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Over the counter products are not recommended to treat nail infection.

Our physicians will prescribe an oral antifungal such as:

  • Terbinafine
  • Itraconazole
  • Fluconazole
  • Griseofulvin

You may use topical antifungal treatments such as:

  • Jublia
  • Penlac lacquer
  • Tolnaftate 1%

These treatments are brushed onto the nail inthe same way that one would apply nail polish. Depending on the type of fungus casuing the infection, as well as the extent of the infection, you may have to use these medications for several months. Topical solutions are not generally effective in curing severe toenail fungal infections.

Laser Treatment

Safe and effective, this in office treatment is pain free, has no harmful side effects, and typically takes only about 30 minutes to complete. The first clinically proven laser device to increase of clear nail in patiens with onychomycosis.

how does laser work?

Our patented laser is specially designed to shine through your toenail and destroy the specific pathogens embedded in and under your nail causing the infection. Unlike other lasers that are used for skin or pain treatments, laser is designed and used for only one purpose, to safely destroy molds and bacteria that cause fungus nail infections

Is this laser painful?

The gentle laser light beam has no effect on healthy tissue. There is no pain but some patients may experience temporary warmth in the nail during treatment. This treatment does not harm or affect your activity in any way.

Does it work?

In the clinical study 81 % of all patients treated sustained a clear nail improvement at 12 months after a single treatment. After the one 15 minute treatment, the nail plate should grow out clear in 6-8 months if there is a healthy nail bed.

Does My insurance pay for this? How much dose it cost?

Please call our office to find out your benefits

Treatment Plan for Different Stages

Fungalnail Stage I

Treatment options

1. Topical medication (prescription vs. over the antifungalThere are many medications available. Prescription topical anti fungal medications are generally covered by most insurance plans and more effective than over the counter topical anti fungal medications.

2. Laser treatment (The number of treatments varies depending on the severity.)

  • Advantage:
    Success rates have been reported to vary between 70-90% effective.
    (Randomized Clinical Trial to Evaluate the Efficacy and Safety of Combination Therapy with Short-Pulsed 1,064-nm Neodymium-Doped Yttrium Aluminium Garnet Laser and Amorolfine Nail Lacquer for Onychomycosis)
  • Disadvantage: It is not a covered benefit with insurance. The cost can vary between $300-1400, depending on the number of treatments required.

3. Oral medications (Lamisil daily for 3 months) – Advantage: The success rate varies but this study that looked at 43 different studies which included 9730 patients and found Laminal to have a 58% cure rate.

  • Disadvantage: Liver damage has been reported. Sometimes the liver damage is just temporary but sometimes it is not. Careful consideration should be given to patients with pre-existing medical conditions that may increase the risk of liver damage from taking oral antifungal medication.

Fungalnail Stage 2

Increased migration of the fungus towards the nail root

Treatment options

1. Topical medication (over the counter topical medication is typically ineffective.)

2. Laser treatment (The number of treatments varies depending on the severity and is very efficacious.)

3. Oral medications (Lamisil daily for 3 months)

  • For stage 2 It is the recommended to periodically debride ((cleaning) the affected nail professionally to improve the penetration of the topical treatment. This is covered a covered benefit by most insurances. If you don’t have health insurance, the cost ranges between $100-$150.

Fungalnail Stage 3

Increased thickness that extends to the nail root and brittle nature of nail in addition to infection of the nail bed.

Treatment options

1. Combination Therapy- This is very successful and includes regular debridements every 2-4 weeks with monthly laser treatments (usually at least 3), in addition to the use of daily prescription topical anti fungal medication.

2. Total Nail Rejuvenation – This is usually recommended only if the nail root is infected or successful treatment is not achieved with Combination Therapy. A toenail removal is performed in the office with local anesthesia. You are able to walk the same day and should have a full recovery in 1-2 days. A single laser treatment is usually performed 2 weeks after the toe nail is removed. Prescription anti fungal medication is applied to the nail bed until the nail grows in clear which is between 4-12 months (depending on which nail is removed.)

3. Oral medications (Lamisil daily for 3 months)

  • INFECTION of the nail bed. The nail bed is a thick layer of skin that is attaching nail plate to skin

Fungalnail Stage 4-A

Significant thickness of the entire nail that is also brittle with significant infection of the nail bed. (sometimes the thickness of the nail can cause pain due to the pressure against the skin.)

Treatment options

1. Total Nail Rejuvenation – This is usually recommended for a stage IV A only if the nail root is infected. A toenail removal is performed in the office with local anesthesia. You are able to walk the same day and should have a full recovery in 1-2 days. A single laser treatment is usually performed 2 weeks after the toenail is removed. Prescription antifungal medication is applied to the nail bed until the nail grows in clear which is between 4-12 months (depending on which nail is removed.)

2. Combination therapy- This is recommended if the nail root is not infected and can be successful if the nail infection is successfully eradicated. This includes regular debridements every 2-4 weeks with monthly laser treatments (usually at least 3), in addition to the use of daily prescription topical antifungal medication.

3. Oral medications (Lamisil daily for 3 months)

Fungalnail Stage 4-B

A significant thickness of the entire nail that is also brittle with complete infection of the nail bed and root.

Treatment options

1. Total Nail Rejuvenation – This is recommended for stage IV B. A toenail removal is performed in the office with local anesthesia. You are able to walk the same day and should have a full recovery in 1-2 days. A single laser treatment is usually performed

2. weeks after the toenail is removed. Prescription antifungal medication is applied to the nail bed until the nail grows in clear which is between 4-12 months (depending on which nail is removed.)

3. Oral medications (Lamisil daily for 3 months)

  • INFECTION of the nail bed. The nail bed is a thick layer of skin that is attaching nail plate to skin

Our physicians have successfully treated thousands of patents with nail fungus (onychomycosis). Total Nail Rejuvenation should not performed if you have severe peripheral vascular disease or any immunodeficiency.

Successful treatment is only accomplished with determining the cause and diagnosing the correct stage. Trauma, toe deformity (hammertoe) and environmental factors can all be predisposing factors in how determining the cause of onychomycosis.

Persistent nail bed infections require a longer treatment period (12 months) with Combination Therapy. Please get a consultation to determine what the best treatment option for you is.

We accept online consultations. If you are interested please email a picture of your toenail and we would be happy to offer you a treatment plan.