What if Conservative Treatments Don't Get Rid of Toenail Fungus?

Nail fungus, medically termed onychomycosis, is a common infection of the fingernail or toenail, though it’s more common in the latter.

It starts as a white or yellow-brown spot under the tip of the nail. As the infection goes deeper, the nail may turn yellow or brown, thicken, and start crumbling at the edge. Nail fungus can affect several nails at the same time.

When the infection affects the area between your toes and the skin on your feet, it’s known as athlete’s foot (tinea pedis). The fungus can spread from a nail to the skin and vice versa.

Dermatophytes, a type of toenail fungus, cause 90% of toenail fungal infections, which are called tinea unguium. A dermatophyte is a mold that needs keratin protein to grow, and keratin is the main structural material of your nails.

If your condition is mild and doesn’t bother you, you probably won’t need treatment. But if your nail fungus is painful and has led to thickened nails, a combination of self-care steps and over-the-counter or prescription medications may help. 

But even if treatment is successful, nail fungus often recurs. Taking preventive steps may be the best option.

At Chicagoland Foot and Ankle, our team of board-certified podiatrists sees many cases of toenail fungus at our offices in and around Chicago, Illinois, and we have a number of conservative treatments that can help. But what happens if these measures aren’t enough? Our team weighs in here.

Causes of toenail fungus

Nail fungus is the result of a variety of fungi, with the most common being the dermatophyte. Yeast, bacteria, and molds can also cause nail infections. While fungi tend to color the nail a yellowish-brown, a bacterial infection is often green or black.

It’s easy to pick up the fungus if you aren’t careful. You can get it from warm, humid areas like pools and locker rooms if you walk around barefoot, or inside dark, sweaty shoes. The fungus enters the foot through minute cuts in the sole, taking up residence in the nail.

You’re also at higher risk of developing a fungal nail if you’re older, have a skin condition that affects the nails such as psoriasis, or have diabetes, blood flow problems, or a weakened immune system.

Treating toenail fungus

There are two basic ways to treat tinea unguium:

Oral antifungal medication

Options include terbinafine (Lamisil®), itraconazole (Sporanox®) or fluconazole (Diflucan®). You have to take the drug every day for several months, or even longer, and your doctor may use blood tests to check for potential medication side effects. 

These medications are known to affect the liver and interact with other medications, so oral antifungals may not be right for you.

Topical medication

You can apply a topical medication directly on your nail, like putting on nail polish. The medication treats the fungus over time. Topicals are most effective when combined with oral medications.

But what happens if you try these conservative treatments and the fungus persists?

You may be a good candidate for laser therapy. We direct both a laser beam and special lights at your toenail, which go to work fighting the fungus. You should know, though, that lasers are FDA-approved only for “temporary increase of clear nail” in nail fungus. That means they’re not a cure.

In fact, cure rates for laser treatments are lower than for oral and topical medications, so they’re never a first-line treatment. But if you’re not a good candidate for the drugs, lasers are a viable option.

If you’re fed up with toenail fungus, come into Chicagoland Foot and Ankle for effective treatment. Call any of our locations (Mount Greenwood and Portage Park areas of Chicago, as well as Orland Park, Bartlett, Niles, and New Lenox, Illinois), or book online today.