Fungal Toenails (Onychomycosis)

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Thick, discolored, or brittle toenails? We diagnose and treat fungal toenails with debridement, topical or oral medications, laser options, and prevention plans—so nails grow healthier over time.

Fungal toenails (onychomycosis) occur when fungus invades the nail and nail bed, leading to thickening, discoloration, and brittleness. It often starts at the tip or sides of the nail and can spread to other nails or skin (athlete’s foot).

Common symptoms

• Yellow, brown, or white discoloration
• Thick, brittle, or crumbly nails that are hard to trim
• Changes to nail shape or separation from the nail bed
• Mild odor; tender nail edges in shoes

Why it happens (risk factors)

• Warm, moist environments (sweaty feet, occlusive footwear)
• Tinea pedis (athlete’s foot) spreading to nails
• Nail trauma, running, or long hours on your feet
• Shared showers/locker rooms; non-breathable socks
• Diabetes, circulation issues, or weakened immunity

We begin with a focused exam to confirm that the changes are truly fungal (trauma and psoriasis can look similar). When needed, we may take a small nail sample for lab testing to guide treatment.

Clearing a fungal nail takes time because toenails grow slowly. Most plans combine nail thinning/debridement, medication, and prevention to reduce recurrence.

In-office care

• Gentle nail debridement to reduce thickness and pressure in shoes
• Management of coexisting athlete’s foot to limit reinfection

Medications

• Topical antifungals for mild to moderate disease or when oral meds aren’t appropriate; require consistent daily use for several months
• Oral antifungals (when medically appropriate) for higher success rates; we’ll review medical history, potential interactions, and decide on baseline/interval labs when indicated

Laser therapy (if you offer it)

• A non-drug option used alongside trimming and hygiene measures; evidence varies. We’ll set expectations and discuss whether you’re a good candidate.

Footwear & hygiene

• Daily sock changes; breathable shoes; rotate pairs to allow drying
• Antifungal sprays/powders for shoes; disinfect nail tools
• Don’t share clippers; consider salon hygiene carefully

Cosmetic options

• Medical-grade antifungal polish or breathable polish during treatment (if desired)

1. Evaluation: Nail and skin exam; lab testing if needed.
2. Plan: Debridement the same day, medication options, and a practical hygiene routine.
3. Follow-up: Progress checks every 6–12 weeks; nail appearance often improves gradually over 6–12 months as new nail grows in.

• Spreading redness, warmth, or drainage around the nail (possible bacterial infection)
• Diabetes or poor circulation with any new nail pain, swelling, or skin breakdown
• Sudden severe nail pain after trauma

• Care led by Hannah Lee, DPM, with clear, evidence-guided options
• On-site debridement for comfort and shoe fit
• Thoughtful use of topical, oral, and laser options when appropriate
• Prevention plans that fit your footwear and lifestyle

How long does it take to clear?
Toenails grow slowly—visible improvement can take 3–6 months, with full outgrowth often 9–12+ months.

Will it come back?
It can, especially without shoe/sock hygiene. Ongoing prevention greatly reduces recurrence.

Are oral antifungals safe?
They’re effective for many patients. We review medical history and monitor when needed to minimize risk.

Can I wear nail polish?
Yes. Consider breathable or antifungal polish during treatment and remove polish regularly to inspect nails.

Is it contagious?
Fungus can spread in shared wet areas and between nails/skin. Hygiene steps help protect you and household members.

Let’s create a practical plan that fits your routine and goals.