Quit Hiding Those Toes

A New Image Cosmetic Laser Center offers a highly successful laser treatment for nail fungus.

Dr. Dwight Korgan of A New Image Cosmetic Laser Center.

While most people never ­experience the serious complications of toenail fungus, known as onychomycosis, it can nevertheless have major complications such as cellulitis (local bacterial infections), osteomyelitis (bone infections) and gangrene.

    Most people just complain of those ugly nails that only ­occasionally cause minor ­discomfort and sometimes don’t quite clear the couch or coffee table and end up being stripped off (avulsed). Frequently not even the best nail polish will do an adequate cover up. Many women don’t wear open toed shoes and just put up with the embarrassment. This is especially true when the fingernails are involved.

    There are several causes such as exposure in a wet ­environment and trauma to the nail. Many, however, appear to be genetically impaired with the apparent inability to fight the infection. (Think: “Did either of my parents have thick ugly ­toenails?”) Tens of millions of Americans are afflicted with this malady, with up to one in ten people having the problem. It tends to be much worse in the older population and in those who have diabetes. Unfortunately, except for ­occasional cases caused by trauma, it rarely resolves by itself.

    Infections may be divided into three types: distal subungal onychomycosis (DSO) involving the end portion of the nail, proximal subungal onychomycosis (PSO) involving the area around the cuticle, and white superficial (WSO) occurring as a powdery substance on the surface. Deformities from psoriasis, lichen planus and trauma may cause look alike nails.

    While most of the time ­diagnosis is made by clinical inspection, culture and biopsy may be necessary in difficult ­cases. One challenge is that even when present, cultures may fail to grow the causative agent and may take several weeks or months to grow.

    Treatment is difficult because the fungus is sequestered in the nail and between the nail and the nail bed where the body’s defenses have a difficult time penetrating. Up until recently treatment was divided into topical and ­systemic. Topical agents include over-the-counter remedies such as mentholatum, vinegar soaks, tea tree oil and various herbal preparations. Several antifungal creams are also available over the counter. Unfortunately this class has minimal benefit except maybe in the white superficial type.

    Prescription topical creams and lacquers are available with only slightly higher success rate and a lot more cost. Several ­systemic (oral) medications are available by prescription, but have the downside risk of ­irritating and even damaging the liver and require monitoring with lab tests. Until recently when generics became available, these were very expensive and even now many insurances are reluctant to cover them. The best of these, terbinfine is approximately 85 percent effective.

    There is a relatively new treatment available now using a YAG-1064 laser to momentarily heat the nail area and kill the fungus. Several treatments are required but last only about 15 minutes with minimal ­discomfort, and no risk of injury to the liver. Success rates approach 95 percent.

    Regardless of the treatment type, it takes six months to a year for a new non- infected nail to regrow (shorter time for fingernails and longer time for toenails). Unfortunately reinfection may occur, but in the case of the laser, a treatment every six months to one year may be all it takes to keep the fungus at bay and great looking nails.

    A New Image is proud to be able to offer this new treatment at an introductory rate. Initial consultation is free. There are some illnesses that would ­prevent using this treatment and a few screening questions will be asked before an appointment is made.

    So if you tired of hiding those nails, come in see our ­photo gallery of successes and give us a chance to show you what your nails could look like next summer.

For more information, contact

A New Image Cosmetic Laser Center

(918) 341-2000