Hi!  I am Dr. Segler and this video will explain Laser treatment for toenail fungus. 

Normally toenails are clear and healthy. But once they get infected with toenail fungus all of this changes. 

All it takes is for you to bump your toes up against the inside of the shoes where you get fungal spores stuck between the toenail and the nail bed underneath. Then the fungus starts to grow, and as it does it separates the layers of keratin within the toenail making the toenail thicker and causing the ugly discoloration you see on the surface of the toenail. 

To treat this your podiatrist moves the laser back and forth across the surface of the toenail in a grid pattern in order to destroy all of the fungus that is infecting the toenail. As the laser penetrates the toenail, the laser actually damages some of the cell components of the cell membrane of the fungus and starts to kill the fungus. The laser penetrates all the way through the toenail to kill the fungus. 

In this video you can see the laser moving back and forth across the surface of the toenail during an actual toenail fungus removal treatment. 

All you notice during the procedure is a little bit of warmth that might be generated as the laser kills the fungus. But after the procedure is over there is really no change in the appearance of the toenail at that time. The fungus is dead but you have to wait for the damaged areas of the toenail to grow out. You gradually trim off all of these damaged crumbly areas of the toenail over the next few months. Then you will have clear toenails.

If you think you have a fungal toenail you can actually call and talk directly to our podiatrist, or you can send a picture and we will take a look to see if laser treatment might work for you.  Call today! We do house calls to treat toenail fungus all over the Houston area. Call 

 
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Funky ugly toenails seem to plague runners. Toenail fungus is one cause of thick yellow toenails and it is very common. In fact 14% of Americans have toenail fungus. Based on this, if you are out for a run with six other runners, one of you probably has toenail fungus. 

Although running shoes can put you at risk of toenail fungus there are some simple steps you can take to prevent a toenail fungus infection from your running shoes.

Guns Don’t Kill People...

But flying bullets sure do! Spores are the seeds that give rise to a foot fungus infection. The spores are everywhere. And if they get into your shoes they can grow and multiply. The more fungal spores in your shoes, the more risk of toenail fungus infection. 

Active fungus thrives in any environment that is dark, warm and moist...like the inside of your running shoe. Running shoes are the perfect incubators for toenail fungus! If you get spores in there the active fungus starts to grow and sheds even more spores inside your running shoe. 

The Real Problem...

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The worst thing you can do is rush into the house after you finish your run, take off your running shoes and throw them into a dark, poorly ventilated closet. Or if you have been running on the treadmill at the gym you take your shoes and stuff them into your gym bag. 

Your damp running shoes will then sit in the dark and any fungus will thrive in that moisture from your sweaty feet. If you run every day, the running shoes never really completely dry out. These are ripe conditions for toenail fungus. 

The next day you put on your running shoes and head out the door. Not only is there active fungus within your running shoes but you have fungal spores which are basically the seeds for toenail fungus all lining the interior of your running shoes.

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So as you are running your toes hit the inside of the running shoes the fungal spores get wedged in between the toenail and the skin underneath. If you have any trauma to your toenails such as banging the end of the running shoe when you're running up or down hill (or stopping quickly) the fungal spores can actually get into the nail bed and start to develop a toenail fungal infection.

Once that happens the toenail fungus actually grows within the keratin of the nail plate separating all of the layers of the keratin and making the toenail thicker.

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All of that separation of layers in keratin of the toenail plate causes light to refract unevenly through the toenail. This is what causes the discoloration and crumbling of the toenail that creates the ugly appearance.

While it is possible to treat the toenail infection and kill the fungus, it is critical that you reduce your exposure to the fungus spores if you want to keep your toenails clear.  Remember, you have to stay out of the line of fire if you don’t want to get hit by the bullets. 

You must prevent the accumulation of active toenail fungus and fungal spores in your running shoes. If you don't, it will just be a matter of time before you get a fungal foot infection.

The best defense for a runner against toenail fungus is to make sure that you dry your running shoes out completely. Leave them somewhere where they will dry near a heating vent or in the sunlight.

If you are a high mileage runner and run on back-to-back days it might be a good idea to buy 2 pairs of running shoes. Alternate the running shoes so that they have a chance to dry out completely. This won't be any more expensive because the running shoes will last twice as long.

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It is also important to make sure that your running shoes fit correctly. If your toes are bumping the end of the shoes (as evidenced by discoloration such as bruising or dark spots under the toenail) you might actually be traumatizing the toenails when you run. This trauma to the toenail puts you at enormous risk of developing toenail fungus.

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If you had athlete’s foot or toenail fungus in the past you have to kill of all the fungus in your running shoes. The easiest way to do this is to use an ultraviolet shoes sanitizer. Ultraviolet light will actually kill all of the fungus without any odor or toxic chemicals. The other alternative is to spray the inside issues with chemical disinfectant. If you use a disinfectant spray to kill the fungus in your running shoes make sure that it dries out completely before you wear them again.

As long as you keep the fungus out of your running shoes and allow your shoes running shoes to dry completely after your workouts you should be able to prevent your toenails from turning yellow as the result of a toenail fungus infection.


Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices throughout the Houston Metro including the Montrose, Galleria area and  Pearland, Texas.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.

 
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Hi My Running Doc,


A couple of days ago I accidentally kicked the wall with my right foot. My foot still hurts and it is bruised.  I read on your website that bruising can be a sign of a metatarsal fracture. How can I tell if it is just bruised or if my foot is actually broken? I would love to have your expert opinion!


Thanks!
David, Houston, Texas.



Hi David, 

Bruising is a Bad Sign

It is true that bruising is a bad sign when it comes to foot and ankle injury. When you actually fracture a bone, the bone cracks and bleeds quite a lot. That blood diffuses throughout the soft tissue under the skin. What you see is a bruise. That is part of the reason that a bruise can be so concerning for a fracture in the foot. 

In fact the sort of bruising pattern that the picture of your foot shows is often indicative of a fracture or broken bone in the foot. Given your pattern of bruising it is more likely that you have a metatarsal fracture or a fracture in one of the bones in the little toe such as the proximal phalanx phone.


Myths about Foot Fractures

1.  If you can walk on the foot, it can’t be broken.  FALSE!

This may be one of the most widely perpetuated myths about foot injury on the Internet. I have seen many patients with serious fractures that are walking on the foot. Some patients are limping and obviously in a tremendous amount of pain while other patients with fractures or broken bones barely feel any discomfort at all. This is not a reliable indicator of whether or not you have a broken bone in your foot.

2.  There is nothing you can do for a broken toe.  FALSE!

This is also absolutely not true. While it is true that most fractures in the toe will heal uneventfully, there are things you can do to speed healing and decrease your risk of complications. Fractures of the bones in the toe can move if not properly stabilized. Certain shoes will speed healing. Taping the toes to provide stability and immobilize the fracture will also help. But some toes should never be taped together. 

Without the proper treatment of a broken toe, the fracture can fail to heal leading to what physicians refer to as a nonunion. A fracture that never heals correctly can lead to pain, disability and interfere with your ability to run or even walk without pain.  Occasionally patients that take the approach that “nothing can be done for fractured toe” just end up in surgery later.  For the most part this is avoidable if the toe treated correctly.

Diagnosis and Treatment Options

If you are suspicious that there might be a broken bone in your foot (or in one of your toes) it is best to figure out whether or not it is actually broken.  The best option is to have an in-person evaluation by a sports medicine specialist such as a sports podiatrist.  The second option is to have a remote consultation with a sports podiatrist via webcam. A third option is an attempt at self-diagnosis. This video on YouTube can show you how to perform self-diagnosis of metatarsal stress fractures. This same video would apply in your case if the pain is located where you’re bruising is in the foot.

If you see a physician in person or via webcam or you perform your own self-diagnosis and think that you probably have a fracture then you should get x-rays. X-rays will not only confirm (or rule out) a broken bone in the foot but it will also give you an idea of the severity of the problem. There are some fractures that absolutely must be treated surgically. Others simply need a fracture walking boot in order to stabilize the fracture and allow it to heal. And occasionally it is necessary to use crutches. 

But not all fractures are the same. So if you have pain and bruising after this sort of injury and suspect that you have a fracture in your foot it is important to determine whether or not there actually is a broken bone, and treat it appropriately. As long as you treat the fracture correctly you should be able to heal and then get back to running.

Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices throughout the Houston Metro including the Houston Heights, The Woodlands, Baytown and  Sugar Land, Texas.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.

 
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Barefoot running has increased in popularity in recent years. In fact, Dr. Segler recently lectured at a medical conference on the topic of barefoot running trends. Part of the appeal in barefoot running technique is to increase your efficiency by using more natural running biomechanics in order to hone your running form.

The American Podiatric Medical Association has a position statement declaring that barefoot running is an unsafe activity and is not recommended by podiatrists. Of course not all podiatrist agree with this position. I happen to be one of those dissenting physicians.

Toenail fungus is common among runners. In fact all fungal infections are common among runners. Particularly athlete's foot. Athlete's foot is nothing more than a fungus infection of the skin on the foot. A toenail fungus infection is actually caused by the same organism that causes athlete’s foot.

When you run your feet sweat, moisture collects in your shoes and the ideal environment for fungal growth is created. If you run on back-to-back days the problem is compounded because your running shoes never completely dry out.

If you happen to develop a case of athlete's foot, the fungus is growing between the layers of the skin. As the skin peels it sheds fungal spores into your shoes. These spores of course are the seeds from which fungus grows.

If you are running, doing hill repeats or some other strenuous workout, and you repeatedly bumped the toes and the end of of the toenail on the inside of the running shoe, the fungal spores can get between the toenail and the underlying nail bed. The fungal spores begin to grow and develop into a fungal toenail infection.

However when you run barefoot, you not have any risk of bumping the toenails repeatedly against an inside of a running shoe that is ripe with fungus. So in that respect, running barefoot is actually much lower risk for developing a toenail fungus infection as compared to running with running shoes.

The risk is mainly related to the potential for fungal spores to collect in your shoes and then have trauma where those spores are actually in contact with the toenail in such a way that they can become embedded in or underneath the toenail and start to grow. If you are wearing minimalist running shoes such as the Vibram Five Fingers without socks the risk of developing one of these toenail infections actually increases significantly. 

If you start to notice discoloration such as white or yellowish spots where the toenail seems to be changing and getting thicker it could be a fungal toenail infection. Treating these infections is not really a big deal. Our podiatrist can actually bring a laser to your home or office in order to directly kill the fungus and help your toenails returned to their normal clear and healthy state.  For more information on discount toenail fungus laser treatment and laser toenail fungus removal treatment visit http://www.lasertoenailhouston.com/

Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices throughout the Houston Metro including Downtown Houston, the Houston Heights and  Sugar Land, Texas.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.

 
The laser treatment will kill the fungus in your toenails. But to keep your toenail clear after the laser toenail fungus treatment you have to make sure you don’t get re-infected with toenail fungus. Up to 50% of patients who effectively treat the toenail fungus infection will get the nasty infection again within a few years. 

The key is to keep the fungal spores under control.

Spores are basically the seeds from which toenail fungus grows. They are very durable. In fact, fungal spores can lay dormant for many years and still remain viable. Just place the spores in a warm, moist, dark environment and they will start to grow sprouting a new toe fungus infection. 

The laser will effectively remove the fungus from your toenails, but that is only the first step.

The whole time you have had a fungal infection, you have been shedding fungal spores into your shoes and socks. Getting free of the spores is the best way to prevent the fungus from infecting your toenails again. 

1. Wash all of your socks in hot water. This will get rid of the fungus and spores in your socks. Some people throw out all of their socks and replace them. But this isn’t really necessary. 

2. Kill the fungus in your shoes. Use an antiseptic spray or an ultraviolet sanitizer to kill the spores and live fungus in your shoes. Bowling alleys have been doing this forever. They simply spray some toxic chemicals in the bowling shoes to kill all of the germs between rentals. Sprays like Lysol will work, but frankly they make your shoes smell like Lysol. So if you are going to try this, make sure you test it out on a pair of shoes you aren’t crazy about before you spray all of your shoes. The Steri-Shoe is a much nicer alternative. It uses ultraviolet light to destroy the live fungus and spores in your shoes. No smell, no toxic chemicals and no waiting to dry the shoes out. You can order one online at a discount here.

3. Watch out for and aggressively treat any athlete’s foot. The fungus that causes athlete’s foot is the same one that causes toenail fungus infections. Those little spots of peeling skin are the classic sign of athlete’s foot. Many people think that if the skin doesn’t itch, it isn’t athlete’s foot. This is false. 

Every time I see a patient who wants the toenail fungus laser removal treatment I ask them if they ever get athlete’s foot. Less than 10% say yes. But about half of all the laser toenail patients actually have signs of an active case of athlete’s foot that they haven’t even noticed. 

So it is possible that you could pick up a case of athlete’s foot and not realize it. You should check your feet every day. Look for peeling skin around the edge of the sole and between the toes. 

If you get athletes foot, you are actually growing fungus between the layers of skin. As the skin peels, fungal spores are shed into your socks and shoes. Then all it takes is to bump your toenails on the inside of the shoe and those spores can get in again start another toenail fungus infection.

If you notice some athlete’s foot don’t panic. You can simply apply an over-the-counter cream for a couple of weeks to cure the skin infection. Of course you will want to use the Steri-shoe ultraviolet sanitizer in your shoes again and wash your socks in hot water, just like you did after the laser procedure.

Taking these simple precautions you will help ensure that your toes stay clear, healthy and fungus free!  If you have a question about a toenail fungus infection, call the toenail fungus expert directly at 713-489-7674.


Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices throughout the Houston Metro including the Montrose, Galleria and The Woodlands, Texas.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.
 
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When you have a toenail infection, the fungus is growing under, and within the toe nail. As the fungus grows, the fungus sheds spores which are basically toe fungus seeds. These spores can end up in your socks. If you don’t get rid of the spores you will be at a higher risk of getting the toenail fungus again even after you have successfully rid your toenails of the nail fungus with the laser fungus removal treatment. 

On strategy is to simply throw out all of your old socks and buy new ones. But this is usually not necessary. If you wash your socks in hot water, it should get rid of the fungus in your socks. 

Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices throughout the Houston Metro including the Montrose, Galleria and The Woodlands, Texas.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.

 
The laser toenail fungus removal procedure kills the fungus on contact by directly damaging components of the fungal cell membranes. But the appearance of the toenail is not related to whether the fungus is living or dead. The funky appearance of a fungal toenail is more related to the damage the toenail fungus causes to the keratin in the toenail.  

The ugly thick, yellow appearance of fungal toenails is actually related to the separation of the keratin into distinct layers. The toe fungus grows within the toenail and separates the toenail plate, causing the toenail to become friable and crumble. When the toenail keratin separates, light refracts unevenly through the toenail. The result is that the toenail appears yellow, white of otherwise discolored.  

The actual appearance of the fungal toenail will not change during the laser procedure. The laser will kill toenail fungus on contact during the laser treatment. But you will have to wait for the dead fungus and newly treated toenail to grow out.  

This is when the clear, healthy-appearing toenail will start to change. It takes about 8 months to one year for a new toenail to grow all the way out. So if your toenail is 50% yellow, it will likely take about 4-6 months for you to regrow the toenail.  

As the the toenail grows out, you of course will be trimming the funky, crusty, discolored toenail. As you trim the toenail, you will slowly see the clear healthy nail returning.  

Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices in the Houston Heights, Montrose and Cypress, Texas.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.


 
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If you have toenail fungus, you probably have fungal spores in your shoes. This is not a cleanliness issue. It is just a fact of life with a fungal toenail infection.

The longer you have had the toenail fungal infection, the more likely it becomes that shedding spores (that have the potential to sprout a new fungus infection) are collecting inside your shoes.

Some patients are so afraid of getting a re-infection from the toenail fungus,that they will get rid of the old shoes and buy all new shoes. This isn't really necessary.

Another strategy is to wash the shoes in hot water. Washing your shoes in hot water is not really a great idea as this would obviously ruin most shoes. There are other ways you can get the fungus out of your shoes. 

One way to get rid of the fungus in your shoes is to spray the inside of your shoes thoroughly with a disinfectant spray like Lysol. Be prepared for the shoes to smell like Lysol. Make sure you dry the shoes completely before wearing. 

Another less noxious option is to kill of of the fungus and fungal spores with an in-shoe ultraviolet sanitizing light, like the Steri-Shoe ultraviolet sanitizer. UV light is toxic to fungus, killing live fungus and spores that collect inside your shoes. Using a Steri-Shoe ultraviolet sanitizer will reduce the risk of becoming re-infected with toe fungus after you have cured the fungus infection with the laser nail fungus treatment. 


Dr. Christopher Segler, DPM is Board Certified, American Board of Podiatric Medicine.  He believes the best podiatry practice combines cutting edge technology with the old-school convenience of house calls. He makes podiatry house calls for young active adults who want to get rid of their funky toenails as quickly as possibly. He brings the laser to homes and offices in the Houston Heights, Sugar Land and The Woodlands.  If you have a question about fungal toenail laser treatment, you can reach him directly at  713-489-7674.

 
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Question: Is the the laser your doctor uses to remove toenail fungus an infrared laser?
 
The laser used by San Francisco laser toenail housecalls is one of the newest medical lasers on the market.  In fact it has is only been on the market for less than a year, at the time of this writing.  Like most technologies, there are continual improvements with equipment and techniques. This newer laser is much more compact than older models allowing us to bring it on house calls.

The laser that we bring to your home or office in order to remove the toenail fungus and treat your toenail fungal infection is a  multifunctional medical diode laser system.  The laser is capable of  radiating light in a number of wavelengths including 810 nm, 980 nm, and 1064 nm.

The 1064 nm wavelength is the wavelength that is currently considered to be the most effective at treating onychomcosis (fungal toenail infection)1,2.  We use the new German-made A.R.C. Laser Medical Diode Laser System. 

When we bring the A.R.C. Laser to your home or office the podiatrist will program the laser system to produce a laser beam in the 1064 nm wavelength.

The light spectrum can be divided by wavelength as follows:
Gamma ray: less than 0.01 nm
X-ray: 0.01 nm to 10 nm
Ultraviolet: 10 nm – 380 nm
Visible light: 380 nm – 700 nm
Infrared: 700 nm – 1 mm
Microwave: 1 mm – 1 meter
Radio: 1 mm – 100,000 km

The medical laser system we use to treat toenail fungus is 1064nm. Since 1064nm is greater than 700 nm and less than 1 mm, this means that the laser beam is categorized as an “infrared” beam of light energy.

The laser beam itself is invisible. When the treatment is being performed, you will see a small spot of light moving back and forth across the toenail. The light you see is not actually the laser. The light you see is simply an aiming light.  Because the laser beam itself is invisible it’s necessary to have an aiming light that allows the doctor properly direct the laser beam in order to kill the fungus that’s within the toenail.

The laser can kill the fungus. But the laser can also damage your eyes.  looking directly into the laser beam or from light reflected by the medical laser beam system could cause serious eye injury. 

Even though the laser is invisible (unlike a laser pointer)  you have to protect your eyes from damage. Both you (the toenail fungus patient) and the doctor performing the laser toenail fungus removal procedure will wear protective eyewear that will shield you from any possible harm. The doctor will bring and supply a pair of specially constructed glasses that protect your eyes during the laser toenail fungus treatment. 

The protective glasses simply look much like green tinted sunglasses.  You can still see just fine with the glasses on. Because the procedure takes about 20 minutes or so, most patients will work on a laptop computer or an iPad while they are having the laser toenail fungus removal procedure. The laser protection eyeglasses not interfere with these activities at all.

Dr. Christopher Segler, DPM is board certified, American Board of Podiatric Medicine.  He believes that the best medicine can be fast, convenient and low-cost treatment. His innovative housecall podiatry practice model helps to keep costs down for patient with making expert care more convenient than ever.  

If you have a tight work schedule we can even see you in your own office.  We often do house calls for executives so that they can be seen between meetings.  When there is no time to waste, a house call is definitely the best treatment and just what the doctor ordered!  

We offer house calls all over the Houston area, including the Galleria Area, West University, Bellaire, Southside Place, Downtown Houston, Midtown Houston, Uptown Houston, Memorial, Montrose, Houston Heights, and Washington Heights.

If you have a question about toenail fungus and wonder whether or not the laser fungus removal treatment might be right for you, you can call and speak directly with a toenail expert by calling  713-489-7674.  And yes, you will actually get to speak with the doctor.

 
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I recently had a doctor as a fungal toenail patient who asked me this question. He wasn’t a podiatrist, so infected toenails are not his specialty. 

The question is an interesting one and speaks to the conception that many people have about lasers. Many think that a laser is a laser.

All lasers are not the same. 

Some lasers cut steel, others kill toenail fungus and some only highlight presentations. 

Laser pointers are not medical lasers and cannot treat toenail fungus. 

Here is why:

The medical laser we use to treat kill toenail fungus is 1064nm wavelength YAG laser. This is the wavelength that has been shown in clinical trials to remove the toenail fungus that infects the toenail plate causing a toenail infection (known as onychomycosis). 

Laser pointers are all a much shorter wavelength than the toenail laser:
       Red laser pointers are 635nm wavelength
       Green laser pointers are 532nm wavelength
       Blue laser pointers are 445nm wavelength 

All three varieties of laser pointers are within the visible light spectrum  (380 nm – 700 nm).  A medical laser used to remove toenail fungus and treat a fungal toenail infection is an infrared laser (1064nm)and the light energy from it behaves much differently. 

The nail fungus treatment laser beam has the ability to directly damage components of the toenail fungus cell membranes and kill the fungus. Laser pointers that are used to highlight a powerpoint presentation simply can’t remove the toenail fungus from the infected toenail. 

Dr. Christopher Segler, DPM is board certified, American Board of Podiatric Medicine.  He believes that the best medicine can be fast, convenient and low-cost treatment. His innovative housecall podiatry practice model helps to keep costs down for patient with making expert care more convenient than ever.  

If you have a tight work schedule we can even see you in your own office.  We often do house calls for executives so that they can be seen between meetings.  When there is no time to waste, a house call is definitely the best treatment and just what the doctor ordered!  

We offer house calls all over the Houston area, including the Galleria Area, West University, Bellaire, Southside Place, Downtown Houston, Midtown Houston, Uptown Houston, Memorial, Montrose, Houston Heights, and Washington Heights.

If you have a question about toenail fungus and wonder whether or not the laser fungus removal treatment might be right for you, you can call and speak directly with a toenail expert by calling  713-489-7674.  And yes, you will actually get to speak with the doctor.