Treatment for Toenail FungusAs part of our feet, our toenails can really take a beating. Our feet are also the area we tend to neglect. Many of us tend to wear improper footwear and usually injure our toes often. It is very important to take care of our feet and toes. Fungus is easily developed through improper care and exposure to public elements. If you develop a toenail fungus it is important to treat it right away.

Toenail fungus is easily picked up in public places where water tends to collect such as public pools, gyms and locker rooms. These moist environments are the perfect breeding ground for fungus. Easily avoid picking up toenail fungus by wearing the proper footwear when you are in these areas.

Another reason a person may get toenail fungus is due to some kind of injury to the toenail. Damaged nails are prone to bacteria and infection. Fungus can get underneath damaged nails and into the exposed area. You may notice a purple coloration forming, this is due to bruising and the rooting of potential fungus. This area under your toenail can provide the perfect warm and moist environment for growth of fungus, especially when you wear socks and shoes. If your toenails have been injured, the effected area may also swell and become very painful.

Another possible cause for toenail fungus is the use of tight shoes and ingrown toenails. Wearing the wrong shoes can cause your toenails to grow inward thus causing poor circulation and swelling. By cutting off the circulation to your toes the toenail can start to die leaving it vulnerable to toenail fungus. Ingrown nails also cause swelling as well as pain around the toenails. If left untreated, or if you don’t properly treat them, it can lead to infection.

When it comes to toenail fungus treatment it is very important to always wear the proper shoes that are the right size and provide proper comfort. When seeking treatment it is important to contact your Temple Hills podiatrist first. Antibiotics are a possible treatment for toenail fungus but usually left for more severe case as the use of antibiotics is taxing on the liver and kidneys. Most commonly a topical treatment is preferred such as tea oil. In some cases the partial removal or complete removal of the affected toenail is done to prevent further fungal infection. The best course of action is to keep your toes clean and dry. Keep toenails trimmed and avoid pulling and ripping the area around the nails.

A toenail fungus infection can quickly develop once an organism known as a Dermatophyte begins to feed on the keratin and protein stores contained within your nail. This fungus can rapidly drain these vital substances from your toenail, causing the painful and unsightly symptoms associated with this serious medical disorder. Unfortunately, the condition is very challenging to successfully treat, as repeat infections are common. Continually struggling with toenail fungus infections can very often lead to discoloration, disfiguration, and eventual destruction of the entire nail.

If you currently suffer from this disease, you’re probably all too familiar with the medications commonly prescribed to treat it. Although these drugs can provide very effective results and relief from this debilitating condition, there are certainly serious side effects strongly associated with these treatment regimens. Many podiatrists will often prescribe an oral medication, such as Lamisil or Sporanox to combat toenail fungal infections. Unfortunately, these drugs often cause many minor side effects, can lead to severe liver damage, and even be life threatening.

Alternative treatments for these fungal infections are available to those suffering with the condition. Many people aren’t aware that a laser can be effectively used to alleviate the symptoms of this disorder, and the number of podiatrists offering laser treatment for toenail fungus is increasing. This option is certainly one to explore and consider if you don’t want to struggle with the serious side effects of medication.

Scientific research studies have revealed that the laser inhibits overall fungal growth and provides the patient’s body with an opportunity to heal itself. Using a laser to combat toenail fungal infection has been reported to be effective in over 80% of patients who have tried it. A typical treatment session lasts anywhere from 30 to 45 minutes in duration. A patient may be required to go through 2 to 4 laser sessions, depending on how severe the infection is.

If you have made the educated decision to get laser treatment for toenail fungus infection, please don’t hesitate to request an appointment at one of our offices offering this cutting edge service.

Nail fungus producing unsightly nails is one of the most common health issues faced by people, especially those who reside in hot, humid climate zones. Previous therapies for fungal nails including surgical excision, oral medication, and application of prescription and over the counter medication to the nails have produced marginal results, and some have produced undesirable side effects such as post-operative pain and disability, liver damage, and ineffective results. Laser treatment kills the underlying pathogens that cause nail fungus. This effective laser light works through the nail. It is safe, painless, and has no side effects like surgery or oral medications.

Fungal infection of the toenail is also known as onychomycosis. Just like any other infection (bacterial or viral), is important that the condition be treated so as not to lead to more serious complications, especially in the diabetic. The disease is characterized by a change in nail color, thickening of the nail, debris under the toenail, a lifting of the leading edge of the nail, and a foul odor. Patients complain that toenail fungus is ugly and embarrassing. This condition is often ignored because the infection can be present for years without causing any pain. If ignored, the infection can spread to other toenails, the skin on the feet (athletes foot), and even the fingernails. Severe cases can impair one’s ability to walk or lead to painful ingrown toenails. Secondary bacterial infections may occur on or around the toenail plate.

Contributing factors for developing nail fungus infection include: a history of athlete’s foot, injury to the nail bed, sports/shoe trauma, excessive perspiration, diabetes, circulatory problems, and immune-deficiency conditions.

When treating nails with the near-infared diode laser, the laser kills the fungus that lives in and under the toenail. During the treatment there is a gentle warming sensation. This walk in and walk out treatment takes only 15 minutes and nail polish can be worn immediately after the treatment. The device operates at physiological temperatures that are thermally safe for human tissue. The 1064 nm wavelength has unique photolethal effects on fungal pathogens. This wavelength is also safe and does not present a danger to normal tissues like ultraviolet light.

In clinical use, most of the time only one treatment is needed, and the nails are photographed, cultured, and evaluated in 6 to 8 weeks. Total cosmetic results occur gradually as the new nail grows out.

To schedule an appointment, contact: Dr. Burton Katzen, DPM – (301) 760-2232

Picture of ingrown toenails. Picture of fungus infected toenails.

Toenail problems are the most common foot condition seen in the Podiatrist’s office. The human toenail is one of the fascinating structures of the human body. Its position on the toe, together with its being encased within the toe box of the shoe, exposes it to frequent micro trauma, which may affect the appearance and health of the nail. Many systemic diseases, such as diabetes, psoriasis, dietary deficiencies, and decreased circulation can manifest themselves early by changes in the appearance of the nails.


Disorders of the toenails are most common in the elderly. They may result from bacterial or fungus infections, repeated trauma, metabolic diseases such as diabetes, and vascular insufficiency. It is extremely important, especially in those people with compromised circulation to adequately diagnose the etiology of the deformed nail and treat it promptly. Any delay may lead to a disastrous outcome.


Picture of an ingrown toenail.An ingrown nail is a condition in which a portion on the nail presses into the flesh, causing pain, redness, and sometimes infection. They are most commonly associated with the inside or outside of the great toe but may occur in any toe. Contrary to popular belief, most ingrown nails are caused by a growth disturbance at the base or root of the nail, not by improper cutting. As the nail plate penetrates the adjacent tissue, it may cause irritation, inflammation, and eventually infection. A permanent cure is easily obtained by removing the irritating portion of the nail and chemically cauterizing the corresponding portion of matrix (root). There are no stitches involved, and the patient may leave the office in normal shoe gear.


Trauma to the nail matrix (root) may cause the toenail to become enlarged, sometimes over a period of many years. The nail becomes hooked at its distal end and may eventually encroach on adjacent toes causing lacerations and infections. If neglected the nail may actually resemble a club or a ram’s horn. Treatment may involve periodic palliative reduction of the thick nails by the skilled use of nail nippers and podiatric burrs usually every 2 to 3 months. Permanent cure in healthy individuals may be obtained by avulsion of the nail and chemically cauterizing the entire root of the nail. This will lead to a non-painful and cosmetically acceptable result in most people.


Besides bacterial infections (ex. Ingrown nails), the nail can commonly be invaded by a fungus or yeast.

Often, a minimal trauma to the end of the nail will allow for invasion of pathogen. Early involvement may manifest itself by colored spots or striations. These may be white, black, brown, black, or green depending on the invading organism. As the total nail and eventually the root become involved, it will become thickened, dry and extremely brittle. When treating a mycotic nail, it is important to identify the offending organism. This may be done by taking a scraping of the nail and placing it in a fungus culture. The results are obtainable in 10 – 14 days. Depending on the length of time and severity of the problem, treatment may involve a topical fungicide along with periodic palliative debridement of the nail or oral fungicides such as Sporanox, Lamisil, or Griseovulvin. Surgical avulsion of the involved nail plate is often necessary to expose the affected nail bed more advantageously to topical therapies.


This is usually caused by trauma and should be treated immediately to relieve pain and pressure. This can be easily achieved by drilling 1 or 2 small holes with a dental drill under local anesthesia. Usually if the trauma involves external bleeding (ex. a bloody sock or shoe), this is unnecessary, and the nail may simply be simply cut back to the point of attachment and allowed to grow back.


Trauma to the top of the nail may produce a reactive periostitis and cause bone or cartilage to grow underneath or to one side of the nail and elevate the nail plate itself. This most commonly occurs underneath the great toe or to the outside of the 5th toenail (often mistaken for an ingrown nail). Treatment usually consists of surgical filing of the spur, usually requiring one stitch.

Dr. Burton Katzen, class of “71” has been elected president of the Temple University School of Podiatric Medicine alumni board of directors.


An alumni dinner and reception will be held in conjunction with the national convention on July 15th at the Philadelphia Downtown Marriott.
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