25 million American struggle with toenail fungus and now there is a new therapy that has been cleared by the Federal Drug Administration for the treatment of onychomycosis (fungal infection of the nail).
Toenail fungus causes both the motional and physical effects, as the fungus grows and spreads deeper into the nail it causes the nail to swell and become significantly discolored. The color of the toenails changes from its translucent pinkish white to a brown-gray-yellow with pits and irregular shapes. At times causing the nail to crumble or thickened to become like claws, it can be very painful causing irritation and burning around the infected area sometimes even wearing shoes can be painful due to the thickness of the nail.
Toenail fungus can be perceived as a social stigma because of the unsightly appearance of the nails, causing foul odors due to the infection and it certainly can interfere with the patient’s social life since they will avoid wearing open toed shoes or even taking there socks off to jump in the pool on the hot summer day. This condition can cause embarrassment and it diminishes the quality of life because of pain while running or doing other athletic activities or even affecting regular routine social activities.
Fungus infection occurs when the microscopic yeast and fungal elements get caught between the nail and the nailbed which can be due to an injury or pedicure or recurrent biomechanical imbalance. It can be due to extremely tight fitting shoes causing pressure on the nail to separate from the nailbed and then if the shoe is hot and moist and dark the fungus can start to regenerate and multiply and in fact the surrounding skin and nail. Patients with diabetes or with compromised immune system’s are much more susceptible to this infection but it can occur to any one.
For many years the only treatment was grinding the nail thin applying a topical antifungal, old wives remedies have included vicks vaporub, Listerine, tea tree oil to just name a couple of treatment that have been in the pelvic media for years none have been shown to have any true effective this in the laminating the fungal infection. Prescription topicals have been around for many years also having minimal effectiveness (8%)when used alone. Approximately 15 years ago terberifine (Lamisil) and oral prescription medication was brought to market which is approximately 70-75% effective in eliminating the fungus but there is risk of side effects including inflammation of the liver, alteration of taste, stomach distress, rash to name a few of the potential side effects. The oral medications must be taken for 90 days and every several weeks blood work needs to be taken to ensure that the liver is not being affected. If you are already taking medication for lowering your cholesterol, then you are risk of liver inflammation increases and he would not be a good candidate to take the oral antifungal medication.
The Genesis Plus Laser is a breakthrough treatment for toenail fungus, as it puts the patient’s safety and comfort first. This system is affective for clearing nails of both mild and severe forms of fungus. Laser energy is applied to the toenail plate and surrounding tissue. As the laser leg gradually heats the fungus, it promotes the growth of healthy, clear nails. The light energy in fact is increasing the metabolism of the fungus and yeast causing the cells to explode from their accelerated metabolism.
The Genesis system has been approved by the FDA for treating onychomycosis, verruca, scars and spider veins. There are many advantages to the Genesis plus system it is quick it is highly effective and relatively pain free. There is warmth generated by the laser occasionally gets a little hot but never burns the patient. The treatment can take 10-20 min. and patients are able to return to the regular activities immediately following the procedure. the genesis plus laser has significant advantages over other systems it has a larger laser spot size, reduces the risk of missing infected areas it has a patent fitted microsecond technology it is more palatal full allowing for a deeper penetration. To avoid overheating the tissue a handpiece of the laser as it built in temperature gauge to measure the temperature of the skin/nail surface. All 10 toes should typically be treated additionally the issues need to be treated and I always recommend that the skin be treated is well since the patient is susceptible to the fungal infection we want to take all precautions to reduce the patient’s exposure to any fungal elements.
Depending on the severity of the infection patient may require anywhere from 1-3 treatments typically spread at 8 week intervals this procedure does not require any anesthetic and there are no adverse side effects reported.
After the first treatment to change in the nail is gradual it certainly is not instantaneous the growth of the nail is very patient dependent everybody has a different rate nail growth. If you are a rapid nail grower with good healthy nails then the nail should clear in about 8-16 weeks if on the other hand if you are slow to grow your nail then it could take 10-to 20 weeks before you will see the nail clear.
It is imperative that after this treatment patient continue to spray their shoes with antifungal spray on a regular basis, I recommend application of antifungal cream to their feet at least 2 or 3 times per week to reduce the exposure to fungus. If you would like a evaluation of your skin and nails please contact Dr.Werber at InMotion Foot and Ankle Specialists at 480-948-2111 or www.inmotionfootandankle.com, Scottsdale AZ.