Read about Laura Milne’s Experience at our clinic in The Express


Martine Abrahams prepares to take on the challenge of Laura’s infected toenails

Tuesday June 5,2012

By Laura Milne

IT’S safe to say my feet have never been my best feature but until I got married six years ago I never paid them much attention. Then during a pedicure the night before my wedding the beautician smacked me on the foot with her file and told me in no uncertain terms she shouldn’t be touching my feet at all.


It seemed my husband-to-be had taken the old adage “what’s mine is yours” rather seriously and had passed on his fungal nail infection.

Several years on and despite a few half-hearted attempts to deal with it by using various over-the-counter potions from the pharmacist it has stubbornly remained and has now spread to the neighbouring toe.

Between 10 and 25 per cent of us suffer from some kind of fungal nail infection or onychomycosis to give it its proper name. There are three or four types of infection but the most common is caused by dermatophytes – which makes the nails become yellow or brown in colour and have a crumbly texture – or candida, which is a yeast that gives the nails a yellow or white powdery appearance. This is caused by microscopic fungi entering the nailbed through tiny cracks, cuts or small separations between the nail and bed.

Cutting the nails too short or over-zealous pedicuring, as well as damage to the nail caused by wearing ill-fitting shoes or playing sport, are all to blame.

The difference with laser treatment is that it is localised.
Martine Abrahams, a podiatrist at the London Nail Laser Clinic

A typical first sign is a white or yellow spot under the tip of the nail. As it spreads the nail becomes more discoloured. It may also thicken and develop a distorted shape and the edges may become brittle and deteriorate.

It is not only unsightly but can also be painful and the nail becomes impossible to cut at home. In some cases the infected nail even separates from the bed.

If this is combined with poor circulation due to age or numbness (often seen in diabetics) it can cause real problems.Men tend to be affected more often than women as are those who use gym or swimming pool changing rooms or have sweaty feet.

Fungal nail infections are very difficult to treat. Once you develop one it is unlikely to go by itself. Our bodies can fight off viruses or bacterial infections but not fungus.

Traditional treatments include topical anti-fungal solutions such as Curanail which are painted on to the nail or oral anti-fungals for more stubborn infections.

They have to be taken for several months and can cause unpleasant side effects such as nausea, headaches or abdominal pain. In extreme cases they can even cause liver damage.

In search of a less severe cure I seek out Martine Abrahams, a podiatrist at the London Nail Laser Clinic who has successfully treated 2,500 patients using a laser treatment called the Cynosure PinPointe FootLaser.

Developed in the US it uses an infrared beam to target the fungal spores and nailbed.

It is administered via a pen-type device that is passed over the entire surface of the nail and back over the bed. The spores react to the heat which breaks up and destroys them.

“The difference with laser treatment is that it is localised so it only treats the immediate area and healthy tissue is left undamaged,” explains Martine.

It isn’t painful but I can feel the nail heat up as the probe passes across the surface. Occasionally there are popping noises and I can see little sparks caused by the laser burning away spores on the surface of the nail. When the nail becomes hot I can feel little pinpricks of heat.

If it works, in a couple of months time the new healthy nail should start to become visible as it grows – hopefully reattached to the bed.

WHILE effective in one treatment the clinic advises a follow-up to ensure infection is cleared. Risk of re-infection is high. Martine recommends over-the-counter creams Canesten and Lamisil sequentially following the treatment.

She also prescribes separate towels to dry the infected areas, wiping the shower or bath with antiseptic wipes before and after use, washing socks and bed linen at 60ºC to kill the spores and spraying footwear with an anti-fungal spray.

There is also an ultraviolet shoe sanitiser (www.sterishoe. to kill the bacteria and fungus in the ends of the shoes.

Cynosure PinPointe FootLaser treatment costs from £400 for one foot or £500 for both.