SPECIALTIES: Fungally Infected Toenails

A fungus that grows under the toenail often causes thick, discolored, and brittle toenails. The fungus grows under the toenail, often killing the nail, causing thick and discolored toenails.

Many believe the cause to be related to a genetic predisposition. It has never been proven that poor hygiene nor locker rooms have any correlation to developing a fungally infected toenail.

Treatment options for fungally infected toenails involve either an oral medication taken for 3-5 months, removal of the toenail, or application of a topical liquid applied every day for up to a year. Leaving the condition alone is not likely to cause long term problems, with the exception of potential recurrent fungal skin infections (athlete’s foot), involvement of more toenails, or for patients who are diabetic and/or have poor circulation, development of sores on the toes caused by pressure of the thick nail.

The oral medications (Lamisil/Sporonox) are approximately 70% effective at getting rid of the fungus. The oral antifungal medications are perfectly safe to take, but do require periodic labwork to monitor liver function. Certain insurance restrictions may prohibit use of the antifungal medications.

KERYflex is considered to be the “gold standard” cosmetic improvement to compliment laser fungal treatments. A series of KERYflex treatments are applied during the time it takes new nails to clear. Applications are stopped when new nails emerge.

Removal of the nail is performed in the office under a local anesthetic. Allowing the nail to grow back will often result in recurrence of the fungus. Killing the root of the nail preventing regrowth of a toenail is an effective option. The area under the nail will heal with regular skin. There are no long-term effects of having toenails permanently removed and nail removal does not cause any problems with shoes.

The final option is daily application of a topical medication, Penlac. This medication is applied every day for up to a year and has a success rate of 20-30%. The advantage of this option is that it does not require the labwork necessary with the oral medication.

If you suffer from foot pain, give us a call at 270-684-5252.


Dr Block is an excellent podiatrist. The staff is friendly and very professional.

John H