The most common cause of yellowed, thick and /or deformed toenails is a fungal infection of the toenail. The fungus that infects the nail, most commonly, is the same fungus that causes athletes foot. It tends to be slowly progressive, damaging the nail to a greater and greater degree over time. The infection usually starts at the tip of the nail and works its way back. It usually is not painful and often not noticed until it has gotten well established. A single toenail or any number of nails can be affected. It can also occur on just one foot. Over time, the nail becomes thickened, crumbly, and distorted in appearance. Sweaty feet contribute to the initial infection process and contribute to its spread. The fungus prefers an environment that is moist, dark, and warm, which is why it affects the toenails much more often than fingernails. It does not spread through the blood stream. The infection limits itself to the nails and skin. It is often found in association with areas of dry scaly skin on the bottom of the foot or between the toes. The dry scaling skin is frequently found to be chronic athletes' foot. It is not highly contagious, and family members are almost as likely to contract it from some other source as they are from the family member who has the infection. Keeping common showering areas clean is recommended, and sharing shoes should be avoided.

Diagnosis

Not all thicken or yellowed toenails are caused by a fungal infection. Injury to a toenail can cause the toenail to grow in a thickened or malformed fashion. This can be due to an established fungal infection or may be due to the damage caused to the nail root when it was injured. In these instances, treatment with anti-fungal medications will not correct the malformed nail. Other causes of thickened toenails are small bone spurs that can form under the toenail and psoriasis. Taking a scraping of the toenail and culturing it makes the diagnosis.

Treatment

It is best to treat the condition as soon as it is noticed. In early cases, over the counter medications may be sufficient. It is also important to treat any concomitant athlete’s foot that may be present. In more advanced cases, a prescription medication may be needed. There are effective topical and oral medications available for the treatment of fungal toenails. If sweating feet are a problem, changing shoes and socks during the day is recommended. There are some topical medications available that help to reduce the sweating of the feet. On occasion, your doctor may recommend removing the toenail.

source: Yelp

Dr. Young performed surgery in his Issaquah surgical suite. I had a bone spur removed and a repair from a previous surgery. He is the most caring physician I have ever encountered and I have plenty of experience with physicians. He is efficient and skilled and has a wonderful staff. His office was open until noon on Christmas Eve so he could do follow up on his surgical patients from that week. He is a dedicated professional and I would highly recommend him...The office called the night before to ensure I followed presurgery instructions. During my preop appointment I was given the needed perscriptions, walking boot and the perscription to get my handicap parking permit. The surgery was held right on schedule and I received a follow up call that night as well as the next day. I have had weekly postop appointments since and I am very pleased with the results. I can't say enough about this caring, talented physician and his staff.A.S. - Issaquah, WA

Dr. Young, I appreciate the thorough care that you provided. You did a great job not only with the surgery to correct my bunions, but also letting me know what to expect during the postoperative period.Harborview Emergency Room Nurse, Seattle, WA

After 6 months of being seen by my primary care and referred out to a DPM in my area. I was told there was basically nothing they could do for my toe infection besides antibiotics. I kept telling them that, I thought there was something still in my toe. I had two previous procedures that had removed many pieces of nail. I was in excruxiating pain and frustrated with not knowing exactly what was going on. I knew there was something wrong, it could not just "all be in my head" I then decided to find my own DPM for a second opinion. I was lucky enough to run across Issaquah Foot and Ankle. The staff there is great and Doctor Nelson listened to my concerns. He was able to explain to me what was going on with my infection and what my treatment options were. The pain in my toe is almost completely gone and there are no signs of infection after the surgery they performed. The staff followed up with phone calls before and after surgery. I was impressed to have a follow up phone call from doctor Nelson after surgery to see how I was doing. It was nice to know my care was important to them and that they do treat their patients like family. If I ever have any problems with my feet again, I will be going back to Dr. Nelson.C.K. - Cle Elum, WA

When I first saw Dr. Nelson I had been diagnosed with Parkinson's. Pain in my left foot was unbearable and we were not sure if it was related to the PD or was something new. X-rays showed damage to my left Achilles tendon and heel. Also present was a stress fracture. Dr. Nelson treated my problem conservatively at first and then felt surgery was necessary to make the repairs. Three month later, there is no pain and my gait is normal. I would recommend Dr. Nelson to anyone who is suffering from foot/ankle pain. He is very caring and gentle and listens to his patients. I was extremely impressed that an entire medical practice could be this professional.J.R. - WA (Thank you, very much for the kind words J.R.)

I was able to set up an appointment for very next day. Took me about 5 min for paper work. Before I was done with that I was already called in by nurse. Waited another 3 min for a doctor. And they have a pharmacy too. Nice!!!R.S. - WA (Thanks R.S., we strive to make everyone's visit as painless as possible!)

Your use of the TENS system as an adjunct for clinical pain management is one example of an exceptional level of professional care. Thank you so much.Melbern D.

I was having pain with every step, I even found myself limping. Dr. Nelson casted me for orthotics and the orthotics completely eliminated my pain. Thanks Issaquah Foot & Ankle Specialists!Alexus - age 13 - Issaquah, WA

Dr. Nelson has been awesome, he put me at ease tried a treatment, helped me be able to sleep finally and made a follow up after I called the following morning after my appt. He has let me know he is there for any questions whethere I continue to seek care or not.R.G. - WA