The most common nail disorder is a fungal infection of the nail called Onychomycosis. Fungus is everywhere including your shoes and socks. Some people get fungal infections and others don't. This is predetermined by genetics as some people can walk through a puddle of fungus and not get the infection and others can walk around the puddle and become infected.
A fungus is a common mold that thrives in dark, warm, moist areas so inside shoes one would expect to find fungus. On the feet, it can grow on the toenails. Fungal problems can be result of environment
(socks, shoes, heat and humidity) or weakened immunity (diseases such as diabetes). Chronic fungal infections are most common in adults, while acute fungal infections are seen more often in children.
As a fungal infection progresses, it may infect one or more nails, turning them yellow, green, black or other colors. Fungal nail infections can cause nail thickening, inflammation, or sensitivity. The fungus lives under the nail at the root and on the surface in some instances.
The diagnosis of Onychonycosis can be made clinically however a culture may be taken to confirm the presence of fungus.
Treatment consists of doing nothing which will allow the fungus to spread and the nails to thicken and spread to all toenails possibly. Allowing the fungus to persist can cause spreading which can cause complications like ulceration (if the nail gets very thick) and athlete's foot.
The toenail can be removed permanently with a small short in-office procedure. The nail will never come back after this and people do well without the toenail.
There's a pill that you can take but it has the potential to affect your liver. The medication is a safe medication for the most part and monitoring your liver function while taking the pill is mandatory. Blood tests will be done 2 times, at the beginning and in the middle of oral therapy. The therapy requires a pill a day for 3 months, can be expensive and maybe completely or partially covered by insurance companies.
Finally, the most effective topical medication we have found is the Formula 3, which is a anti-fungal oil based solution that is applied to the toenails that are infected. The Formula 3 is applied to each infected toenail 2 times a day. There is no liver toxicity with the Formula 3 therefore, no liver testing is needed. You won't have to have blood drawn to use the Formula 3 and there are no adverse side effects. Most people start off using this medication. The Formula 3 usually takes 2-4 weeks to 2-4 months to work. You can start using the Formula 3 right away and it is affordable, available in our office store and effective.
It makes sense to kill the fungus in your shoes as they can serve as a reservoir for infecting your toenails. This can be achieved by using Lysol disinfectant spray in the shoes every other day or by placing shoes in a large zip lock bag and freezing them for 48 hours.