I’m too embarrassed to show my feet…
Embarrassed about your ugly fungal toenails? With the warmer months just around the corner, many of us are thinking of putting on some lovely strappy sandals, well we can hope for some sunshine! What if you suspect you have a fungal nail problem? What can be done about it?
Our feet have been hiding away over the winter, and whilst we have been able to be more active during lockdown – taking those long walks, or finally deciding to start that couch to 5K which you have been putting off for so long, the combination of sweaty socks and trainers creates the perfect environment for fungi to thrive. This, along with possibly not paying much attention to your feet, contributes to the likelihood of developing a fungal nail and or skin infection being thrown into the mix.
What type of treatment is available?
Most fungal nail infections can be treated effectively and successfully; treatment can prove to be a long process in some cases, and therefore requires a lot of patience, persistence, and perseverance, I call it the 3 Ps.
There are different treatment options offered by Podiatrists, from laser treatment to topical treatments, therefore, visiting a Podiatrist so they can guide and advice you is essential to treat the problem effectively.
Over the counter treatments will only be useful if the surface of the nail is affected in mild to moderate infections, and not effective if your nail is very thick, or if the infection has spread underneath the nail plate.
What should I expect at an initial consultation?
An initial consultation will enable the Podiatrist to confirm a clinical diagnosis of a fungal nail infection, and where possible, should ideally be accompanied with a report of a positive nail lab test before starting any form of treatment. Treatment choice depends on the severity of the fungal nail infection; and severity can be classified by the percentage of nail affected.
Below is a simple classification I use, and should only be used as a guide:
- Mild – less than 40% of the nail is affected
- Moderate – 40-70% affected
- Severe – the whole nail is affected, often involving the nail bed and matrix – this is the cuticle area and beyond
What can be done to treat my embarrassing fungal nails?
Fungal toenails are one of the most common nail conditions we see in our clinic every day. We can now offer a consultation and instant testing with same day results, where previously for many years Podiatrists have relied on sending nail clippings through the GP for laboratory testing, which took 6 weeks. The results sometimes would come back negative or inconclusive, even though clinically we can tell that fungal elements are present within the nail.
Our same day testing service, returns an accuracy with over 97%. This tests for the most common cause of fungal nail infections – dermatophytes.
The tests take takes no more than 5 minutes, all that is required from you are nail clippings that are processed straightaway in our clinic. The results are sent to you within 24 hours with a diagnosis, with treatment options for you.
We employ two main treatment modalities with excellent clinical outcomes.
- Treating conservatively with antimicrobials and antifungals, and monitoring the progress whilst having the bulk of the infected nail/s cut back periodically (every six to eight weeks) where loose, and;
- Painless removal of the infected nail to expose the nailbed where the infection resides, and over a period of time as the nail grows back, topical antimicrobials and antifungals are applied to the nail bed daily with the expectation that a healthy new nail will regrow.
If treating conservatively, treatment of fungal nails with topical antifungals and antimicrobials for mild to moderately infected nails can take approximately two years. For a quicker turnaround, or if all other treatment has failed, the painless removal of the infected nail/s under local anaesthetic and treating the nail bed with an antifungal medication over a period of 6- 12 months as a new healthy nail grows may be considered. Removal of a nail is a well-known procedure used by Podiatrists to treat problematic toenails.
So to get your feet sandal ready, why not look into treating those toenails you’ve been hiding for so long? you only just have to pick up the phone and take the first step… remember, we’ve seen it all before, no need to be embarrassed.
Below are pictures of before and after treatment of some of the success stories of my patients who have been treated either conservatively (Patient 5), or by removal of the nails (Patient 1,2,3 and 4) and treating the nail bed with antifungals and antimicrobials. All have given their consent.
Read Brian’s feedback about his experience of having his toenails treated following painless removal of the infected toenails.
“For many years I had suffered from fungal infections on three of my toes. Over that time, I‘d tried several different ‘over the counter’ treatments, all of which were all only partially effective. The infections always returned and became even worse. Following a consultation with Ronke she proposed the removal of the infected nails together with a course of post-operative treatment with antifungal medication.
The removal of the nails was carried out under local anaesthetic which was a straightforward and painless procedure. I continued to see Ronke for regular check-ups and 5 months later the nails have almost completely regrown without any sign of re-infection. Ronke has been very professional and caring throughout and she was always happy to be contacted between check-ups for any additional advice. I am very happy with the treatment I received and delighted with the final result.”
To find out more about treatment offered at the clinic or to book an appointment, call 07988 916 198, you can also book online.
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To find a list of HCPC registered podiatrists and chiropodists near you, check out the NHS website here.