Expert Opinion...


What is nail fungus?

Nail fungus, also called onychomycosis, is an infection of the lower part of the nail plate and usually yellowish in color.

Nail fungus not only causes physical discomfort but also negatively affects the patient's mental state due to unpleasant appearance and smell.

Fungal infection is the most common nail infection. Nail fungus accounts for approximately 50% of all nail diseases.

Dermatophytes, fungal species, are found in the skin, hair, and nails. When they find suitable conditions they can cause onychomycosis - a fungal infection of the nail. Most often patients complain about the unpleasant appearance of the nail but the main problem is the infection of the nail plate. This infection is progressive and contagious.

Why does nail fungus occur? What are the risk factors?

  • Nail fungus is an easily transmitted disease, so it is common among the population.
  • The fungus can live on a nail for years without causing any pain that is why people do not take it seriously.
  • Studies show that half of the people had feet and nail fungus at least once before the age of 70. Feet fungus can also cause nail fungus, which is more difficult to treat.
  • Big toes are more susceptible to diseases, for this reason, fungus is usually found on the big toenails.

Groups with increased fungus risk:

  • People over 55
  • Athletes, sportsmen, swimmers, people who regularly do sports and use public showers
  • People with circulatory disorders
  • People with the weakened immune system
  • Patients with diabetes
  • Men (fungus infection risk is higher in men than in women)
  • Patients with Athlete's foot
  • People with excessive sweating
  • Patients with skin diseases such as psoriasis
  • Those who have a genetic predisposition to the disease
  • People prone to recurring foot injuries

Warm and humid environments contribute to the development of nail fungus. Wearing boots and shoes that do not allow air and cause sweaty feet also contribute to fungus development.

  • Public places create a suitable environment for the spread of this infection.
  • Pools, public baths, saunas, showers, and bathrooms - these are places where the fungal infection is transmitted very quickly.
  • Manicures and pedicures performed with non-sterile instruments can also cause fungus and other infections.
  • People whose hands are constantly in contact with moisture due to work (e.g. dishwashers and cleaners) are more prone to nail fungus.
  • Sometimes more than one person in a family suffers from nail fungus. This is due to the fact that all family members often share towels.
  • Weakening of the immune system and negative effects of smoking can also add to the risk of fungal infection.

Symptoms of nail fungus

At first, the fungus is yellow-green in color, then it gets a brown tint. Later it causes onycholysis - detachment of the nail from the nail bed, nail thickening, looseness, opacity, and peeling. Nail pain is one of the common symptoms.

List of symptoms:
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  • Nail thickening
  • Nail fragility and sensitivity
  • Detachment of the nail from the nail bed
  • Nail deformity
  • The excessively pale and lifeless appearance of the nail
  • Change of the nail color (white and yellowish)
  • Pain in the nails
  • Unpleasant smell in the infection area

Is nail fungus contagious?

  • Nail fungus is contagious. In particular, people who are in close relationships with each other are more likely to get infected.
  • If you do not take the necessary precautions one nail fungus can infect the other healthy nails.
  • On the other hand, fungus progresses slowly and the symptoms do not immediately reach alarming proportions.
  • The fungus can live on the nail plate for months before it spreads to other nails.

How to treat nail fungus?

First of all, it should be noted that a fungal infection of the nails does not heal by itself. In addition, the treatment takes a lot of time. If you suspect nail fungus contact your doctor to diagnose it. Laboratory tests of a nail scraping sample are used for this purpose.

1- Abrasive or mechanical treatment methods: It aims to remove the affected tissues of the nail. It includes drugs, various pedicure procedures, partial or complete removal of the nail. This is a long and complicated process. In addition, patients often do not comply with all treatment rules. Therefore, the risk of relapse is high.

2- Applying nail fungicides: this is the most commonly used method. It can be effective only at the initial stage of infection. However, as the nail thickens, it gets more and more difficult for the medicine to penetrate into ​​the fungal nest. The course of treatment is from 3 to 6 months. In addition to the low effectiveness of treatment, there is a high probability of relapse. The above-mentioned abrasive methods slightly increase the success of the treatment.

3 - Oral fungicides: Firstly, the nail samples are tested in a laboratory. Depending on the individual healing speed, oral administration of antifungal drugs is prescribed for a certain time. To speed up the process, it is necessary to grind a thickened nail and to support treatment with external medicines.

Studies show that one of the most effective treatments is to take termafina (Lamisil) and itraconazole (Sporanox). These drugs help the new nail to develop without infection.

These drugs are taken from 3 to 6 months. However, there is no immediate effect after the medication. To see the effect, you must wait until the new nail is out completely.

During and after treatment you should keep your feet clean and dry, wear slippers/shoes in public places, choose comfortable shoes, wear socks made of natural materials and change them during the day if necessary.

4 - Laser treatment: this treatment is also used in our clinic. The laser beam destroys the fungus with high temperatures.

The use of laser beams in the treatment of fungus gives very good results. Details about this method are given below.

What are the benefits of nail fungus laser treatment?


First of all, you need to remember that any fungus treatment method is a long and painful process. If you do not follow it properly you will have to repeat the treatment. If we compare only laser therapy and oral medications, the effectiveness is usually the same. However, if you combine the laser treatment with and oral medications the success rate is higher. Laser treatment has an advantage over abrasive methods since a laser beam can penetrate deeper into the nail tissue.

Oral fungal medications can have significant side effects. They actively interact with other drugs and negatively affect liver function. The laser can be used for people with liver disease, elderly patients and children.

In the video you can see how the laser treatment of nail fungus is performed in our clinic:

Watch the procedure of nail fungus treatment and medical nail care in our clinic:

What type of laser is used to treat nail fungus?

Nd Yag laser is most often used to treat nail fungus. Fractional CO2 lasers are also used for this purpose.

How is nail fungus treated with laser?

All nail tissue affected by the fungus is scanned with a laser beam. 4 sessions of laser therapy with an interval of 1 or 2 weeks are sufficient for the treatment of nail fungus. Sometimes very slight pain may occur during the procedure. Local anesthesia is not required. The effectiveness of laser treatment increases with the use of nail abrasion procedures.

Topical creams are applied between laser therapy sessions to ensure the maximum effect of the treatment. Fungal infection is cured in about a month. However, the nail appearance improves only after the emergence of new intact nail tissue. Therefore, the whole process takes several months.

How does laser affect nail fungus?

The fungal infection makes the nail look yellow or black-gray or dark green. The temperature of the laser beam absorbed by this color increases to 50 ° C. This heat removes fungal microorganisms without damaging the nail bed and the surrounding soft tissues.

What are the rules to be observed after the laser treatment?

After a session of laser treatment, you can immediately return to your daily life. Compliance with the following rules is important for the effectiveness of treatment.

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In what cases laser cannot be used?

Although laser treatment is a safe remedy for nail fungus, in some cases it cannot be applied. Laser therapy is not prescribed to patients who have used isotretinoin (Roaccutane) for the last 6 months, as well as patients with psoriasis or lichen in the nail bed. Moreover, the presence of permanent or semi-permanent nail polishes excludes the use of a laser beam.

What doctor should I consult in case of nail fungus?

Treatment of nail fungus should be carried out in the dermatology department. Treatment is prescribed by a dermatologist. The problem can be solved much faster in cooperation with podologists (orthopedists).

How to prevent nail fungus?

  • The most important thing to remember is food hygiene. Therefore, every day before bed you need to wash your feet.
  • If you use a public shower use slippers.
  • After exercise changes your sweaty socks and shoes.
  • Wear cotton socks and change socks daily. Choose only comfortable shoes.
  • If you have excessive sweating, or if you live in a hot and humid climate, such as Antalya you should wear shoes that allow air.
  • Toenails should be kept short and clean. Wash your hands immediately if you touch the fungus-infected nails with your hands.
  • If you have your manicure and pedicure done in a beauty center make sure that the instruments are sterilized.
  • Do not allow other people to use your nail file, scissors, towels, socks, and other personal hygiene items.
  • Stop smoking.
  • Check blood glucose levels.
  • Use an antifungal spray for shoes.