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.

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.

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.

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.

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. 

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.