Laser Toenail Fungus Treatment in Manhattan: Why Fungus Doesn't "Grow Out," and What Actually Works
By Dr. Kristina Janson, DPM · Walk Healthy, 185 Madison Ave, Suite 802, New York
Is it really toenail fungus?
Not always. We regularly see patients who are sure they have fungus, but their nails are actually thick from repeated injury, for example from hammertoes rubbing against the shoe. We also see the opposite: patients with clear fungus who think it's a bruise that will grow out. Both patients I saw recently were doctors, so don't assume you know. After 40 years as a podiatrist, I can usually tell in a quick visit, and we can test the nail if needed.
Why doesn't toenail fungus grow out like a bruise?
When you drop something on your toe, blood stains the nail. As the nail grows, you see the stain move out. Fungus is different. The fungal cell lives between the nail and the skin underneath it, called the nail bed. It's protected by the nail above and fed by the circulation below. From there it sends tiny "rootlets" up into the nail to feed on keratin, the protein that makes up your skin, hair and nails.
When the nail grows, you only lose some of those rootlets. The fungal cell itself stays in place and keeps making new ones. Waiting does not get rid of it.
Why don't creams, polishes or pills usually cure it?
Creams and polishes sit on top of the nail. They can kill some rootlets, but they can't get through the dense nail to reach the fungal cell underneath.
Pills reach the nail bed through the blood. They can kill rootlets there, but they don't reach the cell sitting above the bed, under the nail.
How does laser treatment work?
Fungus thrives in the dark, which is why mold grows in basements. Laser is a powerful, focused light. The nail is translucent (you can see the pink of the nail bed through it), so the light passes through the nail and reaches the fungal cell underneath. It's harmless to you. You just wear protective glasses during treatment.
How many laser sessions do you need?
More than one. Each session kills a portion of the fungus, maybe 10–30%, so it takes several rounds to reach every hidden cell. Spacing sessions a month or two apart makes each one more effective. A single session almost never clears it, and I'd be cautious about any offer that promises it will.
That's why our program is 6 laser sessions over a year, with a follow-up visit about 6 months later. If we need a bonus session then, it's included in the package.
Why does my nail still look bad after treatment?
The damaged part of the nail can't be repaired. I call it a "cooked chicken": you can't uncook it. A toenail takes 12–18 months to grow out completely, so even after the fungus is dead, it takes time for a healthy nail to replace the damaged part.
Why treat toenail fungus at all?
Fungal nails can get thick and painful, can cause ingrown toenails, and are contagious. They can spread to other people and eventually to your fingernails. Your immune system is also constantly fighting the infection at the nail bed, and you'd rather it fight colds and flu.
Does insurance cover laser toenail treatment?
No. Laser is considered cosmetic, so insurance doesn't pay for it, and you pay out of pocket. We offer it as one package so you know the full cost up front, and we go over it at your free assessment.
Free nail assessment in Midtown Manhattan
Not sure if it's fungus? Book a free 10–15 minute nail assessment with Dr. Janson at 185 Madison Ave, Suite 802. Call (212) 689-9388 or book online.
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