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.

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.

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. 

Hi My Running Doc,


A couple of days ago I accidentally kicked the wall with my right foot. My foot still hurts and it is bruised.  I read on your website that bruising can be a sign of a metatarsal fracture. How can I tell if it is just bruised or if my foot is actually broken? I would love to have your expert opinion!


Thanks!
David, Houston, Texas.



Hi David, 

Bruising is a Bad Sign

It is true that bruising is a bad sign when it comes to foot and ankle injury. When you actually fracture a bone, the bone cracks and bleeds quite a lot. That blood diffuses throughout the soft tissue under the skin. What you see is a bruise. That is part of the reason that a bruise can be so concerning for a fracture in the foot. 

In fact the sort of bruising pattern that the picture of your foot shows is often indicative of a fracture or broken bone in the foot. Given your pattern of bruising it is more likely that you have a metatarsal fracture or a fracture in one of the bones in the little toe such as the proximal phalanx phone.


Myths about Foot Fractures

1.  If you can walk on the foot, it can’t be broken.  FALSE!

This may be one of the most widely perpetuated myths about foot injury on the Internet. I have seen many patients with serious fractures that are walking on the foot. Some patients are limping and obviously in a tremendous amount of pain while other patients with fractures or broken bones barely feel any discomfort at all. This is not a reliable indicator of whether or not you have a broken bone in your foot.

2.  There is nothing you can do for a broken toe.  FALSE!

This is also absolutely not true. While it is true that most fractures in the toe will heal uneventfully, there are things you can do to speed healing and decrease your risk of complications. Fractures of the bones in the toe can move if not properly stabilized. Certain shoes will speed healing. Taping the toes to provide stability and immobilize the fracture will also help. But some toes should never be taped together. 

Without the proper treatment of a broken toe, the fracture can fail to heal leading to what physicians refer to as a nonunion. A fracture that never heals correctly can lead to pain, disability and interfere with your ability to run or even walk without pain.  Occasionally patients that take the approach that “nothing can be done for fractured toe” just end up in surgery later.  For the most part this is avoidable if the toe treated correctly.

Diagnosis and Treatment Options

If you are suspicious that there might be a broken bone in your foot (or in one of your toes) it is best to figure out whether or not it is actually broken.  The best option is to have an in-person evaluation by a sports medicine specialist such as a sports podiatrist.  The second option is to have a remote consultation with a sports podiatrist via webcam. A third option is an attempt at self-diagnosis. This video on YouTube can show you how to perform self-diagnosis of metatarsal stress fractures. This same video would apply in your case if the pain is located where you’re bruising is in the foot.

If you see a physician in person or via webcam or you perform your own self-diagnosis and think that you probably have a fracture then you should get x-rays. X-rays will not only confirm (or rule out) a broken bone in the foot but it will also give you an idea of the severity of the problem. There are some fractures that absolutely must be treated surgically. Others simply need a fracture walking boot in order to stabilize the fracture and allow it to heal. And occasionally it is necessary to use crutches. 

But not all fractures are the same. So if you have pain and bruising after this sort of injury and suspect that you have a fracture in your foot it is important to determine whether or not there actually is a broken bone, and treat it appropriately. As long as you treat the fracture correctly you should be able to heal and then get back to running.

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. 

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.