Lets quickly review the basics: what is onychomycosis? Onychomycosis (on-EE-ko-my-KO-sis) is a fungal infection of the nail that can be caused by 3 types of fungus: non-dermatophytic molds, yeasts, and dermatophytes. The most common infective “bug,” accounting for 70% of all toenail infections, is a dermatophyte by the name of T. rubrum. The names, none of which are important, mean very little in relation to treatment modalities that can be used. It is, however, important to know that the types of fungus causing toenail infection thrive in moist environments, therefore keeping feet clean and dry helps prevent infection by one of these “bugs.” It is also important to clean community showers frequently with chemicals like bleach, killing any organisms living on the tile. Wearing shower shoes, in situations where you are not responsible for cleaning, is also a wise decision!
When the organism gets into the bed of the nail and/or the nail matrix (the tissue from which the nail grows), your nails will become thickened, discolored, and often brittle. Patients experience associated pain with fungal nails due to increased thickness which causes the nails to become pressed up against the inside of shoes. Nails become difficult to trim at home and embarrassment in open-toed shoes or sandals is imminent!
Treatments, as they are currently available, do very little for long-term cures. Several pills and nail lacquers do help the appearance of nails and decrease thickness. However, they are not without their side-effects, and when the use of these medication sare discontinued reoccurrence of fungal infection is likely is 70% of patients. Over-the-counter methods such as mouthwash, Vicks Vapor Rub, and Vitamin E lotion seem to benefit in decreasing thickness, but long-term research studies have yet to be conducted to determine the effectiveness of such remedies for providing a cure. My guess would be that their cure rates would be similar to oral and topical prescription medications, as fungal nail infections are typically VERY difficult to treat. The problem with treating and curing fungal infections long-term is seeded in the way the fungus manifest within the nail, making it very difficult to get to the source of the infection and kill it from the inside out.
In short, fungal nail infections are extremely difficult to treat and only time and continued research will tell if a long-term cure is a possibility, especially in the realm of Laser Therapy. The best option available today is to try one of the currently approved methods, and once treatment has concluded, prevention of reoccurrence becomes key!