Help...my toenails are getting worse again!

This question came from a patient who had laser treatment and improved, but then started to notice the toenails were getting worse again... 

Question:
Hey doc, 
So my to nails appeared to get better but now my nails are getting worse again. :(
Any recommendations on what we should do?

Answer:
I am sorry to hear that your nails may be back-tracking. If you feel they are getting worse, we could re-treat them with the laser. In that case we would really crank up the heat so to speak and make sure we wipe the fungus out and kill the fungus infection in the toenails. 

One thing to be sure of is that you don't have any athletes foot AT ALL. Athlete's foot is the same fungus infecting the skin. If you athlete's foot, it can easily re-infect the toenails that have been damages by the fungus infection. So, if you currently have (or recently had) any athlete's foot, you MUST get rid of it. You have to kill the athlete's foot fungus in the skin no the feet, and the toenail fungus spores in your shoes. Otherwise your toenails can easily get re-infected and the toenails may get worse again.  

If you would like you could take a picture of your feet (top and bottom) then send it to me so I can have a look to see if you have any athletes foot. If you do have any athletes foot, you could simply take a 2 week course of prescription Lamisil pills to wipe out the fungus infection in the skin, before re-treating with the laser. 

Thanks!
Dr. Christopher Segler