Fungal Toe nails and Photodynamic Therapy (PACT)

Fungal infections are very common on the toe nails leaving the nails looking discoloured, cracked and thick. Generally the toe nails aren’t painful and it is the cosmetic condition that means an individual seeks treatment.

How does an infection get into the nail?

Fungal infections can be caused by a multitude of different fungi that are already present in the environment. Damage to the nail can allow for a portal of entry for these fungi. Other factors which may contribute to being susceptible to a fungal infection include a compromised immune system, chronic diseases such as diabetes, circulatory issues and drug interactions.

Tips on reducing the risk of a toe nail infection
  • Always replacing your socks at the end of the day, sometimes doing this twice a day if you have particularly sweaty feet
  • Drying your toes properly after a shower/bath
  • Always wearing thongs in public showers/swimming pools
  • Checking to make sure your foot wear is correct to avoid unnecessary trauma
  • Not sharing nail clippers and files between family members
  • Allow your shoes to air out at the end of a day
Treatment options

It is worth seeing your myPod Podiatrist to determine the best course of treatment for your fungally infected toe nail. Depending on the severity of the infection, your myPod Podiatrist will provide some preliminary treatment and then discuss with you the best management strategy moving forward.

  • Topical over the counter treatments
  • Oral anti-fungals
  • Photodynamic therapy
  • Laser treatment

Photodynamic Therapy or PACT is a newer treatment we use for Onychomycosis or (fungal toe nail) infections.  Traditionally the two main form of treatments for onychomycosis are topical nail lacquers and oral anti-mycotics. Disadvantages for these are compliance of having to apply these lacquers (often daily) and the potential gastrointestinal side effects of the oral anti-mycotic medication.

At myPod Podiatry we are able to offer PACT as an attractive alternative. It has the advantage of being a very localised, non invasive treatment applied directly to the affected toe nail. It only requires 3 weekly consecutive treatments and then a one month follow up.

How it Works?

The process works by having ultraviolet light react with photosensitive agents. In the instance of fungal toe infection we apply a blue gel to the toe nail which causes the fungal toe nail become photosensitive by reacting to the normal light first. We then apply an ultraviolet light onto the toe nail for approximately 10 minutes creating a chemical reaction which destroys bacteria, viruses and fungi from the skin surface and nails.


A typical treatment would involve:

  1. Mechanical debridement – to reduce the thickness of the nail which will allow for better penetration of the nail gel.
  2. Gel application – of the photosensitiser (non toxic dye) and allowing this to sit for 10 minutes reacting with the normal light
  3. Light application – UV light applied to the photosensitive toe nail for 10 minutes.

Treatment frequency – Once a week for 3 consecutive weeks and then a 3 month follow up. In severe cases we may need a follow up after a month.

myPod PACT
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