Setting the Pace

Nail Pathologies

Fungal and bacterial nail infections, as well as nail disorders, are fairly common. Our toenails are constantly exposed, therefore they tend to endure quite a bit of abuse. Moisture, poor hygiene, improper diet, genetics, and tight shoes can all encourage issues. With most common toenail conditions, the sooner you initiate treatment, the better. Schedule an appointment with our office to get started on your diagnosis and treatment plan.





Nail Abnormalities We Treat

Toenail Fungus

Toenail fungus is extremely common, especially in South Carolina where moist, humid environments are optimal for fungal growth. Onychomycosis is usually associated with thickened, painful, discolored toenails with debris underneath the nail.

In-Office Nail Biopsies
We can take samples in our office and send them to a lab that performs specific genetic PCR testing to diagnose not only if the fungus is present within the nail, but what type of fungus (there are hundreds of fungal species). This will help to better dictate treatment since nail fungus is not a one-size-fits-all infliction.

Regular Nail Debridement
Nail debridement involves the removal of a diseased toenail bed or viable nail plate. When toenails become too thick from fungal overgrowth, we have proper sterilized medical-grade instruments in our office to perform routine care for patients.

The Tolcylen™ Difference

Associated Foot & Ankle Specialists carries Tolcylen™ Antifungal/Nail Renewal Solution, developed initially to be marketed as a prescription drug, for purchase in its office. The system comprises anti-fungal skin cream, nail solution as well as shoe spray.

A Professional Nail Restoration System

KeryFlex Nail Restoration is a painless, in-office application that restores the appearance of an individual’s natural nails. This system allows for a certified provider to remodel an individual’s damaged nails affected by fungus, defects, and trauma. The composite resin creates a flexible, but durable, non-porous nail that allows the remaining natural nail to grow. The KeryFlex nail is an immediate cosmetic improvement providing a natural-looking nail. It is unaffected by acetone, nail polishes, or detergents.

KeryFlex Nail Restoration should not be used on individuals with peripheral vascular disease, arterial insufficiency, peripheral neuropathy, suspicious pigmented lesions on the nail, or in-grown toenails. It should be avoided in patients who are pregnant, nursing, or known to be sensitive or allergic to any of its ingredients.

In-Office Laser Treatment

GenesisPlus is the culmination of more than a decade of experience and one of Cutera’s most advanced Nd:YAG laser systems. The most powerful Nd:YAG laser for toenail fungus and skin rejuvenation. 

A specially designed laser beams through the toenail and safely kills the organisms embedded in the nail bed that cause Onychomycosis – more commonly known as toenail fungus.

The procedure requires one or a small number of safe, quick treatments with little or no discomfort and is performed as an outpatient service with no anesthesia. The gentle laser light beam has no effect on healthy tissue and treats only the infected area of the toe. No drugs or topical ointments are used, eliminating the total-body side effects of traditional oral medications.

Laser for Nails: One treatment every 3 weeks for 3 total treatments

  • 1-5 nails: $300 for all 3 sessions
    Optional maintenance session @ 3 months = $50

  • >5 nails: $450 for all 3 sessions
    Optional maintenance session @ 3 months = $75

Ingrown Toenail

Ingrown toenails occur when the side of the nail grows into the skin causing a “digging” sensation often coupled with irritation, pain, and swelling. Sometimes, bacteria can enter and cause an infection known as paronychia which may require antibiotics.

We provide a variety of in-office procedures to remove the offending nail border depending on the severity of your condition. For your convenience, we have provided all post-procedural nail instructions.

Non-permanent partial nail avulsion: Your toe is anesthetized with a local anesthetic, the offending nail border is removed with sterile tools, and a compressive dressing with antibiotic ointment is applied to the toe.

  • Ingrown Toenail Procedure (without phenol – for infected toenail): Includes initial visit + 2 post-op visits: $250

Permanent nail avulsions with chemical matrixectomy: When performed with a chemical matrixectomy, the nail will not regrow and you will no longer suffer from the problems your toenail was causing.

  • Ingrown Toenail Procedure (with phenol – for permanent removal): Includes initial visit + 2 post-op visits: $300

For non-infected ingrown toenails, we can perform a nail avulsion with chemical matrixectomy which has a high success rate in permanently treating ingrown toenails. The same procedure as above is first performed, but a chemical called Phenol is additionally applied to the nail root which stops nail growth at that site. Phenol is a colorless chemical derived from coal and essentially burns the nail root to prevent new growth.

The success rate for this procedure in the literature is >90%. Patients should expect higher volumes and duration of drainage after this procedure in the setting of a chemical burn.

Nail Lacerations

Sometimes when there is trauma to a nail (such as getting caught in the door or someone dropping something on their foot), the nail plate can be avulsed (ripped away) from the nail bed. This can sometimes also be associated with a fracture or a laceration underneath the nail which will require stitches. We workup these injuries and can care for them within an office setting.

Other Nail Diseases

There are many conditions that can cause changes in nail appearance and health, which we do see on a regular basis.

Psoriasis: Nail psoriasis is an autoimmune disease that causes discoloration, pitting, and changes in the structure of your nails.

Lichen Planus: Swelling and irritation in the nails.

Onycholysis: A spontaneous separation of the nail plate.

Brittle Nail Syndrome: Nails easily crack, chip, split, or peel, and can be observed as a sign of aging or in response to the long-term use of nail polish or exposure to moist conditions.

Onychogryphosis (Ram’s Horn Nails): A nail disease that causes one side of the nail to grow faster than the other. The nails are thick and curvy, like horns or claws.

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    (843) 852-9444


    (843) 852-9404

    Office Location

    2097 Henry Tecklenburg Dr. #210 West
    Charleston, SC 29414

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