Yellow, thick, crumbly, and ugly toenails are hiding behind shoes. They smell a little funky, they look a little funny, and they drive your significant other into frenzy! Toenail fungus is extremely common. As a foot doctor, I see it every day. Over the last several years, treatment for nail fungus has been getting a lot of attention. There are topical options and oral options for treating the ugly toenails. In addition, there are newer treatments that are non-harmful and very effective. My patients are always very concerned about the treatments and how they will affect their body. So let us discuss the pros and cons of the popular oral treatment, Lamisil as well as the new treatments.
Why take a pill? There are many medications that can be applied directly to the nail but they are not always effective. If the fungus is only at the tip of the nail or less than half of the nail is infected, the topical treatments can work to eliminate the fungus. This can take up to 10 months and there is a high risk of recurrence. Once the fungus has infected the entire nail the topical agents are not strong enough to kill the fungus. The nail is too thick for the medication to penetrate to under the nail, where the fungus calls home. Taking oral medication works from the inside of your body to fight the fungus and research, and in my personal experiences, has proven the pills to be more effective.
How long until the fungus is gone? The oral medications, such as Lamisil, are taken for three months. It takes a nail ten to twelve months to grow out. Thus, after three months of treatment, your nail may still look a little funny. When the fungus lives under your nail, it causes damage to the nail and will make it turn yellow and thick. As new, healthy, and uninfected nail growth takes place the ugly portion with grow out and eventually be replaced. Many of my patients get nervous after three months of treatment when their nail doesn’t look normal yet. If the part of the nail that is closest to your body looks normal, then the treatment worked and the nail will start appearing more normal over the next several months.
Is Lamisil hard on my body? Lamisil, much like Tylenol and alcohol can cause damage to the liver. Luckily, the liver unlike most organs in our body can quickly and easily repair itself form minor damage. To ensure the medication is safe for the patient, blood work is done to check the patients liver function. If the patients liver enzymes do not come back normal, then the patient is never started on the medication. If the liver is healthy, as it is in most people, the patient is started on the oral medication and blood work is repeated again after six weeks of taking the medication. If there liver enzymes are still at normal levels, then no damage to the liver is taking place. If the enzymes levels are abnormal then the patient is taken off the medications. At this time, the damage is so minor that the liver easily repairs itself after the medication is discontinued. If the drug is managed correctly by your doctor, Lamisil can be safer than Tylenol on your liver!
NEW and SAFE TREATMENTS
If you suffer from these ugly looking nails, then our new combination of Keryflex/Laser treatment can be effective. Keryflex is a resin that has an anti-fungal in it. Our laser is the K-laser. This is a cost effective, safe and painless procedure. We perform the laser treatment for seven minutes per foot and then apply the Keryflex resin. We use one or two laser treatments and apply the resin once a month for five months. Your nails will look better immediately.
Lamisil works about 80 percent of the time which is the same efficacy as the Keryflex/Laser. Due to the lack of any side effects, I prefer to recommend the application of the resin and use of the laser over the Lamisil.
So, it is time to show your feet at the beaches and no more wearing socks to bed. Besides, your feet will love you for it.
Wednesday, February 10, 2010
Saturday, September 19, 2009
Toenail Fungus: The Getting, Going and Staying Gone.
Onychomycosis is the medical term for nail fungus and yes, you are not the only one hiding your ugly toenails. Over 6 million Americans suffer from toenail fungus and the number continues to grow more every year. Every day, I am faced with questions regarding oral treatment for toenail fungus, and there seems to be a lot of misunderstandings and myths. Do you know the truth about oral fungal treatments?
Truth or Myth? Oral treatments such as Lamisil damage your liver.
This can be true and false. Oral fungal medication does put your liver at an increase risk of damage, but when used properly the risk is minimal. For this reason, activities like consuming alcohol are prohibited while taking the medication because it intensifies the risk of liver damage. To prevent any damage from occurring, doctors will take blood work to determine your liver function before and during the course of your treatment. If any signs of risk are present, the treatment is discontinued and there are often no consequences once the treatment is halted.
Truth or Myth? You can NEVER have toenail fungus and athletes foot at the same time.
Myth. Toenail fungus and athlete’s foot are caused by the same fungus, thus it is very common to see both at the same time. Often, one will experience athlete’s foot first and then the fungus migrates to the toenails. It is thus very important to treat athlete’s foot aggressively and to use preventative medicine to keep the fungi off of your feet. I often suggest patients to use over the counter antifungal cream a couple times a week on their feet if they are prone to getting fungal infections.
Truth or Myth? Sweaty feet can cause toenail fungus.
True! Fungus loves warm moist environments. You’re gym sneakers are a 5 star resort for the family fungi vacation. If you have sweaty feet, you are creating a haven in your shoes and socks for fungus to multiply. A podiatrist can offer several treatments for excessive foot sweating and will help decrease the nasty growth from spreading. It is also suggested to change your socks twice a day and to alternate shoes so as to not wear the same pair two days in a row and thus allowing them to dry and air out.
Truth or Myth? If I take oral medication for toenail fungus, I’ll never have to worry about fungus again!
Myth. The fungus that grows under our toenails also grows in our shoes, showers, floors, soil, and almost everywhere you walk. Thus, reoccurrence after the oral medication can be very common. It is important to take preventative measures to keep fungus out of your toenails! There are a number of products that kill fungus in your shoes and on your feet. Using these products weekly after your toenail fungus is gone can help decrease the risk of seeing those ugly toenails.
Truth or Myth? Oral treatment is the only way to get rid of Toenail fungus?
Myth? If the entire nail is infected, there are very few treatment options and oral medication has the most documented success. But recently, there have been some breakthrough treatments that have become very popular. There are several types of lasers that are on the market that are showing good signs to eliminate the fungus. In addition, there is a product called Keryflex that not only improves the aesthetics immediately but has been to cure it as well. This product is a topical that is applied by your podiatrist and requires 4-5 treatments every 6-8 weeks. Keryflex is a simple procedure that is painless and about a tenth of the cost of most laser treatments. See a video on how Keryflex is applied.
Truth or Myth? Oral treatments such as Lamisil damage your liver.
This can be true and false. Oral fungal medication does put your liver at an increase risk of damage, but when used properly the risk is minimal. For this reason, activities like consuming alcohol are prohibited while taking the medication because it intensifies the risk of liver damage. To prevent any damage from occurring, doctors will take blood work to determine your liver function before and during the course of your treatment. If any signs of risk are present, the treatment is discontinued and there are often no consequences once the treatment is halted.
Truth or Myth? You can NEVER have toenail fungus and athletes foot at the same time.
Myth. Toenail fungus and athlete’s foot are caused by the same fungus, thus it is very common to see both at the same time. Often, one will experience athlete’s foot first and then the fungus migrates to the toenails. It is thus very important to treat athlete’s foot aggressively and to use preventative medicine to keep the fungi off of your feet. I often suggest patients to use over the counter antifungal cream a couple times a week on their feet if they are prone to getting fungal infections.
Truth or Myth? Sweaty feet can cause toenail fungus.
True! Fungus loves warm moist environments. You’re gym sneakers are a 5 star resort for the family fungi vacation. If you have sweaty feet, you are creating a haven in your shoes and socks for fungus to multiply. A podiatrist can offer several treatments for excessive foot sweating and will help decrease the nasty growth from spreading. It is also suggested to change your socks twice a day and to alternate shoes so as to not wear the same pair two days in a row and thus allowing them to dry and air out.
Truth or Myth? If I take oral medication for toenail fungus, I’ll never have to worry about fungus again!
Myth. The fungus that grows under our toenails also grows in our shoes, showers, floors, soil, and almost everywhere you walk. Thus, reoccurrence after the oral medication can be very common. It is important to take preventative measures to keep fungus out of your toenails! There are a number of products that kill fungus in your shoes and on your feet. Using these products weekly after your toenail fungus is gone can help decrease the risk of seeing those ugly toenails.
Truth or Myth? Oral treatment is the only way to get rid of Toenail fungus?
Myth? If the entire nail is infected, there are very few treatment options and oral medication has the most documented success. But recently, there have been some breakthrough treatments that have become very popular. There are several types of lasers that are on the market that are showing good signs to eliminate the fungus. In addition, there is a product called Keryflex that not only improves the aesthetics immediately but has been to cure it as well. This product is a topical that is applied by your podiatrist and requires 4-5 treatments every 6-8 weeks. Keryflex is a simple procedure that is painless and about a tenth of the cost of most laser treatments. See a video on how Keryflex is applied.
Tuesday, September 8, 2009
Treating my toenail fungus…what about all my shoes?
In a recent blog by Dr. Crane, we learned about the new exciting technology of laser treatment for toenail fungus. A lot of patients inquire on what they can do to save their shoes. Afterall, it’s pretty common we have “multiple, can’t be without, spent a lot of money and hardly worn” shoes in our closet.
The answer to treating your shoes is easier than you think. Shoe sterilizers are on the market and at Healthy Steps, we are pleased to offer the best shoe sterilizer on the market.
Introducing Sterishoe. Accepted by the American Podiatric Medical Association, it looks like a shoe stretcher and is available based on your shoe size. The device contains a germicidal ultraviolet light (UVC). This technology is well known to hospitals and water treatment systems. UVC is clinically proven to destroy microorganisms. The Sterishoe is the first ultraviolet shoe sanitizer that utilizes UVC inside a shoe.
How does it work? It’s simple. You insert the SteriShoe into your shoe. As slight compression is applied, the treatment begins as the UVC rays are activated. If compression is reduced, the light automatically turns off.
Since UVC can be harmful if you look at it too long or hold it close to your skin, Sterishoe provides two important safety measures to protect you. A compression sensor and an ambient light sensor. This way, if the shoe sanitizer is removed from the shoe, the compression sensor will automatically turn off the power to the lamp.
To treat open toe shoes or sandals, there are two shoe bags that are provided. If the ambiant light sensor detects too much light, the sanitizer will turn off automatically.
The sanitizer should be applied after wearing the shoes. This way, microorganisms are erradicated and you have healthy feet!
For more information regarding Sterishoe, contact contactus@faant.com or go to Healthy Steps for more information.
The answer to treating your shoes is easier than you think. Shoe sterilizers are on the market and at Healthy Steps, we are pleased to offer the best shoe sterilizer on the market.
Introducing Sterishoe. Accepted by the American Podiatric Medical Association, it looks like a shoe stretcher and is available based on your shoe size. The device contains a germicidal ultraviolet light (UVC). This technology is well known to hospitals and water treatment systems. UVC is clinically proven to destroy microorganisms. The Sterishoe is the first ultraviolet shoe sanitizer that utilizes UVC inside a shoe.
How does it work? It’s simple. You insert the SteriShoe into your shoe. As slight compression is applied, the treatment begins as the UVC rays are activated. If compression is reduced, the light automatically turns off.
Since UVC can be harmful if you look at it too long or hold it close to your skin, Sterishoe provides two important safety measures to protect you. A compression sensor and an ambient light sensor. This way, if the shoe sanitizer is removed from the shoe, the compression sensor will automatically turn off the power to the lamp.
To treat open toe shoes or sandals, there are two shoe bags that are provided. If the ambiant light sensor detects too much light, the sanitizer will turn off automatically.
The sanitizer should be applied after wearing the shoes. This way, microorganisms are erradicated and you have healthy feet!
For more information regarding Sterishoe, contact contactus@faant.com or go to Healthy Steps for more information.
Friday, August 28, 2009
Ugly Toenails Linked With Depression! New Treatments Are Available!
Many people suffer from a common problem: ugly, thick toenails. Often this is caused by onychomycosis, a fungal infection in the nails. Most people actually feel this is simply a minor cosmetic problem and really do not classify this as a disease. Reality is that onychomycosis can actually be a devastating problem for many people. In fact, a recent study has linked onychomycosis with depression in otherwise healthy patients.
Onychomycosis, over a period of time, makes your nails yellow, thick and often extremely disfigured. This is embarrassing and many people hide their toes in closed in shoes due to the disfigurement. Many people will even wear sneakers to the beach to avoid showing their toenails. Surveys have shown a lack of intimacy, decreased feelings of self-worth and depression associated with onychomycosis. With almost 30% of the adult population suffering from toenail fungus, and this number increasing to almost 90% in the elderly, why do most people feel it is just cosmetic? Because it hasn’t happened to them yet!
There is hope for people who suffer from toenail fungus. Traditional topical and oral therapies have been less successful than patient expectations. Lots of unhappy people with sever frustration!
Topical therapies patients have tried encompass a wide variety of products and folklore including the use of Vick’s Vaporub, organic cornmeal soaks, and a variety of over-the-counter products. Even the only FDA approved prescription topical, ciclopirox, is shown to be only 8% effective in their own package insert! Imagine painting your toenail with a topical therapy for over a year, every day, and still having ugly toenails!
After failure of topical therapy, most people discuss oral anti-fungals with their doctors. Common oral therapies include terbinafine, fluconazole, and itraconazole. These are more effective than any topical, but come with possible side effects including many drug interactions and liver problems. They are touted as somewhere between 50 and 70% effective depending on dosage and duration of therapy. Many people after taking these medications still have ugly toenails! More frustration!
Hope has recently increased for patients who have struggled with chronic onychomycosis. New laser therapy for onychomycosis is the most exciting treatment now available. A pulsed UVA laser has been shown in preliminary studies to eradicate much of the fungus and often clearing is seen in 9 to 12 months. This therapy is not widely available, but has been shown to be around 80% effective in these early studies. The FDA is still reviewing the Patholase laser application for approval, but the treatment is available in limited areas as an “off-label” usage. The laser light is painless and only affects the infected tissue. Hope abounds!
Funky looking toenails can also occur from psoriasis, eczema and other nail pathologies. If you have thick, nasty looking toenails, a visit to your local podiatrist for a PAS (Periodic acid-Schiff) stain of a piece of your toenail will determine if you have a fungal infection. If you have a positive PAS stain, look into the new laser therapy before your toenails cause a lifestyle change! There is hope even if you have suffered from embarrassing toenails for years!
Onychomycosis, over a period of time, makes your nails yellow, thick and often extremely disfigured. This is embarrassing and many people hide their toes in closed in shoes due to the disfigurement. Many people will even wear sneakers to the beach to avoid showing their toenails. Surveys have shown a lack of intimacy, decreased feelings of self-worth and depression associated with onychomycosis. With almost 30% of the adult population suffering from toenail fungus, and this number increasing to almost 90% in the elderly, why do most people feel it is just cosmetic? Because it hasn’t happened to them yet!
There is hope for people who suffer from toenail fungus. Traditional topical and oral therapies have been less successful than patient expectations. Lots of unhappy people with sever frustration!
Topical therapies patients have tried encompass a wide variety of products and folklore including the use of Vick’s Vaporub, organic cornmeal soaks, and a variety of over-the-counter products. Even the only FDA approved prescription topical, ciclopirox, is shown to be only 8% effective in their own package insert! Imagine painting your toenail with a topical therapy for over a year, every day, and still having ugly toenails!
After failure of topical therapy, most people discuss oral anti-fungals with their doctors. Common oral therapies include terbinafine, fluconazole, and itraconazole. These are more effective than any topical, but come with possible side effects including many drug interactions and liver problems. They are touted as somewhere between 50 and 70% effective depending on dosage and duration of therapy. Many people after taking these medications still have ugly toenails! More frustration!
Hope has recently increased for patients who have struggled with chronic onychomycosis. New laser therapy for onychomycosis is the most exciting treatment now available. A pulsed UVA laser has been shown in preliminary studies to eradicate much of the fungus and often clearing is seen in 9 to 12 months. This therapy is not widely available, but has been shown to be around 80% effective in these early studies. The FDA is still reviewing the Patholase laser application for approval, but the treatment is available in limited areas as an “off-label” usage. The laser light is painless and only affects the infected tissue. Hope abounds!
Funky looking toenails can also occur from psoriasis, eczema and other nail pathologies. If you have thick, nasty looking toenails, a visit to your local podiatrist for a PAS (Periodic acid-Schiff) stain of a piece of your toenail will determine if you have a fungal infection. If you have a positive PAS stain, look into the new laser therapy before your toenails cause a lifestyle change! There is hope even if you have suffered from embarrassing toenails for years!
Wednesday, May 6, 2009
Deadly Pedicure?
With so many lawsuits connected to deaths, chronic infections and disfigurement from pedicures; you would think the public would be clamoring for reform. Just the opposite, most consumers completely blow off the risks and have the "it won't happen to me" attitude. Approximately $6 Billion dollars are spent on spa related nail care every year, making it a huge industry.
Unfortunately, along with that pretty pedicure you can take home: hepatitis, cutaneous herpes, warts, HIV, bacterial and fungal infections. These can be deadly, especially in the diabetic or immuno-compromised patient!
A 43-year-old San Jose, California woman's husband remembers the small cut on her toe that led to her death from a skin infection in 2004.
A 46-year-old Ft Worth, Texas mother left the pedicure salon with a small abrasion on her heel from a pumice stone in July 2005 and died of staph related illness in Feb 2006. Her family is still embroiled in a wrongful death lawsuit.
Texas, California, and Florida have taken a closer look at the cosmetology industry and have put stronger sanitation laws in place, but the consumer needs to be more aware of their risks and simple precautions!
You may never be 100% safe from infection when receiving a pedicure, but there are many simple precautions consumers can take to protect themselves.
1. What does the salon look like? If it's not clean and shiny like a doctor's office, don't stay! Cleanliness is next to godliness in the nail salon!
2. Check the photo on the license of the nail technician. Make sure they match.
3. Ask about sanitation procedures. Instruments should be autoclaved in a steam sterilizer just like surgical instruments. When in doubt, bring your own! There are lots of instrument sets available to purchase and clean yourself.
4. Is the spa chair pipe-less and cleaned after each pedicure? This is a new chair technology that is available to make you safer. Has the spa updated their old whirlpool chairs with this pipe-less technology?
5. Did the nail technician wash their hands after their last pedicure? Hand washing should be standard protocol and prevents spread of almost all pathogens including the common cold.
6. Is the nail technician wearing gloves? This is the only profession that handles sharp instruments putting the client and the technician at risk that OSHA does not require them to wear gloves. You wouldn't let a dental technician clean your teeth without gloves, would you?
7. Never let the technician use a sharp blade to trim a callus or cuticle. This puts you more at risk. If your calluses or heel fissures are that thick, please visit your podiatrist prior to the nail salon.
Nail salons are definitely improving their sanitation and trying to make you safer, but you must be a savvy consumer. The risk of infections from pedicures can be virtually eliminated if the operator used autoclaved or disposable instruments, used a pipe-less pedicure spa chair, wore gloves, employees washed their hands, and used proper sterilization techniques. Demand a safe pedicure or you and your family may be sorry!
Unfortunately, along with that pretty pedicure you can take home: hepatitis, cutaneous herpes, warts, HIV, bacterial and fungal infections. These can be deadly, especially in the diabetic or immuno-compromised patient!
A 43-year-old San Jose, California woman's husband remembers the small cut on her toe that led to her death from a skin infection in 2004.
A 46-year-old Ft Worth, Texas mother left the pedicure salon with a small abrasion on her heel from a pumice stone in July 2005 and died of staph related illness in Feb 2006. Her family is still embroiled in a wrongful death lawsuit.
Texas, California, and Florida have taken a closer look at the cosmetology industry and have put stronger sanitation laws in place, but the consumer needs to be more aware of their risks and simple precautions!
You may never be 100% safe from infection when receiving a pedicure, but there are many simple precautions consumers can take to protect themselves.
1. What does the salon look like? If it's not clean and shiny like a doctor's office, don't stay! Cleanliness is next to godliness in the nail salon!
2. Check the photo on the license of the nail technician. Make sure they match.
3. Ask about sanitation procedures. Instruments should be autoclaved in a steam sterilizer just like surgical instruments. When in doubt, bring your own! There are lots of instrument sets available to purchase and clean yourself.
4. Is the spa chair pipe-less and cleaned after each pedicure? This is a new chair technology that is available to make you safer. Has the spa updated their old whirlpool chairs with this pipe-less technology?
5. Did the nail technician wash their hands after their last pedicure? Hand washing should be standard protocol and prevents spread of almost all pathogens including the common cold.
6. Is the nail technician wearing gloves? This is the only profession that handles sharp instruments putting the client and the technician at risk that OSHA does not require them to wear gloves. You wouldn't let a dental technician clean your teeth without gloves, would you?
7. Never let the technician use a sharp blade to trim a callus or cuticle. This puts you more at risk. If your calluses or heel fissures are that thick, please visit your podiatrist prior to the nail salon.
Nail salons are definitely improving their sanitation and trying to make you safer, but you must be a savvy consumer. The risk of infections from pedicures can be virtually eliminated if the operator used autoclaved or disposable instruments, used a pipe-less pedicure spa chair, wore gloves, employees washed their hands, and used proper sterilization techniques. Demand a safe pedicure or you and your family may be sorry!
Tuesday, April 14, 2009
Friday, April 10, 2009
Toenail Laser Therapy on the News!
Toenail Fungus Laser on Good Morning America!
see the video by clicking here
Discusses the new PinPonte Laser therapy available at Foot and Ankle Associates of North Texas after May 1, 2009!
see the video by clicking here
Discusses the new PinPonte Laser therapy available at Foot and Ankle Associates of North Texas after May 1, 2009!