Question 1

What is a fungal nail?

Accepted Answer

A fungal nail (onychomycosis) is an infection of the nail and nail bed by fungi, usually dermatophytes. As a result the nail can discolour, thicken, become crumbly or come loose. It mainly affects the toenails.

Question 2

How do I recognise a fungal nail?

Accepted Answer

Common signs are a yellow, white or brown discolouration that often starts at the free edge, a thickened or dull nail, crumbly material under the nail and a nail that (partly) comes loose. Often one nail is affected first, usually the big toe. Sometimes there is also athlete’s foot between the toes.

Question 3

Is every yellow or thickened nail a fungal nail?

Accepted Answer

No. Trauma (for example from tight shoes or sport), nail psoriasis, eczema and ageing can also make a nail yellow or thick. That is why we first assess your nails carefully. If in doubt, we advise mycological testing via your GP.

Question 4

Are fungal nails contagious?

Accepted Answer

Yes. The fungus can spread via skin flakes to other nails, to the skin of your feet and to people you live with, especially in warm, damp places such as showers, swimming pools and changing rooms. Good hygiene and flip-flops in shared wet areas reduce that risk.

Question 5

Can fungal nails go away by themselves?

Accepted Answer

Almost never. Without treatment a fungal nail usually persists and can slowly spread. A fungal nail is not dangerous, so treatment is not a must. It can, however, cause discomfort or spread.

Question 6

How does laser therapy work for fungal nails?

Accepted Answer

We use the Nd:YAG 1064 nm wavelength of the Lutronic Clarity II. This light penetrates the nail plate and is converted into heat in and under the nail. The aim is to damage the fungal tissue with that heat, so a healthy nail can grow out. The existing discoloured part of the nail always has to grow out.

Question 7

Does the laser treatment hurt?

Accepted Answer

Most people experience the treatment as warm, sometimes with a brief, prickling moment of heat. We pause as soon as it gets too warm. No anaesthetic is needed and you can walk straight away.

Question 8

How many laser treatments do I need?

Accepted Answer

We usually work with a treatment plan of six treatments: three treatments in quick succession, a growing-out period of 8 to 12 weeks and then three more treatments, followed by another growing-out period and a check-up. The exact number depends on the number of affected nails, the severity and progress. Six treatments are no guarantee of a particular result.

Question 9

Is laser therapy proven to be effective?

Accepted Answer

The scientific evidence is limited and mixed. The Dutch GP guideline on dermatomycosis (NHG) assesses laser and light therapy as not effective based on current research; international review studies speak of low-certainty evidence. Oral antifungal medication is better supported for some people. We see the laser as a possible option within a personal plan, never as a guaranteed cure.

Question 10

Can I put my shoes on straight after the treatment?

Accepted Answer

Yes. There is no recovery time. Preferably put on clean socks and wear shoes that you let dry properly between wears.

Question 11

Can a fungal nail come back after laser treatment?

Accepted Answer

Yes, just as after other treatments. Sometimes the fungus had not completely gone, sometimes a new infection develops from athlete’s foot, shoes or shared spaces. Consistent home care, treating athlete’s foot and ongoing prevention reduce that risk, but don’t rule it out.

Question 12

Is laser treatment suitable for everyone?

Accepted Answer

Not always. With diabetes, reduced sensation in the feet, poor circulation, open wounds or inflammation around the nail, extra caution or a medical assessment first is needed. During pregnancy we postpone the treatment as a precaution.

Question 13

When will I see improvement?

Accepted Answer

Right after a treatment you usually see little difference; that is normal. Improvement becomes visible as a clear nail grows forward from the nail root. With toenails you usually only see this after a few months. We track this with photos.

Question 14

How long does it take for a toenail to grow out completely?

Accepted Answer

A toenail grows about 1 to 1.5 millimetres per month. A complete big toenail therefore often needs 12 to 18 months to renew, sometimes longer in older people or with poorer circulation. Fingernails are usually renewed within 4 to 6 months.

Question 15

Why does my nail still look yellow after treatment?

Accepted Answer

The laser does not make the existing, affected part of the nail clear. That old part stays yellow or thickened until it has grown out and been clipped off. What matters is the new nail from the root: if it is clear and smooth, that is a good sign.

Question 16

Can a severely thickened nail become normal again?

Accepted Answer

Sometimes, but not always. If the nail bed has been affected for a long time, a nail can remain slightly thicker or more irregular even after a successful treatment. Professional filing to thin the nail helps with comfort and with the treatment.

Question 17

Can my shoes be a source of reinfection?

Accepted Answer

They can. Skin flakes and fungal spores can remain in shoes, especially shoes that are often damp. That does not mean every shoe is contaminated. Letting them dry properly, alternating and possibly a suitable shoe spray reduce the risk.

Question 18

Do I need to throw away my shoes?

Accepted Answer

Usually not. Let shoes dry for at least 24 hours, alternate them and use a shoe spray if needed. Only old, worn-out shoes that always feel damp or smell musty are better replaced.

Question 19

How do I prevent my fungal nail from coming back?

Accepted Answer

Dry your feet well, including between the toes, change your socks daily, let shoes dry and alternate them, wear flip-flops in shared wet areas, use your own nail tools and have athlete’s foot treated. Keep this up after the treatment plan too.

Question 20

Can athlete’s foot cause a fungal nail again?

Accepted Answer

Yes. Athlete’s foot between the toes or on the sole of the foot is one of the main sources of (re)infection. That is why we also look at the skin of your feet and advise treatment if needed.

Question 21

Does my partner need treatment too?

Accepted Answer

Only if your partner or housemate has athlete’s foot or fungal nails themselves. Then it is wise to have that treated too, because otherwise you can reinfect each other. In any case, use your own towels and nail tools.

Question 22

What does fungal nail treatment cost?

Accepted Answer

A single laser treatment costs €75 for one foot or €112 for two feet (up to ten toes). The complete treatment plan of six treatments costs €499, including guidance, interim assessments and a home kit worth €45. The intake is free of charge.

Question 23

Is laser treatment reimbursed by health insurance?

Accepted Answer

Laser treatment of fungal nails is generally not reimbursed by the basic insurance. Some supplementary insurance policies reimburse part of foot care or skin therapy; check your own policy for this.

Question 24

Can I have fungal nails treated during pregnancy?

Accepted Answer

As a precaution, we don’t start laser treatment during pregnancy. Oral antifungal medication is also not recommended then. A fungal nail is not dangerous, so waiting until after the pregnancy is usually perfectly possible.

Question 25

Can I combine laser therapy with antifungal medication?

Accepted Answer

In consultation, that is possible. If you already use medication or nail lacquer prescribed by your GP, we don’t change anything about that. Let us know during the intake.

Question 26

When is it better to see my GP?

Accepted Answer

With diabetes, reduced circulation or immunity, pain, redness, swelling or pus around the nail, when several or all nails are affected, if there is doubt about the diagnosis, or if you prefer a better-supported medication-based treatment.

Fungal nail treatment in Almere

In short

What are fungal nails?

Not every abnormal nail is a fungal nail

How do you get fungal nails?

Treatment doesn’t stop at the nail

Three situations that look alike

Laser therapy for fungal nails

This is how a treatment goes

What does the science say?

From intake to evaluation

Results from our clinic

What can you do yourself?

Investing in a careful approach

Expert, careful and personal

All about fungal nails

Explore further

Have your nails professionally assessed

What would you like to work on?

{{bConcernName}}: what suits you?

Intake with skin analysis