Well my dear NYC podiatry patients, here we are at the dawn of a new year.  Full of possibilities, promise, potential and – wait for it – pfungal ptoenails.  Yes folks if the soft tissue appended to your most distal extremities looks like a prop from an Ed Wood film, and it takes an industrial sander to grind down those talons that would make a bald eagle jealous, it may be time to make an appointment with your friendly neighborhood podiatrist, and time is of the essence, as ye shall see in our most holy and hallowed blog.

Toenail fungus, or onychomycosis as we call it when looking to confuse patients, is a very common condition, affecting somewhere around 15-20% of the population, which means that of the 5 chairs in my waiting room, at least one may be filled by someone with nail fungus.  How did they all get it?  It’s not just hygiene, it’s genes.  This condition, like so many others is hereditary, so if you have it, you have your parents to thank, and they can thank theirs, and your kids can thank you. 

Because the little fungal buggers live under the nails, treatment has to be directed toward that area of skin – which means those wimpy over the counter treatments are nothing more than a nice bath for the buggers.  The primary treatments are in the form of an oral medication you may have heard of that eradicates the fungus over a period of a 3 month course.  It works well, but because it’s metabolized through the liver and has a remote potential for complications, many folks are a bit wary about taking it – although the safety profile is quite good for the medicine and it is the most effective cure. 

The second option is a newer topical designed to penetrate the nail to the skin beneath.  Works well, but slow and expensive and insurance companies are not keen on covering it.  The third option is – cue the sound effects – laser therapy.  This is a newer therapy that works well in many cases, with cure rates rivaling those of the pill in the right patient.  The downside is the total lack of insurance coverage, so it’s an out of pocket expense, but the decided upside is the efficiency of treatment and avoiding the use of medicines. 

Now here’s the rub.  Any treatment, no matter how effective, requires six months lag time for a new nail to grow in, so if you want beach nails, now is the time to start treatment.  Hence the reason for a nail blog in the winter.  So no matter how you choose to treat onychomycosis, this is the perfect time to come in and recapture those teenage toenails just in time for beach season.

See you in the office.

Ernest Isaacson