Definition
Onychomycosis and Tinea pedis are terms to describe fungal and or yeast infections of the skin and nails. Lack of natural immunity, a weakened immune system, diabetes, peripheral vascular disease, excessive perspiration of the feet, prolonged exposure to warm, moist, dark environments, and physical trauma are predisposing factors. Treatment usually takes minimum of a year and recurrence is common.
Anatomy
Fungal infections of the toenail involve 3 layers of tissue. The top layer is the outside of the nail and the outside of the skin. The middle layer is the underside of the nail and the nail bed. The bottom layer is the tissue of the deep nail bed and the dermis below. In order to achieve regrowth of normal uninfected nail, we must treat all 3 layers of tissue.
Treatment Strategy

  1. Identify the Germ: A portion of dystrophic nail is clipped and sent to the lab for culture. Treatment is instituted immediately and does not have to wait for the report.
  2. Clip and Sand Abnormal Nail: Using nail clipper and wet sander abnormal, loose, unattached nail is removed. There is absolutely no pain involved with this process. This process physically removes germs and allows for greater exposure to PinPointe Laser treatment’
  3. Top Layer Treatment: Topical Medication
  4. We treat the outside layer with topical antifungal medication. Medication is applied by you to nails, and the skin of the toes and soles every night before bed.

  5. Middle Layer Treatment: PinPointe Fungal Laser
    • PinPointe Fungal Nail Laser treatment kills the germs that hide in the nail bed. The laser sterilizes all types of germs including fungus, mold, yeast, and bacteria.
    • This procedure is repeated monthly to insure keeping a clean nail bed.
    • This procedure will kill germs that are released from spores in months to come.
    • This procedure will kill germs that may re-colonize the tissue from the outside.
    • We will repeat PinPointe Laser Treatment (called booster treatments) once per month.
  6. Deep Layer Treatment: Pulsed Lamisil Oral Medication

If your medical history permits, Lamisil tablets can be taken one daily for first 7 days per month. Treating with only 7 pills per month allows us to “seed” the deep tissue, and not overwork the liver. 7 pills per month is enough medication to get the deep job done as part of a 3 layer comprehensive treatment plan. Your prescription will say to take the medication every day for 90 days, but you will take only 7 pills per month.
What to Expect?
Your treatment will take 9-12 months. During this time you will be applying medication to your skin and nails every night. You will have PinPointe Laser booster treatments one per month. You will take Lamisil tabs, one tab per day for only the first 7 days of every month. At first you will see no visible change in the appearance of your toes, but as the months pass, if we are diligent and consistent with the treatment regimen, normal nails should slowly grow out from the nail root (matrix).
What will it Cost ?

  • Office visit charges apply for each visit. These are usually covered by your medical insurance but insurance copayments and deductibles may apply.
  • Initial PinPointe Laser Treatment charge is $500.00 (separate from office visits)
  • Booster PinPointe Laser Treatments $100.00 (separate from office visits)

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