Saturday, September 9, 2017

Thickened Toenails - Fungus or Not ?

Often a patient presents to my office complaining of thick fungal toenails.  But is it really a fungus ?  Most people are aware that thickened, darkened toenails often mean fungus of the toenails; a condition called onychomycosis.  However, trauma to the toenail, even seemingly minor trauma, can also cause the toenail to become thick and darkened.
Onychomycosis can be caused by one or more types of fungus, causing the nail to become thickened, darkened, and with hard tissue under the toenail.  Treatment consists of either oral or topical medications.  Resolution is slow, even with the most effective treatments.
If the thickened toenail is caused by trauma, conventional fungus treatments won't work.  Thickened or dystrophic toenails may be caused by direct impact trauma, such as dropping a heavy object on the toe.  Sometimes microtrauma can cause damage of the toenails.  This is mild repetitive trauma that is often associated with stop and go actions, causing the toenail to rub on the sneaker.  This is common with runners, basketball players, and tennis players.  A substance, called keratin, forms under the toenail, causing it to become thickened and dark, mimicking onychomycosis.
The only way to definitively make a diagnosis is with a nail culture, which is analyzed by a lab.
If your toenails are thickened, darkened and uncomfortable, call us today. We can diagnose the problem and give you fast relief.  Our offices stress preventive foot health, especially for at risk patients with diabetes and poor circulation.  We are located at 1398 Highway 35, Ocean,and 191 Highway 37 W, Toms River.  We can be reached at (732) 988-0070 or (732) 286-9200.  For more information , log onto our website at

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