"Hi, I'm Dr. Wachtel and I'm going to talk about thickened, ugly nails. Many patients come in our practice telling me that their nails are thick, white, yellow, brown, have an odor, they hurt, and other issues because they're so thick, they get ingrown toenails from them. What is this condition?
The condition is normally called onychomycosis, or fungal nails. Fungal nails become very thick, white, yellow, and brown, and brittle - they break, cause ingrown toenails, and they hurt. For some patients they don't hurt, and unfortunately they become very unsightly. It is very common to start out with one nail and have almost all of your nails affected by this terrible fungal infection.
The first thing that we typically do, if we think that there is a fungal infection, is we might consider biopsying the nail and sending it to a certain kind of lab that can diagnose fungal infections in the nail. At that point, we have to make the decision as to how we're going to go about treating it. One way is an oral anti-fungal, but there are risks and concerns with the oral medications. There are other ways - a topical, and we will send patients home and have them thin their nails out very well, so that when they apply the medicine, it works properly. Lastly, there is exciting laser treatments now available in our practice. Laser is a beam of light that heats tissue at a certain wavelength and thereby kills the fungal nail. There are other treatments that we recommend to take home, topicals to apply to the nail, topicals to the skin, if there is fungus in the skin, and even a shoe tree that will kill fungus in the actual shoe.
Fungus is complex, it is not contagious from one human to another human, but it is contagious within your own shoe from one nail to another nail. If you have nail fungus or thickness in one nail the chances of getting it in another nail are very high. So we recommend that if you see a thickness in your nail, white discoloration, or brown discoloration or pain in your nails, give us a call and we can provide quick treatment to prevent it from spreading to your other nails."