Toenail Fungus: What You Need To Know About Treatment Options

Here at Skin Solutions Dermatology we have many patients who come to us seeking treatment for toenail fungus.  Toenail fungus is more common than one might think and can be very difficult to get rid of.   Depending on the treatment option used, it can take three to ten months to successfully eliminate the fungus in its entirety, even after seeking medical help!  

How To Spot Toenail Fungus:

Typically, toenail fungus begins as a small white or yellow spot underneath the nail.  Toenail fungus can be especially difficult to treat with topical treatments simply because it is under the nail.  As the fungus develops and goes deeper into the nail it can cause the nail to discolor, thicken, and even crumble at the edge.   It is possible to get nail fungus in fingernails but it is much more common in toenails.  There are a number of factors that increase the plausibility of developing nail fungus, especially in the toenails, such as older age (reduced blood flow), sweating heavily resulting in damp socks or shoes, having a history of athletes foot, walking barefoot in damp areas (swimming pools, gyms, shower rooms), having a prior minor skin irritation, diabetes, circulation problems, or even a weakened immune system.  The potential contributing factors are numerous!  It’s no wonder it is a fairly common thing for people to develop.

What Is “The Best” Treatment Option:

What is the best approach to treating toenail fungus?  Well that depends…  There is a prescription topical anti-fungal that was specifically formulated to treat the nail bed and eliminate the fungus.  However, the success rate of this topical treatment is less than 75% and it takes a full ten months of consistent, nightly application, to reach that cure rate.  Needless to say, it is a labor-intensive approach that many people give up on before the desired results are achieved.  Another more user-friendly alternative, and the one with the highest cure rate, is an oral antifungal prescription medication called Terbinafine.  This option is taken daily for a three-month period.   Previously, there had been some concern with Terbinafine, as it has been associated with liver problems in the past.   New research is finding that this is not necessarily the case, but if this is the treatment deemed best for one of our patients at Skin Solutions Dermatology, we make it a point to check the patient’s liver enzymes midway through the treatment process.  This process simply reassures us that the patient’s liver has remained unaffected by the oral medication.  

When To Make An Appointment:

The safest answer to this question is simply as soon as you see something suspicious that is not going away on its own accord.  The sooner you come in – the sooner the fungus can be treated!  Patients with type 2 diabetes should be extra cautious regarding their feet and toes, as toenail fungus is twice as common in diabetic feet, and if left untreated very serious complications can occur.   Additionally it is important to note that though rare, melanoma can sometimes occur under the nail, and may show up as a dark streak in the nail.  If unsure how to identify or treat toenail fungus please be proactive and book an appointment!  Skin Solutions Dermatology has offices in Nashville, Brentwood, Franklin, Columbia, Pulaski, Hendersonville, Mt. Juliet, and Smyrna, so there is sure to be a location close to your home if you’re in the greater Nashville area!



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Dr Pena

About The Author

Dr. Pena is a Board-Certified Medical Dermatologist, Mohs skin cancer surgeon, and cosmetic dermatologist. Her mission is to educate the diverse patient populations she serves, and their communities, on the importance of skin care in decreasing the risk of skin cancer and minimizing the early signs of aging. She founded Skin Solutions Dermatology with numerous clinics in Nashville, Tennessee and surrounding Middle Tennessee.

Dr. Julia Pena, MD

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