However debilitating, most infections are curable. Ointment, plus the body’s natural healing ability, can take care of most external infections. A notable and rarely discussed exception is an affliction that finds safe harbor in San Antonio’s warm, humid climate: toenail fungus, or onychomycosis.
Since shoes hide (and exacerbate) the unsightly, sometimes fetid condition, it doesn’t exactly stick out like a sore – toe. Yet it afflicts about 10 percent of the U.S. population with greater rates along the aging curve – up to 90 percent in elderly people. Other risk factors include family history, poor health, fitness activities, a suppressed immune system and swimming in communal pools.
As sufferers know, a three-month cycle of antifungal pills completely cures the fungus only less than half the time and carries a risk of liver and kidney damage. Blood tests are necessary to monitor these risks. Applying a doctor-prescribed lacquer to the toenails daily for 48 weeks has a cure rate of less than 10 percent.
“With no prospects of a cure, the despair and embarrassment some patients feel often leads to a loss of self-esteem and even depression,” says local podiatrist Larry Cohen, D.P.M. “And while not being able to wear open-toed shoes may seem a superficial concern, in San Antonio’s summers, it adds to the discomfort of toenail fungus. For diabetics, it is a serious concern because their problems with healing can lead to amputation.”
As often is the case in science, a physician, working in California, began treating the infection with a laser device originally developed for other applications. The laser’s cure rate of 88 percent with just a single, painless treatment has been heralded as the long-awaited nemesis to toenail fungus.
Cohen is the first in San Antonio to obtain the device called the Pinpointe Footlaser, and to become certified to use it.
“The laser treatment is simply a focused light beam that kills fungus instantly,” Cohen says, “and causes no side effects whatsoever. After treatment, nails grow out normally, and the entire nail is new and healthy after six to nine months.”
Under Cohen’s supervision, a technician shines the thin laser light through the toenail. The laser destroys the fungi, molds and bacteria while causing no damage to the nail, skin and other healthy tissue. No anesthesia or injections are required, and the treatment takes about 30 minutes.
David Dittmer, one of Cohen’s first Pinpointe patients, found his way to the treatment through his wife, Judith. He has suffered with toenail fungus for at least 10 years.
“I saw an ad in the paper and went straight to the Internet to healthboards.com, and looked into it,” says Judith. “When I read the testimony of patients who had gotten laser treatment, I told David, ‘You have to do this. All these topicals you’ve been using, all the pills that can affect your liver ....”
David says his problem started with a single toe then spread, as it usually does if left untreated.
“I’m looking forward to being cured,” he said as a technician began to train the laser beam on his toenail.
Shoes as Petri Dishes
The fungi that infect toenails thrive in warm, damp climates such as San Antonio’s. Furthermore, golf shoes, worker’s boots and other closed-toe shoes are virtual Petri dishes for the fungi because our feet sweat up to eight ounces per day, per foot. Fungus spores, like seeds, can germinate even when shoes aren’t worn for months. To prevent re-infection after treatment, Cohen offers ultraviolet shoe sanitizers that clean the insides of shoes.
“It’s a no-brainer prevention method even if you’ve never had toenail fungus,” he says. “Your own shoes can infect your toes.”
