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Onychomycosis, the medical term for toenail fungus, can be quite uncomfortable. These fungal infections can significantly alter the appearance of the nail, with brown and yellow discoloration, excessive nail thickening, cracks and splits. Furthermore, nail fungus can result in pain and discomfort in the affected toe. The actual organism is often the same fungi that cause athlete’s foot, but take residence in the nail plate as opposed to the skin on the soled and web spaces of the feet.
Nail fungal infections tend to begin with a white or yellowish discoloration under a portion of the nail. The fungi most commonly live in soil and warm moist environments like public showers and swimming pools. However, they can also be found in old sneakers and shoes. Cuts or cracks between the nail and toe are a common means for the fungus to enter the skin, and a common way for onychomycosis to develop.
“There are of treatment options, including medicated lacquers, gels and pills that can be used to treat nail fungus,” says Dr. Adam Mamelak, a board-certified dermatologist at Sanova Dermatology in Austin, Texas. Traditionally, oral therapy has been considered the most affective approach for treating this dermatologic condition. However, Dr. Mamelak explains that oral medications have been associated with side effects, and not all patients are willing to undergo the risks for their nails.
“Some of the drugs can cause stomach upset, strange tastes in the mouth, effect the liver, cause skin rashes and even effect blood counts. Some interfere with other medications and can lead to heart problems,” explains Dr. Mamelak. “While these side effects are rare, they are enough to get many patients to seek alternative therapies. ”
The Nd:YAG is skin laser that has traditionally been used for laser hair removal and the treatment of vascular lesions. This laser has also recently been found to be extremely affective for the treatment of onychomycosis. “The Nd:Yag laser is used to warm the treatment area, effectively killing the fungus, while also improving the cosmetic appearance of the nail,” says Dr. Mamelak.
Dr. Mamelak uses the Nd:YAG laser to treat patients with toenail fungus at Sanova Dermatology in Austin.
Laser treatment is a great option for those who do not want to risk the side effects associated with oral medication. Laser treatments are also able to penetrate deep into the nail, and treat areas not accessed effectively by topical treatments. Depending on the number of affected nails, multiple treatments may be required to fully treat the fungus infection.
“I like to monitor the growth of the nail to ensure the treatment has the highest likelihood of success,” Dr. Mamelak shares. Complete response and normalization of the nail can take time with laser treatment, similar to other topical and oral therapies.
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