​Fungal Nail Infection 
​(Onychomycosis)

Fungal toenail infections are a very common condition seen in older population and in immune compromised individuals.  It can also be seeing in patient who are physically active and there has been trauma to the nail.  In the most common cases, the nails become yellow, crumbly and thickened and may be painful when wearing shoes that press against the nail. The fungus residing in the affected nail can easily spread to neighbouring toenails and skin, creating an infecting cycle from nail to skin and vice versa. There are different types of fungal nail infections, and stages, and the sooner a fungal nail is treated the greater the success rate. 

If you see a change in your nail texture, colour and/or thickness, make an appointment to see the Chiropodist/Foot specialist at (613) 440-3839 to get treatment.

Fungal nails are usually more resistant to treatment and more difficult to treat than Athlete’s foot.  There are several treatments available for fungal nails.
1. Topical or oral fungal medications can be used. The topicals have a low rate of success and the oral medications can have serious side effects. 
2. A more drastic treatment is permanent removal of the affected toenail(s).  This is not a common treatment option.
3. Laser Nail Treatments are now available and a very common treatment.  It requires 4 treatments  (depending on severity of the fungus) and has a high success rate. Results are noticed as the nail grows out with a healthy-looking nail taking as long as it takes for the nail to completely grow out. The treatment is virtually pain-free and patients can resume their normal activity right away.
After a fungal nail infection has cleared up, you can take steps to prevent the infection from coming back.

Fungal Nail Laser Treatment

How does this work?
The latest advance in Laser Nail Treatment is the use of cold lasers or the Lunula Laser. This uses two diodes (lights) at 635nm and 405nm which are both passed over the foot and nail to stimulate nail blood supply and immune response and also react with fungal cells interfering with the oxygen in the cell wall. This treatment has been in Chiropody and Podiatry clinics since 2011 and has shows the best long-term results.  
4 treatments for mild infections, and ~6 treatments for severe infections.
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How long is the treatment?
Each treatment takes 24 minutes. Protocol requires 4 treatments with a week between visits. 
 
Does the treatment hurt?
The treatment does not hurt and only takes a short period of time.
 
What to expect after the treatment?
The ultimate goal is to have a decrease of pain and  fungal presence in the treatment area.

When will I see results?
Since most nails grow 1 mm a month, it is common to see visible results 3 months after the last treatment. 

Fungal Nail Treatment Options
1. Do Nothing/Clinical Reduction in Size
Fungal nail infection if left untreated can be managed by Chiropodists who can professionally cut and file the nails using specialist equipment – for example, electric nail files to reduce any thickness. Extra care must be taken to avoid spreading the infection to any healthy nails. Any secondary athlete’s foot needs to be managed, too.

2. Topical Treatments
A variety of topical medicines are available on prescription or from either over the counter at the pharmacist. If you would like further advice please of course contact us. Generally these are indicated for mild infections affecting the tips of the nail and ideally limited to one or two nails. Common examples are Formula 3, Penlac, and Jublia.

3. Oral Medication
Terbinafine (Lamasil) and Itraconazole (Sporanox) are the two common tablets used in treating fungal nail infection. They are taken for three to four months. Average effectiveness is in the region of 60 percent. There are reported side effects from taste disturbance, rash, migraine and liver damage. This medication must be prescribed by a doctor and some will check liver function via a blood test prior to commencing.

4. Surgical Removal
The nails can be removed surgically. This is a minor procedure which can be performed by Chiropodists and is useful if, for example, a large nail is traumatically damaged and grows upwards. Fungal infection would normally remain in the nail bed, so the fungus would usually return unless the entire nail was killed permanently. The nail should not grow back and the nail bed will heal and turn into normal skin.

5. Thermal Laser Treatment
As technology has advanced Chiropodists are moving away from thermal lasers to the Cold Laser which is more effective and far more comfortable. An additional advantage is that Cold Lasers regenerate tissue which thermal lasers do not.  Thermal Lasers can burn toes and be very uncomfortable during and after treatments.

6. Cold Laser Treatment (Recommended)
The latest advance in Laser Nail Treatment is the use of cold lasers or the Lunula Laser. This uses two diodes (lights) at 635nm and 405nm which are both passed over the foot and nail to stimulate nail blood supply and immune response and also react with fungal cells interfering with the oxygen in the cell wall. This treatment has been in Chiropody and Podiatry clinics since 2011 and has shows the best long-term results.  
4 treatments for mild infections, and ~6-8 treatments for severe infections.

Make an appointment to see the Chiropodist/Foot specialist Call:
​(613) 440-3839
Chiropody services/ treatments are covered by most health benefits under Chiropodist/ Podiatrist.