Toenail Fungus Treatment

By MaryAnn DePietro, CRT. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Toenail fungus, medically known as “onychomycosis,” is a fungal infection under the nail.

“Although it can vary, dermatophytes, which are a classification of fungus, [commonly] cause most cases of toenail fungus,” says Jeffrey DeSantis, DMP, board member of American Podiatric Medical Association Board of Trustees and president of Cambridge Foot & Ankle Association. “Although not as common, yeast and non-dermatophytes can also cause an infection that mimics toenail fungus.”  

Usually the first symptom of toenail fungus is a discoloration of the nail. The nail usually becomes yellow or brown. As the fungus continues to spread, the nail may also be affected in other ways.

“Toenail fungus often increases the thickness of the nail and may cause it to become misshapen or deformed. It can also become painful, and in some people, [who have a condition] such as neuropathic diabetics, it may even lead to ulceration,” says DeSantis. 

How Does Toenail Fungus Develop?

Fungi are microorganisms that often live in dark, warm and moist environments.

“Fungus that infects your nails may live in environments such as showers, gyms and swimming pools,” says Michael Uro, DPM, a podiatrist in private practice in Sacramento, Calif. “Some types of fungus can survive as long as 15 months in those kinds of environments.”

When your feet come in contact with fungus, it may get under the surface of your toenail. The fungus may start out as a small yellow or white spot under your nail, but it eventually spreads. If you wear shoes a large majority of the time, you are creating a perfect environment for the fungus. In shoes, your feet continue to be in a moist, dark environment. The fungus subsequently continues to thrive.

Anyone can develop toenail fungus, but walking around barefoot on surfaces where exposure is likely, such as in a locker room, increases your risk. If you perspire heavily and wear socks that don’t wick moisture away, you may also be at risk for toenail fungus.

According to NYU Langone Medical Center, people with certain medical conditions, such as diabetes, decreased immune systems and circulation problems, are particularly prone to toenail fungus.

Toenail Fungus Treatment Options

Toenail fungus treatments vary from home remedies to laser treatments. In some instances, toenail fungus can be difficult to cure. According to the American Podiatric Medical Association, the earlier a person seeks treatment, the greater the chances of curing the condition. Treatment for toenail fungus includes the following:

  • Topical medications: Topical medications are applied directly to the nail and do not have the side effects of oral medications, but they usually do not work.
  • Oral medications: Prescription medication taken orally to treat toenail fungus is often more successful than topical treatment. However, it’s not effective in all cases, and it may not be appropriate for all patients. “Medications taken orally can have potential side effects to the liver, kidneys, retina and taste buds,” says Uro.
  • Laser treatment: Laser treatment for toenail fungus is a newer procedure that presumably destroys toenail fungus by employing intense beams of light. The effectiveness of laser treatment for toenail fungus is still being studied.
  • Surgery: If the toenail is very painful and other treatments have failed, surgery can be done in order to remove the nail. This is usually only performed in extreme cases.

Next Steps

Prevention is best when it comes to toenail fungus. Consider some of the following ways to keep your feet fungus free.

  • Keep your toes dry. Fungus typically survives in moist environments. Keeping your toes dry decreases your risk of fungus surviving.
  • Wear shoes or flip flops in public facilities. For example, you’ll want to protect your feet when using gym locker rooms and showers.
  • Let your feet breathe as much as possible. Wearing shoes, such as sandals or open toed shoes, can help your feet stay dry and prevent the growth of fungus.
  • Get treatment early. Prompt treatment is usually more successful than the treatment of infections that have been allowed to smolder for a long time.  

For Caregivers

Toenail fungus is more common as we age, and podiatrists can often help with nails that are especially hard to trim and other foot ailments of the elderly. A trip to the podiatrist might be just what your loved one needs.

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