Fungal Nail Treatment Options Downtown Toronto 

Fungal Nail Treatment Options Downtown Toronto

There are many different types of infections that chiropodist and podiatrist in Toronto treat. Infections can span from fungal, viral, to bacterial.  Today we are talking about fungal, which is a very common infection we see and treat at our Downtown Toronto Podiatry and Foot Clinic!  Fungal infections are easier to treat on the skin, but once it infects the nails, it can be a lengthy process to treat. That is because with fungal nail infections the skin under the nail is infected and so is the actual nail. Your nail is comprised of the same cells as your skin, just harder. The nail almost locks the infection in and makes it harder to treat. 

Signs and Symptoms of Fungal Nail Infections:

    • Nail discolouration, yellowing, black, green or white nails.
    • Thickening of the nails
    • White flecks on the nails
    • Crumbly soft nails
    • Nails that are slow to grow
    • Pain

Most of the time, over the counter medication does not work to eradicate the fungus. Some people may notice that it may temporarily look a bit better before noticing the infection is quick to come back. Compliance with any treatment of fungal infection is very important. 

What Are the Treatment Options:

  • Prescription Topical Medication 
  • Photodisinfection 
  • Surgical Nail Removal, Temporary and Permanent
  • Oral medications

Prescription Topical Medication

Prescription topical medication is  more effective than over the counter medications with respect to treating fungal infections of the nail. Topical medication that is commonly prescribed is Efinaconazole 10 % in liquid form. This is to be combined with treatment done with a chiropodist or podiatrist to drill down the nails once a month to every 6 weeks for best results. 

If the nail is very thick, the medication has a hard time penetrating the entire nail and the nail bed. This leads to subpar results and delayed clearing of the infection. This treatment can be expected to take about 1 year to see full results. If one cannot afford to see a chiropodist or podiatrist, they can file the nail down themselves with a disposable nail file to help thin the nail out as well as break up the nail fibers to allow for better penetration of the medication. 

It is always advised to not be too eager to stop medication application. It is always best to over treat this condition than stop too soon. That is because the fungal spores can rebound and proliferate if there is any tiny bit left in the nail. 

Photodysinfection

Photodisinfection is a relatively newer treatment option. Here in Canada out of McMaster biotechnical engineers have discovered that using a methyl blue dye combined with a specific LED light can kill fungus on the spot. However, like any fungal nail treatment it takes time. That is because you have to wait for the entire nail to grow out in order to determine if the nail is clear. This treatment is done biweekly for 10 sessions combined with nail filing done by your chiropodist or podiatrist. The reason this treatment is done every 2 weeks is that this treatment “freezes” the fungal growth for 2 weeks. It is important to continue to do this treatment every 2 week intervals for best results. Clinically I have seen amazing results, however patient compliance is very important for this to work well. 

 

Surgical Nail Removal

This is something that can be done when nails are infected with advanced fungal infections. This means that the nail is entirely infected, yellow, black and very thick. When nails are at the advanced stage, usually meaning the infection has been around for many years, it is a good option to remove the nail and start over. The nail is hard to transform when it is that severe which can be a costly and lengthy process. Once the nail is removed the nail bed can be exposed, allowing for the skin under the nail to be better treated. As the fungal nail acts like a shield keeping the fungus in. Then as the nail grows out, one can treat the nail growing in with topical creams for the skin and  treatments for the nail. Or, if the patient is deemed suitable, they may also be able to use oral medication. 

Surgical nail removal has the option of being removed with temporary or permanent options. Permanent options may be for those who cannot care for themselves, or have had complications from the fungal nail, such as recalcitrant ingrown nail infections and pain. This can be performed at our Downtown Toronto Podiatry and Foot Clinic. 

 

Oral Medications

This is the most aggressive form of treatment for fungal nails. This treatment is best  suited for those who are healthy, not on any other medications as well as have good liver health. This treatment requires blood work to be done every 3 months to monitor liver enzymes. This can only be done when the patient is healthy and is compliant with blood work. This treatment also needs to be done under the cooperation of a family physician as the general practitioner is the person who may order blood work, chiropodist and podiatrist cannot. The only problem with this medication is that it takes 6 months to 1 year to have the toenail fully grow out. If the medication  or treatment is stops prior to when the nail has grown out, there is a risk for relapse. This can be prevented by combining one of the other treatments above once the oral medication has stopped. 

For fungal nail treatment in Canada, those previously listed treatments are Canada approved.  Laser is not considered a treatment by our college and Health Canada . It is also costly so it may be wise to save your money for more effective options. The reality is that fungal nails are a condition that requires diligence and patience for best outcomes. Those who fall off their appointments and adherence to treatment protocols will find this a frustrating and difficult thing to overcome. Toe fungus is a common treatment we address at our Downtown Toronto Podiatry Foot Clinic. 

Laura Desjardins Chiropodist.

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