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Toenail Fungus Treatment in Los Angeles

Get Rid of Unwanted Fungus on Your Toes

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Los Angeles resident with nail fungus, exhibiting thickened and brittle toenail.

overview

What is Toenail Fungus?

Toenail fungus, also known as onychomycosis, is a very common fungal infection that affects the nails. It causes them to become thick, discolored, brittle, and sometimes misshapen. The infection typically begins as a small white or yellow spot under the nail and can spread deeper, leading to more severe symptoms.

If you’re experiencing toenail fungus, we’re ready to help at our state-of-the-art clinic, led by the best toenail fungus doctor in Los Angeles, Dr. David J. Soomekh.

Do I Have Toe Trauma or Toe Fungus?

There is an important distinction to be made regarding nail problems. Any trauma to the root or bed of the nail causes damage to the nail cells, from which the nail grows. A damaged nail will grow from this damaged root. For this reason, it can often be difficult to tell the difference between a nail that has been traumatized by an outside force and a nail that has been infected with a fungus.

If a nail is damaged without a fungus, there is no treatment available to cure the damaged root caused by trauma. If a fungus is present, the infection can be treated. Once the fungal infection is resolved, the patient’s body must heal the damage to the root. The longer the infection remains in the nail, the more traumatized the cells become, and the less effective treatments become.

Doctor in Los Angeles looking at patient's foot to determine if nail is infected or suffering from trauma.

Signs and Symptoms of Toenail Fungus

Toenail fungus often starts as a small discoloration but can worsen over time if left untreated. Recognizing the signs early can help prevent the infection from spreading or causing permanent nail damage. Common symptoms include:

Discoloration: Yellow, white, or brown spots appearing on the nail
Thickened nails: Nails become abnormally thick and difficult to trim
Brittle or crumbly texture: Affected nails may break, crack, or split easily
Distorted nail shape: The nail may grow unevenly or appear misshapen
Separation from the nail bed: The nail may lift from the skin underneath
Foul odor: A persistent, unpleasant smell coming from the infected nail
Pain or discomfort: Especially when wearing shoes or applying pressure

CAUSES

What Causes Toenail Fungus?

Nail fungal infections are typically caused by a dermatophyte fungus that invades the nail root and nail bed. Yeasts and molds can also be responsible for nail fungal infections. Fungi are microscopic organisms that don’t need sunlight to survive. Some fungi have beneficial uses. Others cause illness and infection.

Fungi and their spores are prevalent everywhere. Toenails are often confined to a dark, warm, moist environment — inside shoes — where fungi can thrive, contributing to infection.

Fungi live in warm, moist environments, including swimming pools and showers. Fungi can invade your skin through cuts so tiny you can’t even see them, or through a small separation between your nail and nail bed. It can cause problems if your nails are often exposed to warm and moist conditions

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Factors that can increase your risk of developing nail fungus include:

Being older, owing to reduced blood flow, more years of exposure to fungi, and slower-growing nails

Perspiring heavily

Being male, especially if you have a family history of nail fungal infections

Working in a humid or moist environment or in a job where your hands are often wet, such as bartending or housekeeping

Living with someone who has nail fungus

Walking barefoot in damp communal areas, such as swimming pools, gyms, and shower rooms

Having athlete’s foot

Having a minor skin or nail injury or a skin condition, such as psoriasis

Having diabetes, circulation problems, a weakened immune system

Children who have Down Syndrome

Anatomy of a Nail

The root (matrix) of the nail lies just under the skin, just behind the nail. There are specialized cells on the skin under the nail that help the nail attach to the skin. Nails are translucent and will show the color of the skin through the nail.

Fungal Infection in Nail Root = Trauma = Bad Nail Root = Poor Nail Growth

Diagram showing how a fungal pathogen affects the nail root in toe anatomy.

DIAGNOSES

Diagnosing Toenail Fungus

Diagnosing toenail fungus involves a clinical examination and a review of the patient’s medical history. Dr. Soomekh uses the following methods:

Consultation

Discussing symptoms, concerns, and past nail damage

Hands-on Examination

Assessing the foot, skin, and nails for signs of infection

Medical History Review

Identifying previous fungal infections or related conditions

Lab Testing

Collecting nail or skin samples for fungal culture to determine the specific type of fungus present

Diagnostic Timeline

Since fungi grow slowly, lab results may take several weeks

Early diagnosis of toenail fungus in Los Angeles, patient applying topical ointment.

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Toenail Fungus Treatment Options

Dr. Soomekh believes that early diagnosis and treatment of hammer toes are the keys to successful treatment, faster recovery, and a painless lifestyle.

Topical Medications

There are several over–the–counter and prescription medications on the market that are used to treat nail fungus. They can be in the form of a cream, an ointment, or a liquid. Those medications that have an active antifungal are preferred over those that do not. These creams work better if you first thin the nails. This helps the medication get through the hard nail surface to the underlying fungus. The doctor may thin the nail's surface (debride) with a file or other tool.

These medications need to be used two times a day for at least a year. The effectiveness of topical medications is limited due to their inability to penetrate through the nail and into the bed and root.

Oral Medication

When a patient has a bacterial infection, the doctor may prescribe an antibiotic. Similarly, a fungal infection can be treated with an antifungal medication taken orally. The most commonly prescribed antifungal is Lamisil (terbinafine). This medication is taken once daily for three months. During this time, the medication kills the fungus and its spores through the patient’s bloodstream. In this way, the oral medications can be most effective. Treatment success seems to improve when you combine oral and topical antifungal therapies.

After the fungus is eliminated, the nail root and nail bed will take some time to recover and heal from the trauma of the infection. This can take up to six months or more. Once the root and bed heal, a healthy nail can grow. A nail can take six to 12 months to fully grow.

Caution: Oral antifungal medications may cause serious side effects, mainly liver damage. Dr. Soomekh will check your liver with a blood test (liver function test) before starting oral medications to ensure that there are no current liver problems. A second blood test will be taken after the first month of using the medication. Dr. Soomekh does not recommend oral medications for people with liver disease, congestive heart failure, or those taking certain medications.

SWIFT Therapy for Toenail Fungus

Microwaves as a treatment modality for fungal infections offer potential as a unique approach, as they use water within the tissue to generate heat. Unlike lasers, which generate heat through direct absorption of photons, microwaves:

Create rapidly oscillating electric fields that cause water, ions, and other small polar molecules to rotate or move, generating heat.
Have good tissue penetration and are non‐ionizing (i.e., they do not damage proteins and DNA directly).
Can rapidly heat tissues, allowing for effective treatment of infected nail plates, even if dystrophic nails are thick and opaque

Lasers, in contrast, rely on thermal diffusion of heat generated at the nail surface to reach dermatophytes in and below the nail plate.

SWIFT therapy is performed in our Beverly Hills office by the best podiatrist in Los Angeles. The patient rests comfortably in the treatment chair while the doctor:

Painlessly smooths the nail plate for better penetration of the treatment
Places a probe over the affected nail plate and nail root several times in a grid-like pattern
Applies microwave energy to the entire area of each infected toenail
Allows the microwave energy to penetrate through the nail plate, heating up and killing the fungus hiding in the nail bed and root

The procedure typically lasts 15 to 20 minutes, depending on the number of nails needing treatment. Patients experience virtually no pain, although they may feel a slight warming sensation during the procedure.

Once the fungus is eliminated, the nail root and bed will take some time to recover from the trauma caused by the infection. This process can take up to six months or more. Once the root and bed heal, a healthy nail can grow over approximately one year.

SWIFT therapy is a safe, effective, and easy way to treat stubborn toenail fungus.

Toenail Removal

If your toenail infection is severe or extremely painful, Dr. Soomekh may suggest removing your toenail. A new nail will usually grow in its place. But it will come in slowly and may take as long as a year to grow back completely. Removal of the nail will not give the nail any better chance to grow back without infection. Removal of the nail is reserved for those patients who have pain from the excessive thickness of the nail.

Removing the nail and killing the nail root may be recommended in severely painful cases that have not responded to treatment. Once the nail root is killed, there will be no nail growth. This eliminates the infection and the pain from the thick nail. There are no negative ramifications to having no toenail.

FAQs About
‍Toenail Fungus

Where to Find the Best Toenail Fungus Treatment in Los Angeles

If you have stubborn toenail fungus and are looking for a highly effective, cutting-edge solution, our Beverly Hills clinic offers SWIFT microwave therapy, one of the most advanced treatment options available.

Our expert team, led by the best toenail fungus doctor in Los Angeles, provides safe, painless, and efficient care. We ensure you get the best possible results without the need for oral medications or lengthy recovery times. Call us to schedule your consultation and take the first step toward clear, healthy nails.

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