In South Florida where I practice dermatology, it is always sandal season. But many men and women hide their toes in the shadows of closed-toe shoes because they are embarrassed by a microscopic invader- toenail fungus. Nail fungus, or onychomycosis in medical jargon, usually appears as a white or yellow spot under the tip of the nail. As it spreads deeper, it can cause changes in the color of the nail, and lead to thickening and crumbling of the nail. According to the American Academy of Dermatology, approximately 12% of the population has nail fungus. And while toenails are affected more frequently than finger nails, the problem can be easily spread and is notoriously difficult to treat. While potentially dangerous in patients with diabetes, circulatory problems, or immunosupression, toenail fungus is often considered a cosmetic, and not a medical problem by many insurance companies for otherwise healthy patients. So what are those challenged by this bugger to do?
First, or course, see your dermatologist! I can't tell you how many times I have had patients come to my office after a manicurist, friend, other type of physician, well- meaning grandmother, etc, has told them they have toenail fungus, only to let them know they have another kind of nail damage, but happily, not fungus. Once it has been determined that fungus is indeed the culprit (this can be done with a simple test of nail clipping), what are the treatment options? Until recently, the most effective treatment for nail fungus has been oral antifungal medications, such as Lamisil (terbinafine) and Sporanox (itraconazole). These medications carry a 70% success rate, but require monitoring of the liver (and no alcohol for those who imbibe), and may interact with other medications. A course of treatment is usually 6 weeks for the fingernails and 12 weeks for the toenails. Other less effective, but less potential side-effect profile treatments include anti-fungal polishes such as Formula-3 (tolnaftate) and Penlac (ciclopirox lacquer). These nail fungus treatments can take 6 plus months to work, and for women, require abstaining for any other polish during the treatment course. Topical creams, home remedies (tea tree oil, vinegar, bleach, iodine) are not effective against nail fungus.
But what if you could zap the fungus with a laser, and get results comparable to or better than oral medication, with no risk of systemic side effects? And what if this treatment was FDA-approved, painless, and took about 15 minutes to complete with no downtime? Enter the Cutera Genesis-Plus, the "most powerful Nd:YAG laser for the treatment of nail fungus". I had heard about this laser for a while, and was waiting for it to get FDA-approval. I admit, I am usually hesitant about new technology, and I had to see it to believe it. So my guinea pig (aka my husband who refuses to give up his Friday evening martini so I don't have to suffer by looking at his feet- sorry honey) volunteered to let me laze him. No complaints, no downtime, and so far, great results. The science behind the laser is fantastic, and the results I have seen by others who have had it longer have been nothing short of impressive. Published studies have shown 70%+ of patients with clearance after just two treatments spaced six weeks apart. We are so excited to include this laser as the latest addition to our ever-expanding laser offerings. Call the office and make an appointment with either myself of Christina (our P.A.) to see if you have nail fungus. We can then discuss this exciting new treatment with you and determine if you are a candidate.
With ANY nail fungus treatment, there is always a risk of recurrence, but recurrences can be prevented by following a fungus-prevention hygiene program, which we will prescribe during and after your treatment. This includes anti-fungal spray for feet and shoes, not going barefoot, keeping feet clean and dry, and using your own instruments for manicures and pedicures. Oh, and investing in a new pair of sandals to show off your pretty new toes!