Please note this service is only available at our Broadbeach clinic.

What is toenail fungus?

Medically termed – Onychomycosis – it affects up to 10% of the population worldwide ¹ and is marked by discolouration and potential deformity of the nails. Aside from the infected nails being a cosmetic concern, it can cause toe and foot pain in its most advanced state.¹

It is primarily caused by dermaphytes (trichophyton rubrum, trichophyton mentagrophytes & Candida albicans) which are a type of fungus that require keratin to grow.² Keratin is a protein found in skin, hair and nails and is mainly what a nail is made up of. The infection can occur in the nail plate, nail bed and/or nail matrix (from where the nail grows).

How can toenail fungus typically be contracted?

Dermaphytes can be contracted directly by contact with other people, animals, and soil. They can also be contracted in-directly through contact with daily object e.g. upholstery, hairbrushes, carpet, socks, sock liners of shoes, shoe fabric.

The presence of previous nail trauma, diabetes mellitus, advancing age, restricted peripheral circulation and compromised immune function are risk factors for obtaining nail fungus.^{1; 2; 3} An infected nail can also co-exist (over 65.4% of cases) with tinea pedis (a skin fungus infection between the toes) and it can be the actual cause of the nail infection.⁴

What does a toenail fungus typically look like?

The infected nail can have a white and/or yellowish, brown appearance with potential scaling under the nail – with or without detachment. The nail can be thickened with rough ridges. In more advanced infections there can be complete lifting and destruction of the nail plate.

What are non-laser therapy treatments for toenail fungus?

Topical anti-fungals – bought over the counter this is the easiest, most accessible, and well-known treatment – at least in Australia. Initial entry point to treatment, in regard to costs, is the main advantage.

Unfortunately, it is well known that penetration through the nail at effective fungicidal concentrations is limited especially for thick toenails.³ Hence a reason it can take a long time to eradicate the infection – if at all because of potentially no penetration for thicker nails. Another barrier is there needs to be adherence diligently for up to 15 months. The time it takes for a full big toenail to replace itself.

Systemic anti-fungal medication – administered only via prescription by your GP it is typically a 12- week course of treatment. Success rates are often reported as the highest of all treatments with full adherence to treatment.^{1; 3} The seemingly other biggest advantage to this treatment is also cost of treatment – at least in Australia.

The major disadvantage however are the well-known potential side effects such as congestive heart failure, liver toxicity and drug contraindications.³ Additional adverse effects can include headache, loss of taste, and abdominal discomfort.¹ Routine blood testing typically needs to be carried out throughout the course of treatment. Patient adherence can be low due to side effects and actually seeing out the full 12 weeks of treatment.¹ Full course of treatment needs to be followed so therapeutic concentrations reach the nail plate.¹