Ugly Toenail Syndrome

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Ugly Toenail Syndrome Treatment in Marlborough, CT

What causes toenail fungus?

Fungal nail infections are caused by a group of fungi called Dermatophytes as well as yeast and mold.  The fungi are everywhere in the environment. Common areas to pick up a nail infection swimming pools, hot tubs, Jacuzzis, gyms, public showers and nail spas. Also age, genetics, poor health and trauma may be contributing factors in causing a fungal infection.

How does it enter the nail?

The fungi usually enters the nail through an opening between the nail plate and the nail bed. Please see image; Anatomy of a Toe. Once under the nail plate, the fungi begins to proliferate where a small whitish-yellow spot may appear. For the fungi to thrive it needs an ideal environment which is dark warm and moist. Shoes and hosiery act as an incubator allowing the fungi to thrive.


Identifying a fungal toenail

1). Nail plate thickening
2). White or yellow spots on or underneath the nail plate
3). White or yellow streaks under the nail plate
4). Distortion of the nail plate
5). Nail plate separating from the nail bed
6). Brittle, ragged or crumbly nail plate
7). Debris build-up underneath the nail plate
8). Discoloration of the nail plate

What treatments are available?

1). The use of liquid anti-fungals and topical creams has a success rate of 7% to 44%. Treatments may take 12-24 months to clear your toenails.
2). The use of oral prescription drugs; Lamisil and Terbinafine Hcl have a success rate up to 65%-70%. The medication can take anywhere from 12 weeks or longer to clear your toenails. Side effects to taking oral anti-fungal medications are also a concern, especially to your liver and heart. Monthly blood work is also required.
3). Nail surgery is an option but extremely painful.
4). Laser treatment is an effective treatment modality in clearing, restoring and revitalizing your nail plates.

How does the laser treatment work?

Our office uses the Q-switch 1064ND YAG laser, which is one of the most advanced Dermatological laser currently available. The Q-clear laser is FDA approved in the treatment of nail fungus. In 3-10 nano-seconds, an impulse of high powered laser passes through the nail plate, nail bed and the nail growth area which eliminates the fungal infection and allowing your own body to restore and grow a healthy clean clear nail with no damage to the nail or surrounding tissue.


Is the procedure painful?

Most people do not feel any pain. Some patients may experience a slight warmth or an occasional snapping sensation during the procedure. If you have any discomfort during the procedure the laser power can be decreased.


What is the recovery period following the procedure?

The laser does not harm healthy tissue. No post-op treatment for pain has been reported. Following the procedure you may resume all normal activities.

How soon will I see improvement?

At the time of the procedure, no visible changes are seen, until the new nail plate begins to grow out. You will normally see results in 2 to 4 months, depending on how quickly your toenails grow. New clean clear growth begins to appear at the bottom of your nail plate as the disease portion of your nail grows out. Complete regrowth takes up to 9-12 months.

How long does the procedure take?

The amount of time varies on the degree of involvement of the nails. Very thick nails are mechanically reduced to a more normal thickness with specialized equipment. The laser is than applied typically taking 10-20 minutes. Overall a visit for consultation and treatment will usually take 30-45 minutes.

Procedure explained in details:

The toenails are trimmed with nail nippers and then the nail plates are ground down using a dremmel. Once the toenails are flat they are wiped down with alcohol. Now it is the time for the actual laser procedure. Both the patient and I wear special safety glasses during the procedure. The great toenails are treated for roughly 2 minutes each. The smaller toenails are treated for roughly 1 minute each. The procedure really does not take more than 20 minutes from start to finish. Pictures are taken at the beginning of the treatment and than will be taken 3 months later. The patient will leave the office without pain and either given a prescription for a topical anti-fungal or advised to purchase an OTC anti-fungal medication. The patient will also be given a set of instructions to follow to decrease the chances of being re-infected.

Can I polish my nails or have a pedicure?

You can apply polish or have a pedicure the day after the laser treatment. However it is important to remove all nail polish 24 hours prior to having your laser treatment performed. I recommend using a nail polish infused with an anti-fungal medication. I also recommend that you throw out your old nail polish.

Is the laser treatment covered by my health insurance?

Toenail fungus is considered an aesthetic cosmetic condition by the health insurance industry therefore “health insurance does not provide coverage for laser treatments.” Patients with HSA accounts and flexible spending accounts can often use funds from these accounts to pay for the laser procedure.

How much does the laser treatment cost?

The cost varies depending on the number of nails involved and the severity of the fungal infection. The statewide average costs for the state of Connecticut range from $750-$1500. However since our practice is offering the most state of the art laser equipment, I will be providing a low introductory rate for the first 9 months which includes the consultation and the first follow-up appointment. The office fees will be $100 to $600 based on the number of nails involved and severity. Future office visits will be at a reduced rate.


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