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Healthy Living Video Series #1 of 4: Fungal Toenails

Here is a new video from "Healthy Living" with Dr. Donald Pelto. This is the first in a series of 4 videos so far. 


Fungal Toe Nails


Transcript Below

hi and welcome back to healthy living
and I am Dr. Donald Pelto and now we're
going to answer a question that people
have in the summertime and they
sometimes use this which is a band-aid
to hide this problem and the question is
why are my nails thickened discolored in
the summertime thick and discolored
toenails can be caused by a number of
things sometimes they're thick sometimes
they're a little bit lifted and
sometimes they're painful and ingrown so
let me show you a picture here about
some different types of nails the one in
the upper left hand corner is a very
thick toenail it's painful it's a little
bit ingrown and it's discolored the one
underneath it you can see a before and
after picture of treatment how it's a
little bit yellow and it's turned whiter
the one in the upper right hand corner
has only that little superficial white
discoloration on the top of it and
that's actually commonly caused because
of wearing nail polish all summer long
and the one in the bottom right hand
corner is actually a lifted toenail that
had a combination of problems and we'll
talk about that so let's first talk
about fungal toenails I know no one
likes to talk about fungus and
everyone's embarrassed every summer I
have people that come in they say you
know doctor I don't want to wear
flip-flops because of my nail thickening
and the yellowing of my toenail
so let's first distinguish the different
types of nail problems that you may be
dealing with the first thing I want to
talk about is the lifting of the toenail
if you have a nail that's just lifted
you can kind of equate it to the
linoleum at your house if you have an
edge of the linoleum and it starts to
lift off a little bit and then you get
some dirt underneath there and then it
lifts even more it'll start to totally
lift off and that's what can happen with
toenails so it starts to lift a little
bit and then it can continue to lift off
that type of a nail normally isn't
fungus that nail can get water
underneath there and it starts to lift
and it can get a little discolored but
normally because of the liquid
underneath there and then a lot of the
ladies they try to trim out or try to
use a curette or something to dig
underneath there to get all the stuff
that's in there and
lifts it even more how do you treat that
type of a nail first of all you just
quit touching it and you take a little
sample of the nail to determine if it's
a fungus or not if it's a fungus you can
treat it if it's not you don't need to
treat it
another type of thickening of the
toenail can actually be caused by
rubbing so for example if on your
toenails you have some calluses on the
tips you're probably going to have some
thickening of the toenail especially on
the fifth toe nail that toenail is
common to rub on the side of your shoe
and it gets thick and discolored but
let's say you know I know I have nail
fungus and you come in you take a sample
of the toenail fungus and it comes back
that you do have a nail fungus so what
are some of the treatments you've
probably already tried
tea tree oil Vicks VapoRub coconut oil
and every other type of thing that you
can buy in the Internet and then you've
come to the doctor's office when you
come into the doctor's office there's
usually three try three types of
treatments the other treatments they're
safe but they're really not effective
the three type of treatments I find are
either a topical treatment in oral
medication or laser therapy so let's
first talk about the topical treatment
there are many prescription topical
antifungals they do a lot of advertising
but are they really effective you can
try it but the big challenge with the
topicals is you have to use it every
single day for up to a year to see the
results and if you don't have a fungus
and if you're just using it without
taking a nail sample it may not be
effective I don't usually recommend the
topicals unless it's only a portion of
one nail if you only have a little bit
of one nail that's affected then it
might be effective but if all the nails
are thick if they're yellow if they're
discolored it's probably not going to
work the second type of treatment which
I recommend the most is actually the
oral medication called lamisil lamisil
is a pill that you take one pill three
times or four days for three months and
that can clear up the nail fungus now
just be aware of however you treat it
it's going to take about nine months to
a year for a brand new toenail to grow
back and the third type of treatment is
to use laser treatment and that actually
uses heat
to heat up the fungus and kill it I find
laser treatments somewhat effective it
wasn't as effective as I thought it
would be I thought it was going to be
the best thing ever
but really it's a little saddening by
this treatment because it's not the
laser but because the nail gets so hot a
lot of people can't tolerate the
complete treatment
now how about safety everyone's
concerned oh I only want to do two
topical or I want to do the laser
because it's safe I don't want to do the
oral medication the oral medication for
many patients that come in is safe all
you have to do is take a simple blood
test prior called the liver function
test to make sure everything is okay and
you can take that medication there is a
question though if I treat the nail
fungus will it come back there is a high
chance of recurrence with nail fungus so
even if you do have treatment many times
we recommend a shoe sterilizer or
something that can you can spray in your
shoe to kill any of the remaining fungus
that's in there it's something that
you're going to continue to deal with
and then the last question people ask do
I really need to treat my nail fungus
you don't a lot of people live with nail
fungus and they've never have it treated
so you have to determine do you want to
treat it or not and then what type of
treatment you want if you want to learn
more about treating your nail fungus you
can go to and there's a
portion there you're going to learn
about how to treat nail fungus thank you
Dr. Donald Pelto Dr. Donald Pelto Dr. Donald Pelto is a Podiatrist at Central Massachusetts Podiatry, in Worcester and Westborough. Author of several books on foot health, he also speaks Portuguese and Spanish. He likes to go on family hikes and loves learning and talking about health related topics and healthy life hacks. Watch some of his interviews about health and video lectures on

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