Does a Fungal Infection Require Toenail Removal?

Dr. Corey Fox
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Director of Massapequa Podiatry Associates

If you want to get rid of fungal toenails, you might think that the only option you may really have is to remove the toenails entirely.

And it’s not difficult to see why some people may think that, especially if the fungus has been around for a long time and has an appearance that is thick, discolored, and crumbling. It may be hard to imagine anything remedying the situation.

Outright removing your toenails, however, is the absolute last resort option for treating toenail fungus, and only performed in very rare cases. We would much rather use non-surgical forms of treatment that clear out the fungus and allow fresh, clear nail tissue to naturally grow in and take the place of old, damaged nails.

Mushrooms growing in-between toenails

Treating Toenail Fungus Without Surgical Removal

There are a few primary ways to eradicate toenail fungus. Each has its pros and cons, and we may recommend more than one treatment simultaneously for best results.

Laser Therapy

Laser therapy is one of the newest methods for treating toenail fungus, and we are proud to offer this advaced treatment in our office.

Laser treatment uses light energy at specific wavelengths to pass through nail tissue and attack the fungus underneath the nail. In other words, it hits the fungus directly where it is, but without causing any pain or any damage to the nails or skin. This is not the kind of laser that burns your skin.

Laser therapy has a high rate of success compared to other traditional treatments. It is also completely safe and FDA approved. A typical course of laser treatment requires 10-12 sessions, each of which lasts about 20 minutes. The overall length of treatment might be longer or shorter depending your condition.

Topical Medications

Anti-fungal gels are also designed to attack toenail fungus under your toenail plate. The success rate varies depending the severity of your condition. However, topical medication increases the overall success rate when included with other anti-fungal protocols.

If topical medications are indicated as part of your treatment plan, we will typically file the nails down to provide the medication a better chance to reach deeper into the nails.

Oral Antifungal Medications

Yes, you can swallow a pill that attacks toenail fungus too! This delivers the medication through your bloodstream, essentially attacking it from the inside out. 

Oral medications can be effective, but we must always consider the potential of negative side effects. Prior to prescribing, we will thoroughly obtain a medical history, and also give you a script for a liver enzyme blood panel, in order to determine the safety profile of using this drug.

Of the three above options, laser therapy tends to be the most effective. It has most of the benefits with much fewer hassles or potential downsides. The other options might be recommended in conjunction with laser, but also sometimes on their own, depending on the case.

What if Nail Removal IS Considered?

With laser therapy, topical medications, and oral antifungals in our arsenal, we almost never have to actually remove toenails to treat a fungal infection. It does still remain a rare possibility, however, if the case is extreme or continues to come back.

Why not consider nail removal earlier? Because when nails are fully removed, it doesn’t necessarily guarantee that the new nail will grow in properly. The nail can grow back misshapened, thickened, or even with fungus re-infecting the toenail - leading you back to square one.

If the new nail comes back in an unpleasant manner or the fungus just continues coming back no matter what, we can treat the underlying nail matrix to prevent new nail from ever growing again (similar to what may sometimes be recommended for a recurring ingrown toenail). This does not place your nails at any real disadvantage, but it’s still nice to be able to keep your toenails if you can!

What Should You Do for the Best Outcome?

Regardless of the recommended course of treatment for fungal nails, one thing always tends to ring true:

The sooner you come for help with fungal toenails, the better your chances of treatment success—and the faster you can see results!

Letting the fungus continue to grow and thrive within your toenails will only increase the challenge of fighting it. 

You don’t even have to wait until your nails are looking that bad to come to see us. In the earliest stages of a fungal infection, you may only see some white streaks or dark discoloration under your nail. It can be easy to pass these off as simple nicks and bumps on the nail, but keep track of them. If they change shape or grow over time, it’s worth having us take a look. Catching a fungal infection this early can save you plenty of time.

Get the Fungal Nail Treatment You Need

If you are tired of looking down and seeing embarrassing, discolored, and unsightly nails, contact the team here at Massapequa Podiatry Associates. We have many years of experience helping patients restore their nails to healthy clarity, and we’ll be more than happy to help you as well.

Call our office at (516) 541-9000 to schedule an appointment, or fill out the contact form below if you prefer to reach out to us electronically instead.

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