Ankle and Foot Clinic of Idaho

Call Us:  (208) 529-0229

​6 months after laser treatment

​Before treatment

Mild infection

Severe unmanaged infection

Treatment takes 12-18 months to be considered cured no matter which treatment is used. This is because the nail needs to completely grow out due to damage from the fungus.

  • Topical: This is typically reserved for mild cases. Newer medications have up to 55% efficacy (secondary endpoint) after 52 weeks. Advantages include very few side effects. Disadvantages include poor efficacy and requires daily application for months.
  • Oral: Current medications have up to 70% efficacy. Advantages include excellent efficacy and only requires one pill a day for three months. Disadvantages include rare side effects such as liver problems and allergic reactions.
  • Laser: FDA studies show >95% efficacy. Our clinic shows about 90% efficacy at 9 months. Advantages include very few side effects and excellent efficacy. More information about laser treatment can be found here.


  • Genetics: The fungus is not inherited, but individuals can inherit a susceptibility to the fungus. Individuals with a genetic susceptibility tend to develop fungal nails at a young age and it usually involves all ten toes.
  • Injury: There are two types of injury that can lead to fungal nails. The first is a direct injury such as dropping an object or stubbing the toe. The second is small and repetitive bumping of the nail, such as against a shoe when running or walking.
  • Systemic disease: Certain conditions such as diabetes and rheumatoid arthritis affect the immune system. This can lead to a susceptibility to the fungus. Medications used to treat systemic disease such as arthritis and cancer can also decrease the immune response and lead to fungal infections.


Fungal nails are extremely common. It is estimated that it affects up to 35 million people in the U.S. alone. The nails often have a yellow or black discoloration causing the nail plate to become thick and brittle.

Fungal nails