Quick answer: Treatment for thick toenails causes treatment trimming follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.

Watch: Tea Tree Oil Toenail Fungus Home Treatment [Doctor Cure!] — MichiganFootDoctors YouTube
Thick Toenails Causes Treatment Trimming is one of the most common reasons patients book a podiatry visit with Balance Foot & Ankle. Our three board-certified podiatrists — Dr. Tom Biernacki DPM (950K+ YouTube subscribers, 156M+ educational views), Dr. Carl Jay DPM, and Dr. Daria Gutkin DPM — have evaluated and treated this exact concern thousands of times. On this page you’ll find the clinical context, the evidence-based home-care options most patients try first, the three products our doctors recommend most often, and the warning signs that mean it’s time to call a podiatrist instead of continuing home treatment.
If the discomfort has been present for more than a few weeks, if it disrupts sleep, walking, or your usual activity, or if there is visible redness, swelling, bruising, drainage, numbness, or color change, an in-office evaluation with a podiatrist is the fastest path to relief. Home care alone rarely resolves a condition that has become structural. Our diagnostic workup includes same-day digital X-ray, in-office diagnostic ultrasound, and a gait evaluation — results are explained to you during the visit, and we build a written treatment plan with clear next steps.
Topicals only penetrate the top 30% of the nail plate — if the fungus is near the cuticle or under 50% of the nail, oral terbinafine or laser is usually required for full clearance. Balance Foot & Ankle offers in-office fungal nail diagnostics and laser treatment that reaches the nail matrix where topicals can’t. We’ll examine the nail and recommend the fastest path to clear, healthy regrowth.
What to expect at your first visit:
- Appointments at both offices — book online 24/7
- Digital X-ray and ultrasound available on-site (no second trip)
- Most insurance accepted — BCBS, Aetna, UHC, Cigna, HAP, Priority Health, Medicare
- Conservative care first, with surgery only when truly needed
- Written treatment plan with specific milestones
- Offices in Howell and Bloomfield Township, Michigan
Book a Visit at Balance Foot & Ankle
Three board-certified podiatrists · 1,200+ five-star reviews · book online 24/7 · most insurance accepted.
Howell · 4330 E Grand River | Bloomfield Township · 43494 Woodward
More Podiatrist-Recommended Fungus Essentials
Breathable Diabetic Shoe
- Tie-Less Lacing System eliminates the need to tie laces. Heel strap enables to adjust the grip around the heel. Cushioning sole with a mild Rocker adds spring to your step. Soft, padded fabric interior with no overlays eliminates irritation.
As an Amazon Associate, Balance Foot and Ankle earns from qualifying purchases. Product links are affiliate links and we may earn a commission at no extra cost to you. This does not influence our clinical recommendations. Last update on 2026-10-18 / Images from Amazon Product Advertising API
Orthofeet Sprint — deep, breathable design reduces fungal growth.
Moisture-Wicking Sock
- Provides continuous support of the Plantar Fascia by gently stretching the fascia tissue.
- Compression zones promote circulation, reduce impact vibration, boost recovery and strengthen feet.
- Lightweight, seamless design with extra cushioning provides support while still being comfortable.
- Supports the heel/arch and overall foot structure while stabilizing the tendon for better performance
- Made from high quality materials, the socks are moisture wicking and breathable.
As an Amazon Associate, Balance Foot and Ankle earns from qualifying purchases. Product links are affiliate links and we may earn a commission at no extra cost to you. This does not influence our clinical recommendations. Last update on 2026-10-18 / Images from Amazon Product Advertising API
OS1st FS4 — keeps feet dry, eliminating the warm-wet environment fungus needs.
Breathable Recovery Slide
- Model ID: 1135061-BTRT
As an Amazon Associate, Balance Foot and Ankle earns from qualifying purchases. Product links are affiliate links and we may earn a commission at no extra cost to you. This does not influence our clinical recommendations. Last update on 2026-10-18 / Images from Amazon Product Advertising API
HOKA Ora 3 — lets feet air out after closed-shoe exposure.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.

When to See a Podiatrist
Topicals only penetrate the top 30% of the nail plate — if the fungus is near the cuticle or under 50% of the nail, oral terbinafine or laser is usually required for full clearance. Balance Foot & Ankle offers in-office fungal nail diagnostics and laser treatment that reaches the nail matrix where topicals can’t. We’ll examine the nail and recommend the fastest path to clear, healthy regrowth.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Township
In-Office Treatment at Balance Foot & Ankle
When home care and over-the-counter steps haven’t resolved your symptoms, it’s time for an in-office evaluation. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, Dr. Tom Biernacki, DPM and team provide diagnostic imaging, a clinical exam, and a plan tailored to your foot type — book online 24/7.
Book online 24/7. Call (810) 206-1402 or book online. Full treatment overview: Foot & Nail Fungus Treatment.
Frequently Asked Questions
How long does treatment take to work?
Most patients see improvement in 4-8 weeks with consistent conservative care. Persistent symptoms after 8 weeks need imaging and escalation.
When is surgery needed?
Surgery is reserved for cases that fail 3-6 months of conservative care, structural deformities, or fractures requiring stabilization.
Is this covered by insurance?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Custom orthotics often require diabetic or post-surgical justification.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.
