can reduce your risk for fungal infections. Keep your feet clean and dry. Wash and dry them thoroughly, paying special attention to the areas between the toes. Use a high-quality talcum (not cornstarch) powder to discourage excessive moisture.
  • wear flip flops to prevent toenail fungus infectionSafe nail care protocols can prevent injuries that encourage fungal toenails. Disinfect home pedicure tools before and after use, and clip toenails straight across so that the nail doesn't extend beyond the tip of the toe. Avoid applying polish to toenails that may be infected.
  • Catching a developing infection can prevent it from spreading or becoming a chronic problem. Inspect your feet daily for thick or discolored toenails or cuts or cracks in the skin—all of which can indicate fungus.
  • Shared facilities like locker rooms at athletic clubs are breeding grounds for fungal infections. Wear clean shower shoes in these areas whenever possible to protect your feet from exposure to other people's foot problems.
  • Direct trauma to the toenail (from a stubbing injury, for example) or repetitive microtrauma (from running in restrictive shoes) can damage the nail plate, allowing fungus to invade. Wear clear, dry, well-fitting, and breathable shoes to help prevent toenail injuries.
  • Nail salons that don't properly clean their equipment. Check out the hygiene practices of your nail salon.

Other factors like age, diabetes, HIV, and medications that weaken the immune system can also increase your risk of developing a fungal toenail infection.

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testing your toenails for fungusMaking Sure It's Fungus

Fungal infections aren't the only conditions that can cause discolored, white, thick, brittle, or crumbly toenails. We'll verify the presence of a fungal infection with a visual inspection, and send part of your toenail off to a laboratory for testing and confirmation if your diagnosis is in question.

Dystrophic or Deformed Toenails

Another word for misshapen and thick toenails are dystrophic toenails. While dystrophic toenails are most often caused by onychomycosis, they can be caused by trauma. Learn more here.

treating toenail fungus with PinPoint laserTreating Fungal Toenails in North Seattle

Foot and Ankle Center of Lake City offers a variety of fungal nail treatments to meet your needs, budget, and lifestyle, including topical and oral medications, and FDA-approved PinPointe FootLaser™ therapy. While topical medications are less effective and oral medications have the potential for concerning side effects, PinPoint FootLaser™ treatment is painless, has no known side effects, and boasts a success rate as high as 70 percent and new, clear nail growth in as little as three months. Additionally, treatment sessions take just 30 minutes, toenails can be re-treated at three-month intervals without systemic side effects.

Our Comprehensive Laser Treatment Program Including Tolcylen Has An 80%-90% Success Rate

Developed to give you the best chance of successfully eliminating toenail fungus, our comprehensive laser treatment program has an 80%-90% success rate and includes:

  • Three laser treatments.
  • Use of a Shoe Zap Ultraviolet Shoe Sanitizer to sterilize your shoes during treatment.
  • tolcylen topical for treating toenail fungusTopical medications to use on the infected toenails and surrounding skin. We use Tolcylen products for this step in the process. These products not only reduce fungus on the skin and nails but also improve the appearance of nails in a few week's time.
  • A short course of oral medications to improve your treatment's success rate.
  • Follow-up with Tolcylen foot soaks. Tolcylen foot soaks contain a proprietary blend of moisturizers, exfoliators, protectants, cleansers, essential oils, and salts to help keep fungus at bay.

A recent analysis of many studies cites the effectiveness of laser treatment over oral drugs alone.

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How to Correctly Apply Tolcylen to Your Fungal Toenails

Many people tend to use too much Tolcylen when treating their fungal nails and the surrounding skin. Learn the proper way to apply Tolcylen in this video.


Some Patients Who Have Received Laser Treatment At Our Office

before and after photo of fungal toenailsbefore and after photo of toenails with onychomycosisbefore and after photo of toenail fungus

before and after picture of nail fungus



pre and post treatment of fungal toenails with laser4 month before and after pic


laser treatment for fungal toenails before and after photos









For more before and after pictures, check out our photo gallery where patients received the PinPoint Laser treatment at other clinics.

Frequently Asked Questions About Toenail Fungus Treatment At Our Office

1. What are the challenges in treating fungal toenails?

Fungal toenails are difficult to treat because the fungus isn’t just in the toenail, but underneath in the nail bed.  Whatever method is used to treat this condition, it must penetrate the nail and the tissue underneath.  In addition, because your nails only grow 1 mm/month, it can take 4-6 months to determine if the treatment is working. 

We have three treatments that can accomplish this. 

  • Oral medication is delivered to your nails and nail bed through your bloodstream. 
  • Laser treatment can also penetrate into the nail bed.
  • Tolcylen, a topical, is also specially formulated to reach under the nail.

2. How do I know which treatment approach is best for me?

Your podiatrist will review your history and examine your toenails, provide you with the success rates of each treatment type, and give you any information about potential side effects (eg. oral meds have a small risk of liver side-effects).  Together you’ll decide which treatment plan is right for you based on this information. 

3. How do I know if I’m making progress? 

Dr. Berg will check your toenails at the appropriate interval following completion of your initial treatment. Together, with your own impression, Dr. Berg’s opinion, and comparison of before and after photos, we will be able to tell if there is significant progress.

4. Will I need to continue treatment?

Dr. Berg may determine that additional treatment would be beneficial after your first round of therapy. He may recommend continuing application of topical medication and follow up within four  months. Sometimes more laser therapy would be helpful in eliminating your toenail fungus. Finally, if laser was the primary initial treatment, and little progress was observed after four months, switching to oral medication for three months may be recommended.

5. Can I hope to clear my nails completely? 

Treating fungal toenails successfully, with complete clearing is possible, but it is not uncommon for patients to be satisfied with moderate improvement. Much like other dermatologic disorders, maintaining healthier toenails requires management, and may require additional treatment over time. Unfortunately, regardless of how clean we keep our feet and how much we avoid situations where we could reinfect our nails, our shoes harbor fungus and recurrence of fungal toenails is not uncommon. 

Even with all the tools we have to treat you, there is no magic.  Treating fungal toenails takes patience and persistence on both the patient’s and the doctor’s part.  We are always on the lookout for new developments that will improve the outcomes for our patients.

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Toenail Fungus Testimonials

Grateful to Dr Berg for helping me get rid of my toe fungus! The difference is pretty incredible, and restored my confidence in my bare feet- 2021, Kathyrn G.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.