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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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How bad does toenail fungus get?

2/8/2015

2 Comments

 
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Question:

Question: How long does it take toenail fungus to damage toenails and make them thicker?

Answer:


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.
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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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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 do running shoes cause toenail fungus?

8/1/2013

2 Comments

 
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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...

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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.

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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.



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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.

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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.

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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.

Dr. Christopher Segler is a San Francisco based podiatrist. He is board certified, American Board of Podiatric Medicine. He is also a runner and 11-time Ironman triathlon finisher.  If you are a runner with a question about toenail fungus you can call him directly at 415–308–0833. He treats runners all over the Bay Area and actually brings the toenail laser to the homes of runners to save them time and embarrassment when they need to have their toenail fungus treated. You can learn more about running injuries at www.DocOnTheRun.com 
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Does Running Barefoot Cause Toenail Fungus Infections?

7/14/2013

0 Comments

 
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Barefoot running has increased in popularity in recent years. In fact, Dr. Segler recently lectured at a medical conference on the topic of barefoot running trends. Part of the appeal in barefoot running technique is to increase your efficiency by using more natural running biomechanics in order to hone your running form.

The American Podiatric Medical Association has a position statement declaring that barefoot running is an unsafe activity and is not recommended by podiatrists. Of course not all podiatrist agree with this position. I happen to be one of those dissenting physicians.

Toenail fungus is common among runners. In fact all fungal infections are common among runners. Particularly athlete's foot. Athlete's foot is nothing more than a fungus infection of the skin on the foot. A toenail fungus infection is actually caused by the same organism that causes athlete’s foot.

When you run your feet sweat, moisture collects in your shoes and the ideal environment for fungal growth is created. If you run on back-to-back days the problem is compounded because your running shoes never completely dry out.

If you happen to develop a case of athlete's foot, the fungus is growing between the layers of the skin. As the skin peels it sheds fungal spores into your shoes. These spores of course are the seeds from which fungus grows.

If you are running, doing hill repeats or some other strenuous workout, and you repeatedly bumped the toes and the end of of the toenail on the inside of the running shoe, the fungal spores can get between the toenail and the underlying nail bed. The fungal spores begin to grow and develop into a fungal toenail infection.

However when you run barefoot, you not have any risk of bumping the toenails repeatedly against an inside of a running shoe that is ripe with fungus. So in that respect, running barefoot is actually much lower risk for developing a toenail fungus infection as compared to running with running shoes.

The risk is mainly related to the potential for fungal spores to collect in your shoes and then have trauma where those spores are actually in contact with the toenail in such a way that they can become embedded in or underneath the toenail and start to grow. If you are wearing minimalist running shoes such as the Vibram Five Fingers without socks the risk of developing one of these toenail infections actually increases significantly. 

If you start to notice discoloration such as white or yellowish spots where the toenail seems to be changing and getting thicker it could be a fungal toenail infection. Treating these infections is not really a big deal. Our podiatrist can actually bring a laser to your home or office in order to directly kill the fungus and help your toenails returned to their normal clear and healthy state.  For more information on discount toenail fungus laser treatment andlas er toenail fungus removal treatment visit http://www.lasertoenailsanfrancisco.com/

Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He is an 11-time Ironman triathlon finisher and is an expert on running injuries.  If you have a question about toenail fungus, you can call 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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