On average, it takes about 6-9 months for patients to notice the results of treatment for thickened, discolored, and unsightly nails. That’s a long time! With this lengthy time frame, how can patients be truly confident that their nail treatment plan is being effective? 

      Antifungal nail treatments have evolved greatly over time. Between oral Lamisil, topical nail formulations, Laser, and UV shoe inserts,  how can one decide which treatment is correct to eradicate a persistent, chronic nail problem.? Onychomycosis is the name given to a fungal nail infection and there can be many different causes. Nail fungus can be contracted by contiguous spread i.e., sharing shoes, or communal locker rooms with someone who already has a nail fungus. Trauma, ill-fitting shoes, or anything that causes mechanical force on the nail can even cause nail fungus. This allows the nail to be lifted from the underlying nail bed, which breaks a protective barrier to allow opportunistic micro-organisms to gain entry. But with all the latest technology and development of new medications (both oral and topical), how does one know which treatment is best?

       The answer to our question here is…. A nail biopsy! Taking a small sample of nail to be sent for analysis at a lab can determine the underlying cause of the unsightly nail. First of all, a special staining procedure will help to identify which type of organism is present. For example, there are certain types of fungus that are less susceptible to Lamisil and better treated with other medications. There are even cases where nail thickening is not caused by a nail fungus.

       A nail biopsy is easily performed in your podiatrist’s office. A small piece of nail is removed from that portion of the nail that is between the nail bed and where the nail starts to overhang. This is the portion of the nail that gives the most accurate results. The procedure is relatively non-invasive and there is usually no need for post-operative nail care. In about 7-10 days, your doctor will be able to go over the results with the patient and formulate a treatment plan that is better tailored to suit the patient.

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