Dr. Oz Talks Feet

On January 25, 2011 Dr. Oz did a piece on nail fungus. This is probably because nail fungus is becoming a very common problem.  Nail fungus occurs in the toenails of the foot.  Nail fungus in toenails can be identified in many ways. The toenail may be thick and turn white, yellow, and brown. Fungal infections in the nail are called onychomycosis.  Many patients develop nail fungus in the nail, and if not treated effectively all of the nails can become infected.

The problem with nail fungus, or onychomycosis, is that if it does go untreated the thickness of the nail can cause ingrown nails or an infection of the nail.  Many times patients who are diabetic and have onychomycosis can have complications, such as infection, just from the thickness of a toenail. Patients that have diabetes or other patients that may be compromised, sometimes have a hard time healing from infections caused by the nail.  This is why it is so important to treat toenail fungus to prevent further progression.


There are multiple causes for nail fungus or onychomycosis.  The most common reason for nail fungus is trauma.  Trauma occurs either by the actual bumping of the nail against a surface, like stubbing your toe, or more commonly tight shoe gear. Fungus grows from inside the shoe and cross infects the skin. It can be an ugly cycle of shoe to skin and skin to shoe fungal infections.  Lastly instruments that are not properly sanitized may play a role.

Dr. Oz mentioned treatment with vinegar for onychomycosis, which we feel is a myth. Oral medications for nail fungus are quite toxic for the liver and should be prescribed with caution.  Some of the newer, more effective treatments include mechanically cutting the nail and thinning it out. This should be performed professionally by a podiatrist.  There are very effective topical treatments for onychomycosis.  A new topical medication called Formula3 is a very effective way of treating nail fungus. This medicine penetrates through the nail to the nail bed to kill the fungus.  The new technique for eradicating onychomycosis is laser treatments, which are effective and safe.  Podiatrists are now providing laser treatments from their offices.  You can see the results anywhere between six to twelve months from the end of the treatment.  One other problem we see in most patients is improper shoe gear. This occurs because we walk with the toes extending upwards, which hit the top of the shoe. It would be wise to have a foot doctor evaluate the shoe gear and prescribe a shoe that has enough width for the sides of the toes and enough depth for where the toes extend (extra depth shoes are useful).  Lastly treating the shoe is just as important as treating the nail infection to prevent recurrence of the nail infection.   There are devices that can irradiate the shoe to prevent fungal infection.  Moisture control of the skin of the foot should be evaluated as well.  The best clinician to evaluate these problems would be a podiatrist.