Many patients come to me questioning why their toenails are yellow, brown, black, thick, painful or just "gross". Very often the answer is toenail fungus.
Toenail fungus is indeed an infectious process. It very often comes from trauma. This could be as benign as improper fitting shoegear or from what I call repetitive microtrauma. This occurs from exercises such as running or playing sports and having your feet shift inside your shoes with each step. Each time this happens your toes may hit the end of the shoe causing repetitive rubbing of the nails. This causes minute cracks in the nails and fungus (which grows in your shoes) gets in the cracks and causes them to look ugly.
Several things can be done to try to prevent this. Hygiene is very important. Washing your feet daily, including washing with a soapy facecloth in between the toes and then drying well goes a long way. Applying any type of powder between the toes to absorp perspiration may lessen the chance of the fungus from growing (fungus likes a moist environment to grow in). Also, always wear cotton or wool socks on your feet. Do not wear any shoes without socks. Fungus can also grow inside your shoes. Be very careful walking barefoot in public areas such as at health clubs, dance areas, karate dojos or poolside.
What can you do if you already have the toenail infection? Call your local podiatrist. Nail fungus can make the nail so thick that just cutting them properly is a challenge. Your podiatrist can help with that.
Most topical antifungals are for the most part ineffective on toenails. I have found Formula 3 application 2x/day with frequent cutting and thinning of the toenails to be very beneficial. I dispense this in my office.
For more difficult or resistant cases I may prescribe an oral antifungal medication such as Lamisil. This is not for everyone. If you have any history of liver disease this option is out. I have bloodwork performed to check your liver function before prescribing this.
If you have any further questions about toenail fungus please feel free to comment on this blog or call Dr. Tarr for an appointment. His office phone number in Sudbury is 978-443-4878 and in Westford is 978-692-5085.