Why combination therapy for toenail fungus?
Toenail fungus is difficult to treat because it mostly infects non-vascularized tissues like the nail plate where the immune system cannot reach it, and so we must deliver medication to prevent new fungus from growing, then destroy existing fungus living in the nail. Most therapies only do one of these things, and it's simply not enough! You must treat fungus from the inside, and outside!
Step 1
Test the toenail for fungus.
If indicated we take a portion of the nail and send it to a lab to confirm the diagnosis. Often this step is not required.
Step 2
Remove areas of diseased nail.
By removing as much of the fungus as possible it increases the dose of our therapies on the remaining fungus, increasing our chances of killing it.
Step 3
Laser Therapy
We treat the toenails 3 separate times, 4 weeks apart. Laser works to kill fungus in two ways: #1, by heat, and #2, by the wavelengths of the laser which disrupt fungal cell metabolism.
Final Step
Medications
We use several medications to kill fungus:
Topical Tolcylen - This is 4 medicines in one. A specialized formulation which softens the nail to allow medications to penetrate into the nail plate.
Oral Terbinafine (Lamisil). This is the most effective oral medication we have to fight toenail infection from the inside out.
Results in 6 Months!
This is the most comprehensive toenail fungus treatment you will find. Our results produce over 90% success rates.
Dr. Andrew Alward DPM
Board-Certified Podiatrist
A native of Illinois, after completing his medical training in Chicago, IL Dr. Alward relocated to Chattanooga, TN with his wife for the love of the outdoors, great hospitality, and community of Chattanooga! He is honored to serve the area!
Doctor of Podiatric Medicine Rosalind Franklin University North Chicago, IL
Podiatric Medicine & Surgery Residency Sts Mary & Elizabeth Medical Center Chicago, IL
Board Certified American Board of Podiatric Medicine
Fellow of the American College of Podiatric Medicine
FAQs
Is the laser painful?
No. However, the laser's energy can be very powerful, and must be balanced so that it does not cause a thermal injury as it heats up the toenail. Patient's are monitored closely during the procedure by the podiatrist.
Are there side effects to the laser?
Some patients may feel the toe be slightly more sensitive for several days following the procedure.
Will the toenail fall off after the laser?
No. The laser and medications work to eradicate the fungus from the nail plate, and skin. This allows a healthy nail to grow in. The diseased nail will simply grow out and be removed.
Are there any limitations following the procedure?
No nail polish can be worn during this treatment, which is about 3-4 months.
When can I expect the toenail to look normal?
A healthy nail is needed to replace a diseased nail and this can take 6-9 months for the big toenail. However, our topical medication softens, and lightens the nail and can show results in only 4 weeks!
I've heard the oral medication can damage my liver?
For most healthy people this is so rare that studies aren't sure it occurs. However, those with current liver damage should not take Lamisil, the oral medication commonly used for toenail fungus. Also, we prescribe the medication in a pulse-dose regimen to ease any anxiety or complications.
Is this covered by insurance?
No. Laser treatment and Tolcylen treatment is not covered by insurances.
What if this doesn't work?
No treatment is perfect. If this is a confirmed infection we can perform another round of treatment free of charge. Sometimes, the infection permanently damages the toenail, and there isn't much else to do. In this case we have a nail prosthesis system called Keryflex. (click here to learn more).
New Tread Podiatry PLLC
9 - 5 Mon, Tue, & Thursdays
9-12 Fridays