Is your nail salon the culprit behind toenail fungus? Well, according to several studies and reports, your trusted nail salon that provides those glittering pedicures can in fact be spreading nasty toenail fungus that can cause infections. How do nail salons spread toenail fungus? It all boils down to one simple concept – when nail salons don't maintain a sterile environment and use clean tools, fungus and subsequent infections can easily be spread. 

Breaking Down the Sources of Fungus in Salons

• Cuts and bruises along the toenail – If your salon uses a tool on you that was used on someone who has fungus and manages to cut you or bruise you while working on your feet, you are more likely to contract that same fungus. These cuts expose your cells and tissues, and according to expert podiatrists like Dr Segler, even the most trained and skilled pedicurists will occasionally be sloppy in their job slipping and cutting the skin. While this is a rare scenario today when compared to a few years ago (since pedicurists are now more trained and sensitive on hygiene), it still happens from time to time. Even if they use clean tools, the accidental cutting of your skin exposes you to any other germs that may be in the air. So, if they don't regularly clean their area, you could still be in trouble.

• Infections from using artificial toenails – Believe it or not, some people do get artificial nails on their toes, and this is another possible cause of toenail fungus stemming from your nail salon. However, most cases are usually not the direct result of your pedicurist. Artificial toenails increase the risk of hurting the skin around your toenail when wearing sandals. Fake nails also increases the area below which fungi breed and overgrow. It also brings the additional work of cleaning your toenails more carefully. Placing and removing artificial nails can also result in cuts and bruises.

• The pedicurist not wearing gloves and/or not maintaining good hygiene themselves – Even when an attendant uses fresh tools and has a clean area, their own hands and bodies are consistently coming into contact with other people's skin, and thus any infections/fungus them may have. If you don't see your attendant washing their hands before working on you and/or wearing gloves, you could come into contact with fungi and bacteria that leads to infection.

What Can you Do to Prevent Contact With Fungus?
Since we are exposed to fungus and bacteria at all times, contact and subsequent infections are always a possibility. Still, protecting yourself could be as simple as following these practices: 
• Use anti-fungal powders/ sprays before and after your pedicure
• Make a habit off washing your hands and feet regularly and after touching infected surfaces
• Take time to dry of your feet after showering and remember between the toes
• Only use trustworthy professional salons for your pedicure
• Bring your own items to the salon for your pedicures, or at least make sure that fresh, sterile tools are being used
• Choose moisture-minimizing socks and never stay barefoot in public spaces
• Reduce the number of times you use nail polish and artificial nails

There is nothing wrong with getting pedicures. Just make sure you are protecting yourself by only going to reputable salons and following the tips provided above. Fungi and bacteria may be everywhere, but it doesn't mean you have to subject yourself to risk of infection.

If you think you may have gotten toenail fungus from a pedicure at your nail salon, make sure you treat it as quickly as possible. The fungus may only look like spots initially, but it gradually gets worse...and yes, it gets even uglier. You can call Dr. Christopher Segler directly to ask about your toenails if you are concerned that you have toenail fungus infecting your toenails. 415-308-0833 or email him at DrSegler@DocOnTheRun.com.

Health experts have confirmed that fungi is present in and on the body and therefore fungal infections can affect any part of the body. Toenail fungal infections are unfortunately one of the more common infections people can contract. How can you detect whether or not you have a toenail fungal infection? Here are the top five clues to look for to determine if you have one:

1. Toenail color changes 
One of the common changes will be development of yellow streaks under the nails. Health experts consider this the initial sign that an infection is developing. If the nail in question turns green, there is definitely an infection and it is likely bacterial. White and yellow nails indicate fungal and yeast infections. Yellow nails indicate fungus. In some cases, however, the color change is more subtle. The shininess of the nail simply fades. Other times the nails turn a darker color than normal. If you regularly paint your toenails, it's a good idea to take off the polish completely once in a while to check on your nail bed’s color. 

2. Toenail texture changes
If your toenails become exceptionally brittle or have begun to thicken you could be suffering from an infection. In some cases the toenails will break, or the shape will become distorted by the growing fungus.
 
3. Toenail separation
In some cases of toenail fungal infection, the nail can completely separate from the nail bed. If you have not recently stubbed your toe or endured any similar injuries, this could be an indication of trouble. The unfortunate thing is sometimes when you have a fungus-related infection you won't even feel the separation. Therefore, it's even more critical to regularly examine your feet.

4. Pain
As the infection advances, pain may be felt on the affected part. Furthermore, the surrounding tissues may get inflamed. Pain is attributed to the thickening nails. If you gently press the nail and find the area is tender or sore, you could have an infection. It is also important to clarify that the pain is not a result of tight footwear or other toe conditions, however.

5. Odor
A bad smell is another reliable indication that you have a toenail fungal infection. As the fungus causes the toe tissues to die, an odor will be given off. This option is relatively tricky because bad smell can be caused by other factors apart from fungal infection. For example, wearing shoes for a long time can lead to the development of unpleasant odors. This is common in people whose feet sweat. Because of this many people will go undiagnosed, simply assuming they have stinky feet. If this is the case and you're not quite ready to seek medical confirmation, wear open footwear such as sandals for a couple of days. If you still have an odor, it's a pretty clear indication there is trouble afoot. 
​
Other indications include a discharge of pus, running a fever and red streaks around the area. If you suspect you have a toenail fungal infection, visiting a doctor isn't a bad idea. Your case may or may not warrant prescription medication, but it's better to know what you're dealing with than play the wait and see if it gets better game.

Dr. Christopher Segler is Board Certified, American Board of Pediatric Medicine. He see patients at home in San Francisco, Palo Alto, Menlo Park, and San Jose so that they can get cutting edge diagnosis and treatment of toenail fungus infections right in the comfort and convenience of their own homes. If you think you may have toenail fungus and have a question about it, you can reach him directly at 415-308-0833. 

QUESTION:

Hi Doc!

My boyfriend has toenail fungus on both feet and he had a discount laser treatment from another clinic about 6 months ago. We were hoping that this would help, but his toenails still look like they are the same as before the laser treatment. The fungal toenails are still yellow, thick and crumbly. He hasn't had any improvement at all.  If laser treatment did't help, are there other options that he can try?

Thanks!
CJ.

ANSWER:

Hello CJ, 

I am sorry to hear your boyfriend has not made a full recovery. If he had a laser treatment and the toenails didn't get better, he still has several options:

Laser Re-Treatment
1. Re-treatment with the laser. This is the fastest way to kill the fungus. But if we do this, we should schedule more than an hour. I would recommend doing a double laser treatment in one setting. Basically, I would just make sure that the treatment is so thorough that there is no way the fungus could live through it. 

Prescription Anti-fungal Pills
2. Prescription terbinifine pills. If I give your boyfriend a prescription for the course of pills, he will need to have a blood test to make sure his liver is in good shape before beginning the course of medication. He would then need to have a blood test again in 6 weeks to make sure he isn't having liver damage. The prescription medication can cost more than laser treatment. And the pills can alter your taste (making some foods have a metallic taste) but it is usually transient and goes away once he stops taking the medication. Also, he CANNOT drink alcohol while taking the anti fungal pills. 

Prescription Strength Topicals
3. Prescription topical anti-fungal medications can also work, but they can tedious and very expensive. The advantage over the pills is that there is no risk of liver damage. I have seen one patient that had a bad reaction where he had to stop using it because the skin around the toenail became very red and inflamed. But this is not typical, and the redness and pain did resolve after he stopped using the topical anti-fungal on his toenail. The topical solution is applied to the toenails daily. They to be applied every day for almost a year. I have had patients tell me that they often need a few tubes of these medications since they have to apply it for almost a year. The cost can vary depending upon which pharmacy you use, but most patients have said they paid over $500 per tube in some cases. You would want to check with your pharmacy to inquire about cost before getting started, just to make sure it wouldn't be too expensive. 

No matter which treatment your boyfriend prefers, we have to make sure that he has NO Athlete's foot at all trying another treatment. If there is any peeling skin on the feet that looks like an athlete's foot infection, then I would suggest either a month of a topical anti fungal on the skin, or a 2 week course of the oral anti fungal prescription pills (instead of 3 months) just to clear the skin fungal infection. Once the fungus has been removed from the skin, we could do the laser treatment to clear the toenail infection.

Making sure there is no athlete's foot is critical to success. 

Please let me know if you have any questions.  You can also feel free to call me directly at 415-308-0833 if you have any other questions or would like more detail. 

Dr Christopher Segler is Board Certified, American Board of Pediatric Medicine. He brings the toenail laser directly to patients in San Francisco, Atherton, Palo Alto, Menlo Park and San Jose to so that they get have the laser toenail fungus removal treatment in the comfort and privacy of their own homes. If you think you have a toenail fungus infection that may need laser treatment, you can even arrange a complimentary web-consulation here.

​You can also call Dr Segler directly at 415-308-0833.

This question came from a patient who wants laser toenail fungus treatment, but inquired about getting only the worst of the infected toenails treated with the laser.

Question:
Hey Doc, 
Several of my toenails are thick and discolored.  But, the 1st toe on my right foot (my big toe) is the worst.  I'd like to get an estimate for getting that toe treated, and I'd like to know if there are complimentary or discount treatments if I don't see results in 3-6 months.  From my research, it sounds like 2 treatments are often needed.

Answer:
Hello,

Thank you for your inquiry. I am sorry to hear that you're having trouble with your toenails but I would be happy to help.

One thing that you have to understand is that treating toenail fungus is really an all or nothing proposition. Because the toenails become damaged when you have toenail fungus they're very easily reinfected...even from neighboring toenails. In fact, if you even have athletes foot where the same fungus is impacting the skin, then there's a good chance your infection won't completely clear and the toenails will still remain discolored...if you don't treat ALL or the toenails...or if you don't get rid of the athletes foot before we do the laser procedure.

You can actually watch a short video that I created to help explain this....

The total cost of the laser toenail treatment is $949. But we would treat ALL of the toenails. 

The cost includes the house call, evaluation, laser treatment, topical antifungal medication to help prevent reinfection of the toenails and physician dispensed decontaminant to kill the fungus in your shoes.

In the last several years I've had very few patients who have had to have a second treatment. We simply do an extremely thorough job on the first treatment... And we make sure that patients don't have cases of athletes foot or other sources of reinfection that could re-infect the toenails.

The entire appointment takes about an hour to an hour and a half depending upon the extent of the infection. But you will want to make sure that you block out enough time so that we can do an extended laser treatment session and make sure we wipe out the toenail fungus in one long session, rather than two or three short laser treatments.

With this approach, as long as you don't have any athletes foot, (and understand that you have to actually do a lot on your own) we will be happy to come back and do a re-treatment if necessary, in 3 to 6 months...at NO CHARGE.

You just have to confirm that you don't have any athletes foot before scheduling your laser treatment. But, as long as you don't have any athletes foot, just let me know what dates and times work for you and I'll be happy to schedule your laser procedure to remove the fungal infection in the toenails and get you moving back to clear toenails.  

Thanks!
Dr. Christopher Segler

Dr. Christopher Segler, is Board Certified, American Board of Pediatric Medicine. He specializes in the treatment of you healthy patients who lead active, busy lives. He actually brings the laser to patient's homes to perform toenail fungus treatments during a house call appointment. That way there is no missed work. In fact, he can even see you before work if you like. He treats patients in San Francisco, Palo Alto, San Jose and the rest of Silicon Valley. If you have a question about your toes and whether or not Laser Toenail Fungus Treatment is right for you, call him directly at 415-308-0833.

This is a typical question from patients with mild cases of toenail fungus:

"Hi Doc...

I have a mild case of toenail fungus. Only the big toenails have the white spots and thicker nail that suggests a toenail fungal infection. However my dad’s toes are a different story. 

We recently had a house call podiatrist come to the home to check his feet. When I saw my dad’s toes, I was horrified at the sight of his toenails!  All of his toenails are yellow, thick and curving in odd directions. The big toenails are incredibly thick...nearly as thick as the toes themselves. They are crusty and flaking as well. Dad said that his toenails are so thick he hasn’t been able to cut them himself for years.

The podiatrist told us that super-thick fungal toenails are really not that rare in elderly people. He said that the appearance of dad’s fungal toenails is characteristic of a longstanding toenail fungus infection. 

My question is, “How long will it take for my mildly infected fungal toenails to get as thick as my father’s fungal toenails?”

The rate at which toenail fungus gets worse depends upon the type of fungus that has infected the toenail and your body’s ability to fight and slow the infection. 

Fortunately the most common forms of toenail fungus are not caused by overly aggressive organisms. Trychophyton rubrum and Trychophyton mentagrophytes are responsible for most of the toenail fungus infections. There are some less common fungal organisms that progress rapidly, but again, those are rare.

If you are young, healthy, have good blood circulation in your feet and have a strong immune system, you should expect the common forms of toenail fungus to get worse very slowly...almost unnoticeably slowly. You won’t notice any change from day-to-day. In fact, you may not see a change from month-to-month. 

If you takes pictures every few months and then compare over a long period of time, you may gradually notice that the areas of white and yellow discoloration are getting bigger. This may be your only indication that the toenail fungus is spreading and getting worse. If the fungus goes untreated for a long period, you may even notice that the toenail is getting thicker as well. 

But even if you are healthy and have a strong immune system that is fighting the toenail fungus infection, don’t expect your immune system to win. Toenail fungus is not something that you “get over” the way you might get over a cold or a case of the flu. When toenail fungus gets inside the toenail and starts to grow it is there to stay...unless you treat it. If you don’t treat the fungus it will simply continue to grow. 

Over time the fungus spreads throughout the toenail. As the toenail fungus grows, it begins to separate the keratin that forms the toenail. The cracks and splits in the keratin change the way light refracts through the toenail. Once that happens you notice white or yellow areas of the toenail where the keratin has been infiltrated and damaged by the thriving fungus. 

If the toenail fungus does enough damage, the nail plate may become misshapen enough to actually separate from the underlying nail bed. This usually creates large opaque white spot because the pink skin of the nail bed is no longer flush against the undersurface of the toenail. When this happens, it is usually at the end of the toenail in one of the corners.

As the fungal infection continues to get worse, the fungus bores its way through the toenail, moving closer to the root of the nail or “matrix.”  The toenails grows directly outward from the matrix. The matrix is the same size, same thickness and same curvature as a cross section of the toenail. 

If the fungus thickens the toenail and stretches out the matrix, the damage is permanent. At that point, even after you remove the fungus from the toenail, the matrix is permanently deformed and the toenail will always grow out thicker. 

If your immune system has been weakened by chronic disease, malnutrition, HIV infection or over-training, the fungus can grow and spread at a much faster rate. 

So, back to the real question. How long does it take for toenail fungus to become irreparably damaged and terribly thickened?

In many young healthy adults toenail fungus will worsen over the course of a year before the problem seems noticeable. In five years the common forms of toenail fungus can form substantial thickening and possibly permanent damage to the nail plate. But it may take ten years of more to develop the kind of grossly deformed thickened toenails like your father. The fact is, given what you describe, your father has likely had toenail fungus for decades. 

Dr. Christopher Segler offers concierge laser toenail fungus treatment services in San Francisco, Marin and Silicon Valley. If you have toenail fungus he will bring the laser directly to you.  If you have a question about laser treatment of toenail fungus, you can reach him directly at 415-308-0833.

With most technology-based equipment time affords remarkable increases in size and power. This is especially true of computers and other electronic devices. Today smart phones have more computing power than a laptop computer from just a few years ago.  All in much more compact design.

Laser technology has also had similar advancements and improvements. The A.R.C. Laser is one of the newest medical lasers on the market which can be used to remove toenail fungus. The A.R.C. Laser is significantly smaller, lighter and more compact than many of the previously introduced medical lasers. The laser fits in a briefcase and only weighs 4 pounds.

The small size and portability of this laser makes it possible for us to bring the laser to the homes of patients all over the San Francisco Bay area in order to perform laser toenail fungus removal treatments at home.

The Pinpointe laser for example is so much larger and heavier that it would be virtually impossible for our podiatrist to bring the Pinpointe laser into your home or office to perform your laser toenail fungus treatment. 

Toenail fungus can be an embarrassing condition. Although it is extremely common, many people do not feel comfortable exposing their yellow cracking toenails in public. For this reason house calls to treat toenail fungus can help to alleviate this anxiety and discomfort. 

Dr. Christopher Segler is Board Certified, American Board of Podiatric Medicine.  He makes podiatry house calls to perform laser treatment to treat toenail fungus in San Francisco, Mill Valley, San Rafael, Oakland, Berkeley, San Jose and Palo Alto. If you have toenail fungus and wonder if laser treatment at home can help remove the toenail fungus so you can develop clear toenails again, you can call and speak directly to our podiatrist to ask questions. Call 415-308-0833 to reach Dr. Segler directly. 

Yes!  When you have the laser toenail fungus removal procedure the fungus is dead. But the actually appearance of the toenail is no different at the conclusion of the laser treatment. 

You have to wait for the healthy non-deformed toenail to grow out.  This will take several months. 

If you have been using fake nails to cover the ugly, yellow, and white fungal toenail, you can go back to the nail salon to reapply the artificial nails. Eventually you may not need the artificial nails any longer if your toenails clear after the laser treatment. 

Dr. Christopher Segler is a podiatrist Board Certified, American Board of Podiatric Medicine. He performs laser treatments to remove toenail fungus in San Francisco, Oakland and San Jose. He even does House Calls!  That way we bring the toenail laser to you so that you can get rid of your toenail fungus without taking time off work to get laser treatment at a podiatry office. If you have a question about toenail fungus, you can call Dr. Segler directly at 415-308-0833.  You can also click here to get a HUGE DISCOUNT on laser toenail fungus treatment.  

A normal toenail is clear and healthy. It is smooth and uniform in color. But the toenail changes when it gets infected with fungus. All it takes is for your toenail to bump up against the inside of the shoe and get some of the fungal spores up under the toenail where they start to grow.  The growing fungus separates the layers of the keratin within the toenail making the toenail thicker. This causes the ugly discoloration that you see.

During the laser toenail fungus removal treatment, the doctor moves the laser in a grid pattern over the surface of the toenail to make sure that the laser kills ALL of the fungus infecting the toenail. All you will see during the procedure is an aiming light that tells the doctor where the laser is penetrating the toenail. But the laser is actually going all the way through the toenail to destroy the fungus.

In this video you can see the aiming light passing over the surface of the nail while the doctor is treating the toenail to remove the fungus during an actual treatment. The only thing you feel during the procedure is a little bit of heat that is generated by the laser light energy. 

Although the laser completely kills the fungus, the appearance of the toenail does not actually change at all during the laser procedure. Even though the fungus is dead, you have to wait for the toenail to grow out and become clear again. As the toenail grows you will trim off the thick discolored unhealthy toenail that was damaged by the toenail fungus and your nails gradually become clear.

If you have a toenail that you think might be infected with fungus you can call our doctor or even send a picture of the toenail to us so that we can discuss whether or not laser treatment might help you have clear toenails again. 

Dr. Christopher Segler is Board Certified, American Board of Podiatric Medicine. He can actually bring the laser out to your home or office to perform the laser fungus removal treatment in the morning before you leave for  work, during the day, in the evenings or on weekends. Call him directly to schedule your laser treatment at 415-308-0833. We perform podiatry house calls in San Francisco, Berkeley, Oakland, San Mateo and Mill Valley.

This video explains how clear toenails turn into discolored fungal toenails.

A normal toenail is thin, clear and translucent allowing you to actually see right through the toenail to the pink nail bed underneath. However as soon as the fungal spores get in underneath the toenail the toenail fungus starts to grow within the keratin of the toenail itself. The growing fungus actually causes the layers of keratin to separate.

The separation of layers within the toenail causes the toenail to become thicker but it also changes the way that light refracts through the toenail. This causes a cloudy discoloration that is usually white or yellowish. Those thick, crumbling white and yellow areas of the toenail are the classic signs of a toenail fungus infection.

If you think you might have a toenail fungus infection, you can call 415-308-0833 to speak to an expert to find out if you might be able to get rid of the toenail fungus and have clear toenails again. 

Funky ugly toenails seem to plague runners. Toenail fungus is one cause of thick yellow toenails and it is very common. In fact 14% of Americans have toenail fungus. Based on this, if you are out for a run with six other runners, one of you probably has toenail fungus. 

Although running shoes can put you at risk of toenail fungus there are some simple steps you can take to prevent a toenail fungus infection from your running shoes.

Guns Don’t Kill People...

But flying bullets sure do! Spores are the seeds that give rise to a foot fungus infection. The spores are everywhere. And if they get into your shoes they can grow and multiply. The more fungal spores in your shoes, the more risk of toenail fungus infection. 

Active fungus thrives in any environment that is dark, warm and moist...like the inside of your running shoe. Running shoes are the perfect incubators for toenail fungus! If you get spores in there the active fungus starts to grow and sheds even more spores inside your running shoe. 

The Real Problem...

The worst thing you can do is rush into the house after you finish your run, take off your running shoes and throw them into a dark, poorly ventilated closet. Or if you have been running on the treadmill at the gym you take your shoes and stuff them into your gym bag. 

Your damp running shoes will then sit in the dark and any fungus will thrive in that moisture from your sweaty feet. If you run every day, the running shoes never really completely dry out. These are ripe conditions for toenail fungus. 

The next day you put on your running shoes and head out the door. Not only is there active fungus within your running shoes but you have fungal spores which are basically the seeds for toenail fungus all lining the interior of your running shoes.

So as you are running your toes hit the inside of the running shoes the fungal spores get wedged in between the toenail and the skin underneath. If you have any trauma to your toenails such as banging the end of the running shoe when you're running up or down hill (or stopping quickly) the fungal spores can actually get into the nail bed and start to develop a toenail fungal infection.

Once that happens the toenail fungus actually grows within the keratin of the nail plate separating all of the layers of the keratin and making the toenail thicker.

All of that separation of layers in keratin of the toenail plate causes light to refract unevenly through the toenail. This is what causes the discoloration and crumbling of the toenail that creates the ugly appearance.

While it is possible to treat the toenail infection and kill the fungus, it is critical that you reduce your exposure to the fungus spores if you want to keep your toenails clear.  Remember, you have to stay out of the line of fire if you don’t want to get hit by the bullets. 

You must prevent the accumulation of active toenail fungus and fungal spores in your running shoes. If you don't, it will just be a matter of time before you get a fungal foot infection.

The best defense for a runner against toenail fungus is to make sure that you dry your running shoes out completely. Leave them somewhere where they will dry near a heating vent or in the sunlight.

If you are a high mileage runner and run on back-to-back days it might be a good idea to buy 2 pairs of running shoes. Alternate the running shoes so that they have a chance to dry out completely. This won't be any more expensive because the running shoes will last twice as long.

It is also important to make sure that your running shoes fit correctly. If your toes are bumping the end of the shoes (as evidenced by discoloration such as bruising or dark spots under the toenail) you might actually be traumatizing the toenails when you run. This trauma to the toenail puts you at enormous risk of developing toenail fungus.

If you had athlete’s foot or toenail fungus in the past you have to kill of all the fungus in your running shoes. The easiest way to do this is to use an ultraviolet shoes sanitizer. Ultraviolet light will actually kill all of the fungus without any odor or toxic chemicals. The other alternative is to spray the inside issues with chemical disinfectant. If you use a disinfectant spray to kill the fungus in your running shoes make sure that it dries out completely before you wear them again.

As long as you keep the fungus out of your running shoes and allow your shoes running shoes to dry completely after your workouts you should be able to prevent your toenails from turning yellow as the result of a toenail fungus infection.