Onychomycosis is a fungal infection of the nail. It is the most common disease of the nails and accounts for about half of all nail abnormalities. This condition may affect toenails or fingernails, but toenail infections are particularly common. It occurs in about 10% of the adult population. The risk of infection increases with age with about 48% of those older than 70 suffering from it.

The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured: white, black, yellow or green. As the infection progresses the nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. If left untreated, the skin can become inflamed and painful underneath and around the nail. Fungi from the nails may precipitate secondary bacterial infections, cellulitis and chronic urticaria. Infected toenails can also act as a reservoir for fungi, allowing the transmission to other areas of the body or even other people.

There is usually no pain or other physical symptoms, unless the disease is severe. People with onychomycosis may experience significant psychosocial problems due to the appearance of the nail, particularly when fingers – which are always visible – rather than toenails are affected.
Certain conditions make it more likely to suffer from nail fungi. These include diabetes, poor peripheral circulation, a predisposition towards sweating and generally old age.

Treatment options include:

  • mechanical or chemical debridement
  • topical agents
  • systemic antimycotics
  • laser treatment

The choice of therapy is influenced by the severity of the disease, the previous therapy which already has been attempted and a consideration of which other medication the patient is already taking. Laser treatment has been shown to be highly efficient with a near to 100% success rate after 6 months of treatment and does not have any noticeable side effects. It is particularly beneficial with the elderly, compromised patient for which other alternative treatments could present some risks.

Clinical diagnosis of onychomycosis is based on the patient’s history and a physical examination. In difficult or persistent cases the diagnosis might need to be confirmed with a culture of nail specimens. There are no contra indications present. The laser penetrates through the nail plate and produces heat deep within the tissue forming the nail bed. This deactivates the fungi and results in a continuous diminishing of the fungal colony until it is totally eradicated.

For an optimal effect it can be advisable to reduce the thickness of the nail plate prior to the treatment by an experienced podologist.

The treatment is administered as a course of four sessions a week apart. During a session the infected nail is irradiated three times with the laser for a couple of minutes to ensure the tissue heats up adequately. The treatment can be uncomfortable but is usually tolerated.
You can return to your normal activities straight after the treatment. We will carry out a 3 months follow up. 95% of all patients are clear of fungal infections after this period of time. Should you still show some symptoms the procedure should be repeated to eradicate all remaining fungi.


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