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Does Laser Toenail Fungus treatment cure brown toenails?

2/26/2015

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Question:

I have had athlete's foot and toenails are infested with fungus under the toenail which creates a darkish brown color.  Can the brown discoloration improve and look more like a normal toenail with laser treatment?

Answer:

Toenail fungus can cause an embarrassing discoloration of the toenails. Toenail fungus infections can make toenails change in color becoming whitish, yellow, or even brown. So, it is possible that the brown discoloration is caused by toenail fungus. 

If the brown discoloration is in fact caused by toenail fungus, then yes, the laser treatment may help. But if the discoloration is caused by bruising under the toenail or is the result of surface staining of the nail plate, then no, laser treatment would not help.  

A couple of questions may help determine how likely it is that the discoloration is caused by a fungal infection. 

1. How long ago did the discoloration begin.
2. Have you ever had athlete's foot?
3. Have ever had any trauma to the toenails where they became bruised under the toenail?
 
How Long Have You Had The Discoloration
Generally speaking, the longer the toenails have been infected, the more difficult it is to get rid of the fungus and return the toenails to a normal appearance. Some of this has to do with how much the matrix or root of the toenail has been stretched and or damaged by the thickening of the toenail. In some cases the thickening can become permanent. However the color will typically change significantly and improve after being successfully treated to remove the toenail fungus that is infecting the toenails. But, the toenail may remain thicker, if there has been damage to the matrix or root of the toenail. 

Athletes Foot
Athlete's foot is sometimes caused by the exact same fungus that infects the toenails. Toenail fungus is an infection of fungus in then toenails. Athletes foot is just a toenail fungus infection in the skin on the feet. If you have had athletes foot it s possible that you could have the fungus in your shoes that could lead to a toenail fungus infection.

Toenail Trauma
If you have repeatedly traumatized the nails by stubbing your type, or beating them up in running shoes, you may have bruising under the toenail. If there is bruising under the toenails, it may change the treatment options available to you. For example, if there is a large amount of dried blood underneath the toenail, the dried blood is dark in color and may absorb heat and burn the nail bed underneath the toenail if you were to have the laser toenail fungus removal procedure. In addition, a bruised toenail may look like a fungal toenail, but not actually be infected with toenail fungus. 

If you aren't sure whether or not the brown discoloration in the toenail is caused by a toenail fungus infection you can visit a podiatrist specializing in the treatment of toenail fungus. Another quicker option is to take a picture of the toenails and arrange a free remote email or phone consultation so you can get a better idea of the extent of the problem.

Dr. Christopher Segler is a podiatrist who specializes in the treatment of toenail fungus infections in San Francisco, Oakland, San Rafael and San Jose. He is board certified, American Board of Podiatric Medicine.  If you have a question about discoloration of the toenails that may be caused by toenail fungus you can call him directly at 415-308-0833.



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Is it a Doctor who does the Laser Toenail Procedure?

12/21/2013

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Yes!  We firmly believe that if you pay for a doctor’s visit, you ought to see a doctor.  And the doctor ought to be the one delivering the care. 

We never, ever allow non-doctors to perform the laser toenail treatments. 

We have had patients tell us that some medical offices offer laser toenail fungus removal treatment, but that a nurse or “medical assistant” of some type is the person actually performing the laser toenail fungus removal treatment. Granted, there may be a doctor in the office, but the doctor isn’t the one doing the laser procedure.

All of our laser procedures are performed by Dr. Christopher Segler, a podiatrist who is Board Certified, American Board of Podiatric Medicine. 

When you call our office, you will speak directly to Dr. Segler.  He will explain the options for toenail fungus treatment. If you are a candidate for laser toenail fungus treatment, he will bring the toenail laser to your home or office. You will not speak to a nurse or an assistant, but you will speak to a real doctor. A real doctor will perform your laser toenail treatment. 

If you think you have ugly, thick, white and yellow toenails you might have a toenail fungus infection. If so, you can call Dr. Segler directly at 415-308-0833. And yes, you will actually get to speak with a real doctor. We bring the toenail laser to you. Laser toenail fungus removal treatment is available in San Francisco, Oakland, Berkeley, Mill Valley, Tiburon, San Rafael and Palo Alto.

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Why the Arc Laser for Toenail Fungus Removal Treatment

10/30/2013

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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. 


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Can I apply fake toenails after laser fungus removal?

10/20/2013

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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.  
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How Does Laser Toenail Fungus Removal Work?

8/22/2013

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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.

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How do I ensure that the Laser Toenail Treatment will work?

7/13/2013

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The laser treatment will kill the fungus in your toenails. But to keep your toenail clear after the laser toenail fungus treatment you have to make sure you don’t get re-infected with toenail fungus. Up to 50% of patients who effectively treat the toenail fungus infection will get the nasty infection again within a few years. 

The key is to keep the fungal spores under control.

Spores are basically the seeds from which toenail fungus grows. They are very durable. In fact, fungal spores can lay dormant for many years and still remain viable. Just place the spores in a warm, moist, dark environment and they will start to grow sprouting a new toe fungus infection. 

The laser will effectively remove the fungus from your toenails, but that is only the first step.

The whole time you have had a fungal infection, you have been shedding fungal spores into your shoes and socks. Getting free of the spores is the best way to prevent the fungus from infecting your toenails again. 

1. Wash all of your socks in hot water. This will get rid of the fungus and spores in your socks. Some people throw out all of their socks and replace them. But this isn’t really necessary. 

2. Kill the fungus in your shoes. Use an antiseptic spray or an ultraviolet sanitizer to kill the spores and live fungus in your shoes. Bowling alleys have been doing this forever. They simply spray some toxic chemicals in the bowling shoes to kill all of the germs between rentals. Sprays like Lysol will work, but frankly they make your shoes smell like Lysol. So if you are going to try this, make sure you test it out on a pair of shoes you aren’t crazy about before you spray all of your shoes. The Steri-Shoe is a much nicer alternative. It uses ultraviolet light to destroy the live fungus and spores in your shoes. No smell, no toxic chemicals and no waiting to dry the shoes out. You can order one online at a discount here.

3. Watch out for and aggressively treat any athlete’s foot. The fungus that causes athlete’s foot is the same one that causes toenail fungus infections. Those little spots of peeling skin are the classic sign of athlete’s foot. Many people think that if the skin doesn’t itch, it isn’t athlete’s foot. This is false. 

Every time I see a patient who wants the toenail fungus laser removal treatment I ask them if they ever get athlete’s foot. Less than 10% say yes. But about half of all the laser toenail patients actually have signs of an active case of athlete’s foot that they haven’t even noticed. 

So it is possible that you could pick up a case of athlete’s foot and not realize it. You should check your feet every day. Look for peeling skin around the edge of the sole and between the toes. 

If you get athletes foot, you are actually growing fungus between the layers of skin. As the skin peels, fungal spores are shed into your socks and shoes. Then all it takes is to bump your toenails on the inside of the shoe and those spores can get in again start another toenail fungus infection.

If you notice some athlete’s foot don’t panic. You can simply apply an over-the-counter cream for a couple of weeks to cure the skin infection. Of course you will want to use the Steri-shoe ultraviolet sanitizer in your shoes again and wash your socks in hot water, just like you did after the laser procedure.

Taking these simple precautions you will help ensure that your toes stay clear, healthy and fungus free!  If you have a question about a toenail fungus infection, call the toenail fungus expert directly at 415-308-0833.

Dr. Christopher Segler is a San Francisco based podiatrist and is board certified, American Board of Podiatric Medicine.  His practice provides house calls to people who are just too busy to sit in traffic or a doctor's office. He sees patients in their own homes to treat their toenail fungal infections with one of the newest lasers available. We do house calls in San Francisco, Oakland, Berkeley, San Rafael, Mill Valley, San Mateo and San Jose. If you have a question about toenail fungus and wonder whether or not the laser fungus removal treatment will help you have clear toenails again, you can call and ask a toenail expert by calling 415-308-0833.  And yes, you will actually get to speak with the doctor. 
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Can I use a laser pointer to treat my toenail fungus?

4/25/2013

2 Comments

 
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I recently had a doctor as a fungal toenail patient who asked me this question. He wasn’t a podiatrist, so infected toenails are not his specialty. 

The question is an interesting one and speaks to the conception that many people have about lasers. Many think that a laser is a laser.

All lasers are not the same. 

Some lasers cut steel, others kill toenail fungus and some only highlight presentations. 

Laser pointers are not medical lasers and cannot treat toenail fungus. 

Here is why:

The medical laser we use to treat kill toenail fungus is 1064nm wavelength YAG laser. This is the wavelength that has been shown in clinical trials to remove the toenail fungus that infects the toenail plate causing a toenail infection (known as onychomycosis). 

Laser pointers are all a much shorter wavelength than the toenail laser:
       Red laser pointers are 635nm wavelength
       Green laser pointers are 532nm wavelength
       Blue laser pointers are 445nm wavelength 

All three varieties of laser pointers are within the visible light spectrum  (380 nm – 700 nm).  A medical laser used to remove toenail fungus and treat a fungal toenail infection is an infrared laser (1064nm) and the light energy from it behaves much differently. 

The nail fungus treatment laser beam has the ability to directly damage components of the toenail fungus cell membranes and kill the fungus. Laser pointers that are used to highlight a powerpoint presentation simply can’t remove the toenail fungus from the infected toenail. 

Dr. Christopher Segler is a San Francisco based podiatrist and is board certified, American Board of Podiatric Medicine.  He sees patients all over the Bay Area in order to help them treat their toenail fungal infections with one of the newest lasers available. We offer house calls all to treat toenail fungus in San Francisco, Oakland, Berkeley, Corte Madera, Mill Valley, Palo Alto, and San Jose. If you have a question about toenail fungus and wonder whether or not the laser fungus removal treatment will cure your thick, yellow, toenail that has a fungus infection, you can call and speak directly with a toenail expert by calling 415-308-0833.  And yes, you will actually get to speak with the doctor.





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Is the toenail fungus removal laser an "Infrared Laser?"

4/22/2013

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Question: Is the the laser your doctor uses to remove toenail fungus an infrared laser?
 
The laser used by San Francisco laser toenail housecalls is one of the newest medical lasers on the market.  In fact it has is only been on the market for less than a year, at the time of this writing.  Like most technologies, there are continual improvements with equipment and techniques. This newer laser is much more compact than older models allowing us to bring it on house calls.

The laser that we bring to your home or office in order to remove the toenail fungus and treat your toenail fungal infection is a  multifunctional medical diode laser system.  The laser is capable of  radiating light in a number of wavelengths including 810 nm, 980 nm, and 1064 nm.

The 1064 nm wavelength is the wavelength that is currently considered to be the most effective at treating onychomcosis (fungal toenail infection)1,2.  We use the new German-made A.R.C. Laser Medical Diode Laser System. 

When we bring the A.R.C. Laser to your home or office the podiatrist will program the laser system to produce a laser beam in the 1064 nm wavelength.

The light spectrum can be divided by wavelength as follows:
Gamma ray: less than 0.01 nm
X-ray: 0.01 nm to 10 nm
Ultraviolet: 10 nm – 380 nm
Visible light: 380 nm – 700 nm
Infrared: 700 nm – 1 mm
Microwave: 1 mm – 1 meter
Radio: 1 mm – 100,000 km

The medical laser system we use to treat toenail fungus is 1064nm. Since 1064nm is greater than 700 nm and less than 1 mm, this means that the laser beam is categorized as an “infrared” beam of light energy.

The laser beam itself is invisible. When the treatment is being performed, you will see a small spot of light moving back and forth across the toenail. The light you see is not actually the laser. The light you see is simply an aiming light.  Because the laser beam itself is invisible it’s necessary to have an aiming light that allows the doctor properly direct the laser beam in order to kill the fungus that’s within the toenail.

The laser can kill the fungus. But the laser can also damage your eyes.  looking directly into the laser beam or from light reflected by the medical laser beam system could cause serious eye injury. 

Even though the laser is invisible (unlike a laser pointer)  you have to protect your eyes from damage. Both you (the toenail fungus patient) and the doctor performing the laser toenail fungus removal procedure will wear protective eyewear that will shield you from any possible harm. The doctor will bring and supply a pair of specially constructed glasses that protect your eyes during the laser toenail fungus treatment. 

The protective glasses simply look much like green tinted sunglasses.  You can still see just fine with the glasses on. Because the procedure takes about 20 minutes or so, most patients will work on a laptop computer or an iPad while they are having the laser toenail fungus removal procedure. The laser protection eyeglasses not interfere with these activities at all.

Dr. Christopher Segler is board certified, American Board of Podiatric Medicine.  He believes that the best medicine is fast, convenient and low-cost.  He sees patients all over the Bay Area in order to help them treat their toenail fungal infections with one of the newest lasers available. 

We offer house calls all over the San Francisco area, including the Marina, Castro, Sunset, Richmond district, Cow Hollow, Presidio, Seacliff, Downtown, Nob Hill, Russian, and the Financial district. We will even see you at home in Mill Valley, San Rafael, San Bruno, Oakland or Berkeley.

If you have a question about toenail fungus and wonder whether or not the laser fungus removal treatment might be right for you, you can call and speak directly with a toenail expert by calling 
415-308-0833.  And yes, you will actually get to speak with the doctor.


References:
1. Mozena, John; Haverstock, Brent (May 2010). "Laser care for onychomycosis: can it be effective?". Podiatry Today 23 (5): 54–59.
2. Mozena, John D.; Mitnick, Joshua P. (October 2009). "Emerging concepts in treating onychomycosis". Podiatry Today 22 (10): 46–51.


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What is "white superficial onychomycosis"?

4/10/2013

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Many medical terms seem unnecessarily long and complicated.  him and toenail fungus is no different. “White superficial onychomycosis”  is a purely descriptive term.  “White” of course refers to the color. “Superficial” implies that the fungal infection is only really affecting the surface of the toenail. “Onychomycosis” means fungal infection of the nail. 

When you put all of this together of course what it tells you or the doctor is that there is a fungal infection involving the toenail that is causing the toenail to become white and discolored and is only on the surface of the nail plate.

In general these superficial toenail infections do not penetrate the toenail itself.  The toenail will look like it has some white spots or speckled appearance. It sort of looks like there are powder sugar in splotches on the toenail. This particular form of a toenail infection can be related to applications of nail varnish or toenail polish base coats. 

Although this is not the most common form of toenail fungal infections, it can be easier to treat. The reason that it might be easier to cure is that the infective organisms are closer to the surface and not underneath the nail plate where they can be harder to reach.

Because the fungus is actually growing on the surface of the nail plate it is also easier for your podiatrist to take a sample of the fungus and evaluate it.  It may also respond to topical treatment more readily than a fungus that bores all the way through the nail plate down to the nail bed. The laser treatment is also effective for this type of toenail fungus infection.

Dr. Christopher Segler, DPM is board certified, American Board of Podiatric Medicine.  He believes that the best medicine can be fast, convenient and low-cost treatment. His innovative housecall podiatry practice model helps to keep costs down for patient with making expert care more convenient than ever.  

If you have a tight work schedule we can even see you in your own office.  We often do house calls for executives so that they can be seen between meetings.  When there is no time to waste, a house call is definitely the best treatment and just what the doctor ordered!  

We offer house calls all over the San Francisco area, including the Marina, Castro, the Sunset, Richmond district, North Beach, Presidio, Seacliff, Downtown, Nob Hill, Russian, and the Financial district. We will even see you at home in Mill Valley, San Rafael, San Bruno, Oakland or Berkeley.

If you have a question about toenail fungus and wonder whether or not the laser fungus removal treatment might be right for you, you can call and speak directly with a toenail expert by calling  415-308-0833.  And yes, you will actually get to speak with the doctor.


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Does the appearance of my fungal toenail change during the laser procedure?

4/3/2013

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The laser toenail fungus removal procedure kills the fungus on contact by directly damaging components of the fungal cell membranes. But the appearance of the toenail is not related to whether the fungus is living or dead. The funky appearance of a fungal toenail is more related to the damage the toenail fungus causes to the keratin in the toenail.  

The ugly thick, yellow appearance of fungal toenails is actually related to the separation of the keratin into distinct layers. The toe fungus grows within the toenail and separates the toenail plate, causing the toenail to become friable and crumble. 
When the toenail keratin separates, light refracts unevenly through the toenail. The result is that the toenail appears yellow, white of otherwise discolored.  

The actual appearance of the fungal toenail will not change during the laser procedure. The laser will kill toenail fungus on contact during the laser treatment. But you will have to wait for the dead fungus and newly treated toenail to grow out.  

This is when the clear, healthy-appearing toenail will start to change. It takes about 8 months to one year for a new toenail to grow all the way out. So if your toenail is 50% yellow, it will likely take about 4-6months for you to regrow the toenail.  

As the the toenail grows out, you of course will be trimming the funky, crusty, discolored toenail. As you trim the toenail, you will slowly see the clear healthy nail returning.  

If you have ugly fungal toenails and would like to have clear healthy toenails again, you can arrange to have the laser toenail procedure in the privacy of your own home or office. That's right...we do podiatry house calls in San Francisco, Oakland, Berkeley and Houston. Dr. Christopher Segler, D.P.M. is Board Certified, American Board of Podiatric Medicine. If you would like to ask a question about laser toenail fungus removal, or schedule your laser toenail house call, you can reach him directly at 415-308-0833. 
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    Dr. Chris Segler

    Podiatrist, author, inventor, nationally recognized expert, lecturer and teacher,         award-winning researcher specializing in combining the latest technologies and advanced treatments with the old-fashioned convenience of house calls.

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Laser Toenail House Calls 
San Francisco, Marin and East Bay
236 W Portal Ave #332
San Francisco, CA 94127

415-308-0833

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