$40-70 ROUTINE NON-COVERED CARE (trimming and debridement of toenails)
DR. JACOBSON DISCUSSES THICK AND FUNGAL TOENAILS (ONYCHOMYCOSIS)
Topical treatment only 10% success, Oral treatment 70% success, Matrixectomy 99% success rate! All options discussed including laser and maintenance. (for more info and picures see link below)
Do you have brittle nails? Did you notice some changes in the color of your nails? Is it yellowish or maybe brownish? Are your nails becoming bent? Are you feeling some pain nails in your toes? Does your toe smell bad? If you have answered yes to at least three of the questions above, then you are most likely suffering from toenail fungus or what is known in the medical world as onychomycosis. It is not wise to self-diagnose however.
If you notice some of the symptoms mentioned above on yourself, then the best thing for you to do is see a podiatrist who is an expert in diseases that afflict the foot. The clinical presentation often is enough for a firm diagnosis. When unresponsive, a sample of an affected tissue through biopsy can be sent to the lab. The test will be definitive to determine if the infection is caused by a fungus or not.
If you have toenail fungus, don’t be afraid. It lives on the dead tissue under the nail and rarely causes systemic infection. Secondary bacterial infection can occur. The disease is not really serious and is not deadly. However, the disease brings embarrassment to those who have it because it is a very unsightly condition. People who have toenail fungus are unwilling to show their feet in public that’s why they cannot wear sandals or other type of open shoes. The disease is also accompanied by a foul odor. In some cases, individuals with toenail fungus are afraid to socialize with other people anymore for fear of embarrassment. They are also afraid that they might spread the infection to other people.
There are many commercially and prescription anti-fungal topical medicines available in drug stores and even supermarkets. The topical medicines fail 90% of the time and must be used for 9 months to a year. Manufacturers blame the patients for not using the medications ling enough. Most people give up when they don't see change. Nothing turns the nail back. What you are hoping to see is that the new nail is growing out clearer. It takes 9-12 months to replace the entire nail plate. Even when "cured", it often returns over time due to the same factors that caused it in the first place.
Laser may help clear the nails but may be needed to be repeated periodically to keep up the appearance. It is not covered by insurance as it is a cosmetic
procedure. Recurrence is very common as your foot is near the ground in a warm moist environment, which germinates the fungal spores. Circulation wise it is farthest from your heart. There are hereditary factors as well.
Debridement, thinning the thick toenails is something we do every day to reduce the pain from the pressure. It is may be covered by insurance if it is painful, making it difficult walk due to pain, difficult to wear closed shoes. Debridement is very effective in reducing pain and is repeated when painful. This maintenance is the mainstay of treatment if you are going to live with thick painful nails. Debridement (thinning nails)every two months is important treatment to prevent wounds in patients with diabetes, poor circulation (PVD, PAD, vascular disease), loss or altered feeling/sensation (neuropathy).
Total permanent removal, matrixectomy is the only assurance that it won't recur. If you don't have nail you can't have nail fungus!
(for more information and photos use link)