Nail fungus can be unpleasant, frustrating and unsightly. When nails develop a thick, discolored appearance, turning yellow, green, or white with a chalky buildup, it often resembles a calcium deposit. This condition is typically a form of nail discoloration or fungal infection, leading to a thickened nail texture and an unusual look. The nail can start splitting or separating from the underside. In some instances, it can also fall off causing discomfort and pain.
The medical term for nail fungus is *onychomycosis* (pronounced on-ih-koh-my-KOH-sis). This condition is primarily caused by a fungal infection, not by bacteria or a virus. Did you know that athlete’s foot and nail fungus are often caused by the same agent?
Public spaces such as hotel carpets, gym showers, and pool decks are common hotspots for fungi that can lead to skin infections and other issues. When these fungi come into contact with our feet, they can cause an itchy, callus-like buildup, which is the presentation of athlete’s foot.
This buildup may gradually spread to the nails causing an unwanted infection. The infection can make nails thick and discolored, often turning them a yellowish hue with a powdery buildup underneath. The result can be unsightly and, in some cases, painful.
Fungi thrive in dark, warm, and moist environments, making feet in socks and shoes an ideal habitat. Over time, repeated microtrauma—small, unnoticed injuries—combined with the warm, enclosed environment inside shoes, can allow fungi to penetrate deeper into the nail bed. This process enables the infection to progress, leading to thicker, discolored nails that can be difficult to treat.
Over-the-counter antifungal creams and polishes can offer some relief for athlete’s foot but are generally ineffective for nail fungus. Nail fungus embeds deep in the nail bed, making it hard for creams to reach and treat effectively. Let’s explore the differences between at-home care and treatment with your foot and ankle specialist, your local podiatrist.
At home antifungal soak can help get the process started. Cleaning your socks and shoes and keeping the surface of your feet clean and dry can help. However once the nail starts to change color, or becomes thick, its time to see a professional. Onychomycosis is often resistant to home remedies.
There are countless fungal nail treatments available, but at AFC Tennessee, we follow a simpler, proven approach that has helped many of our patients. We typically start with a topical treatment. If that doesn’t work, we may consider oral medication. For patients who aren’t good candidates for oral options, laser treatment is an excellent alternative. It’s noninvasive, painless, and offers highly effective results.
Topical Treatment:
At AFC Tennessee, our recommended over-the-counter polish for nail fungus is Tolcylen. This product offers the best of both worlds: it’s highly effective at targeting nail fungus and more affordable than prescription options. Tolcylen combines antifungal properties with cosmetic and nail renewal benefits, making it a comprehensive treatment in one bottle. Its formula is designed to penetrate the nail more effectively than other products, with additional ingredients that help restore the nail’s appearance after fungal damage. It is applied once or twice daily, and we’ve received excellent feedback from patients on its effectiveness. This product is conveniently available in our office.
Other topical options for treating nail fungus include Ciclopirox and Jublia. Ciclopirox is cheaper and often covered by insurance but has a very low efficacy for nail fungus, making it suitable for mild cases or as a supplementary treatment. On the other hand, Jublia is highly effective but comes at a higher cost. Overall, we have seen a better and more satisfactory outcome with Tolcylen.
Oral Medication:
When topical treatments don’t provide the desired results, oral antifungal medication is the next option and generally offers the best outcome among all antifungal treatments. Lamisil (Terbinafine) is our preferred oral choice for severe nail fungus cases due to its high effectiveness. However, while oral antifungals are powerful, they can come with potential side effects, including a black box warning for possible liver damage. To mitigate this risk, liver function can be monitored with routine blood tests during treatment, ensuring safe and effective care.
Laser Treatment:
In our office, we also offer laser treatment for nail fungus. This advanced option works by penetrating the nail to target the fungal infection beneath without harming surrounding tissue. The laser effectively destroys the fungus and stimulates improved blood flow to the area, supporting the body’s natural ability to rejuvenate and restore the nail. Patients typically begin to see noticeable results about two months after the initial treatment, as the healthy nail gradually grows out.
Dealing with fungal nails can be frustrating, especially as treatments often take time to show results. However, starting treatment early, before the infection progresses to an advanced stage, can make a big difference in achieving a positive outcome. While we didn’t cover surgical options here, we’ll dive into that in an upcoming article. Taking the first step now can help you get ahead of the infection and set you on the path to healthier nails. Starting treatment early can greatly improve your overall outcome, so call us at Ankle and Foot Centers of Tennessee for a consultation and to start your path to healthy feet today.