Onychomycosis, or toenail fungus, is a problem that affects millions of people worldwide. Onychomycosis can be mild and only a cosmetic concern — but for many, the nail changes that occur develop dangerously thick, sharp, malodorous fungal toenails which can result in pain and can sometimes result in secondary bacterial infections.
Most cases of toenail fungus are notoriously difficult to eliminate, mostly because the fungus resides throughout the nail, and even on the nail bed beneath it. The structure of the nail itself is not easily penetrated by topical agents, which makes topical treatments less effective than oral antifungal medicines. Newer oral antifungal medications have a much safer profile than their prior generation of oral antifungal medications. Often only an initial baseline liver enzyme study is required prior to beginning a course of these medications. Other individuals may not desire oral medications. For these patients there are topical options available as well. Laser is a relatively new treatment modality for fungal toenails. It is indicated for the more superficial variety of toenail fungus.
There are plenty of success stories out there when it comes to using topical treatments for onychomycosis, especially for early cases where the thickening or discoloration is mild and affects the edge or top surface of the toenail. When topical medication alone is attempted, one must understand that treatment will be extended up to a year prior to seeing complete improvement. Often we will add various vitamins to help increase the growth of a new fungus free new nail pushing away the old infected toenail.