Fungal Nails

Fungal Nails

Fungal infection of the nail, or onychomycosis, is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail's quality and color, which is often ugly and embarrassing.

In reality, the condition is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and possibly impair one's ability to work or even walk. This happens because the resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where people are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete's foot and excessive perspiration.


  Oral medications have been found to effective in 25% of the time however the toxicity to  the liver is a big risk factor.  Any previous liver issues or alcohol usage precludes usage. A prescription for the oral medication is required and a thorough discussion with your Podiatric Physician  should occur before usage.  Topical medications are most prevalent yet lest effective especially if used as a solitary treatment.  Laser therapy has been shown to be most effective especially when used in conjunction with other treatment modalities. Laser therapy is discussed below in a detailed description.


Laser fungal therapy

How does the LASER work?

The LASER ( ARC Q4 980nm) kills the fungal infection in and under the affected toenails. The LASER light passes through the affected toenail without causing injury to the underlying nail bed or skin. Please keep in mind that the toenails do not instantly appear clear following treatment as the nails will need to grow out and need to be Debrided upon each visit.  In general, it takes up to 10 to 12 months for toenails to grow out completely. At Feldman Foot And Ankle we usually recommend 4 treatments to kill the fungus in most cases. In more severe cases, additional treatments may be necessary, which is offered at no additional cost within a yearly period following the initial treatment. In conjunction with the laser treatment topical creams or drops may be recommend for at home use. 

Is this treatment safe?

YES. Throughout clinical studies, performed since 2007, no adverse reactions, side-affects or injuries have been reported with LASER treatment of fungal toenails. Unlike currently available oral antifungal medications, there are no risks to the liver or other organs. The treatment is safe for adults and children and there are no age restrictions.

Is LASER treatment painful?

NO. The procedure is done in the office setting without anesthesia or injections. Although most patients do not feel pain, a warming sensation may be felt during the procedure.

Do I need LASER treatment on all of my toenails if only one is affected?

As toenail fungal infections are highly contagious and can eventually spread to adjacent toenails, it is recommended that any sign of nail fungus on any toe regardless of severity be treated. 

How long does the treatment take and what is the recovery time?

The LASER treatment generally takes about 30 minutes. Following treatment, you may put your shoes back on and walk out of the office. Patients may even polish their toenails the same day following treatment; however, nail polish must be removed prior to LASER treatment.

What are the chances of the fungal infection recurring?

Clinical reports have demonstrated effectiveness with up to 90% of patients noticing significant improvement after just one treatment. As with any medical or surgical procedure, a guarantee of 100% is virtually impossible; however, we can recommend preventative strategies to reduce the chance of fungal reinfection.

Is this LASER treatment covered by my insurance?

In canada each individual insurance company must be contacted. If insurance companies do not reimburse for the cost usually running between $400-800 for the entire treatment (four visits usually) the cost can usually be used for medical deductions on ones personal income tax deductions.


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