Toenail Fungus or Not?

Toenail Fungus, or Not Toenail Fungus?

That is the question.  And our KC area podiatrists caution you against laser treatment for fungal toenails without proper diagnosis.  Do you have discolored toenails and you “just know” for sure that it’s fungus?  Maybe you’ve tried applying topical medications, or have even been prescribed pills to get rid of the fungus, but to no avail. The nails are still ugly and thickened.  However, is it toenail fungus, or not toenail fungus??


The number one reason that anti-fungal treatments fail is because it wasn’t fungus to begin with!

The most important thing to do when you decide to seek care for your “toenail fungus” is to have it properly evaluated by a podiatrist.  We are experts at properly diagnosing conditions that affect the nails; whether the nail changes are caused by fungus, or by other factors, such as trauma to the toe or nails.  Constant pressure on the nails from toe deformities such as bunions and hammertoes can cause changes that mimic fungus.  Other skin and nail conditions such as psoriasis may also present as fungus.


Even the experts in foot care can’t definitively say that your nail changes are caused by fungus just by eyeballing it.  So when in doubt, we’ll take clippings of the affected nails.  We then send them to the lab for evaluation under a microscope.  The lab will perform fungal cultures to see if anything grows.  If there’s fungus present, we’ll treat the nails appropriately to kill the fungus, usually with laser treatment.  When no fungus is present, treating the nails for fungus is not only inappropriate and bad patient care, but costly to the patient in both dollars as well as exposure to potential side effects of unnecessary treatment.

Toenail fungus or not toenail fungus??

Which brings me to a couple interesting conversations we had today when we called two local medispas.  Both spas are now promoting laser treatment for fungal nails.  Our questions to them, of course, revolved around the proper diagnosis of the affected nails.  When asked if the patient is evaluated by a doctor prior to treatment to make sure that it’s fungus before treating with laser, one spa told us that they do not diagnose the condition, but will treat the nail with laser without a diagnosis.  When we queried about treating without a diagnosis, we were told that they “can tell by seeing it”.  Who’s “they”? Not a doctor. The second spa we called told us that their laser tech “just knows” when it is fungus.  We were told that she “has experience, and can tell by looking at it.”
Really?  The laser tech can tell by just looking at it when podiatrists, the experts in the diagnosis and treatment of toenail fungus can’t always be sure?  And worse, they’ll treat your nails without a definitive diagnosis!  I guess if you think it’s fungus, who are they to argue?  “That’ll be $950, please.”  And of course they make it very clear that laser isn’t 100% effective.  Nothing is.  (Especially when you’re using a laser to kill fungus that isn’t there).

Proper Treatment

At Kansas City Foot and Ankle, we use the latest laser technology in the treatment of fungal toenails.  Other treatment options are also available, and our doctors will discuss the most appropriate treatment options for you.  But most importantly, we’ll make sure it IS fungus before recommending any particular treatment.
So, you can trust your medical treatment to a technician at a spa, or you can let the experts at Kansas City Foot and Ankle properly evaluate your condition and recommend appropriate treatment options.  Your toenails and your wallet will thank you.