Fungal nails

What do fungal infections look like?

Fungal toenails are really quite difficult to self diagnose since many problems can manifest in the toenail. However, fungus may be identifiable by white spots on the surface of toenails, yellow / brown tracks at the end of the nail, similar tracks extending up from the cuticle or crumbling at the nail edges.

At their worst they can cause total destruction or deformity of the nail and may spread to other toenails or may spread to the skin of the foot leading to athletes foot.

Whilst many people find fungal infections are very slow to spread and are completely painless, they are associated with nail thickening, discolouration, deformity and pain. They are common in active adults those with diabetes and seniors.

Chiropodists will assess nails thoroughly and check if there is one of the following forms of fungal infection:

  • White superficial onychomycosis
  • Distal (lateral) subungal onychomycosis
  • Proximal (lateral) subungal onychomycosis
  • Total dystrophic onychomycosis

Chiropodist will discuss appropriate treatments having assessed other possibilities which may have led to nail deformity, discoloration, crumbling or pain.

Treatment for both the nail’s appearance and the underlying infecting organisms means different approaches to care are available, including conservative management of the nail, pharmacological treatments, cosmetic enhancements, combination or advanced techniques.

Can my nail fungus be treated with laser?

Use of class IV surgical laser aims to improve the appearance of a fungal infection, approved in Canada to temporarily increase the clarity of the nail in patients with a fungal nail infection.

Laser compliments other treatments in our aim of treating the appearance of a fungal nail infection as we treat the underlying fungus.

The laser is passed back and forth over the nail surface in a cross-hatch motion. The beam passes through the nail plate covering the nail surface and the lunula beneath (the portion of nail where the nail grows from).

A session for one single affected nail may last a few minutes, and will be longer if all nails are affected. The aim would be to cross-hatch all affected nails that appear infected.

Is it painful?

The appointment session is undertaken carefully; safety glasses are worn and measures are taken to use the surgical laser safely – some patients may notice the nail warming or heating. This is due to the effects of the laser on the nail. Our technique helps manage this and most patients experience minimal or mild side effects. Some may be more susceptible to sensitivity or discomfort including those with darker nails or nails of different thickness.

Does it work?

Fungus is infectious – shoes and socks may harbour fungal spores responsible for a reinfection or new infection.   The laser helps with the cosmetic aspect of an infection.

Our Top Tip: A common method is to integrate laser surgery into an overarching onychomycosis treatment plan: combining it within a broader management plan to include antifungals whilst managing foot hygiene and the ‘foot-sock-shoe’ environment.

Chiropodists can discuss the conservative and longer-term elective solutions for toenails. For those suffering with a toenail problem, then a chiropodist/foot specialist can help develop a plan and give advice. Following assessment chiropodists can discuss if onychomycosis laser nail surgery is appropriate.