Toenail fungus overview

What is Toenail Fungus?

Our feet are often the first part of our bodies to come into contact with a new surface, which means they are susceptible to onychomycosis, more commonly referred to as toenail fungus. Tiny organisms like yeast, mold, and the dermatophyte fungus thrive in warm, moist environments. They lurk there, just waiting for feet to come along, so they can worm their way into the nail bed.

While fingernails may also become infected, the toenails are a better candidate, as life in a shoe results in a hot and sweaty environment that is perfect for fungal multiplication. The presence of toenail fungus isn’t always immediately obvious; some people may have onychomycosis for years before symptoms arise. Although the organisms can make the toenails feel particularly painful and look rather disgusting, treatments and cures usually involve simple anti-fungal medication.

Toenail Fungus Causes

Swimming pools, locker rooms, and even showers are all likely places for finding microscopic fungi. They sneak in through tiny cuts in the skin around the nail, cracks in the nail itself, or areas where the skin has separated from the nail. Then, the foot goes back into the shoe, which provides an optimum environment for a flourishing infection. Additionally, the toes don’t have as much blood flow as other parts of the body, so the immune system has a harder time finding and fighting infections that occur there. 

Toenail Fungus Symptoms

It usually takes some time for the infection to grow before you recognize that anything is wrong. However, when symptoms do occur, it becomes quite obvious. The nails often change in consistency and color, they may become thicker and difficult to cut, or turn very brittle and crumble easily. Instead of the slight shine evident from most healthy nails, the toenails will become very dull; they may turn a dark, yellowish color, because of the stuff building up underneath, or develop white or yellow spots that continue increasing in size. The nail may even change shape and appear distorted, or become separated from its bed (referred to as onycholysis). 

The longer the infection is present and the worse symptoms become, the greater the difficulty in curing the fungus. The longer it is untreated, the more likely it is that toenail fungus will spread to additional toes, and even the fingernails or skin. Additionally, the infected toes themselves may become painful, and you may notice a bad smell. 

Toenail Fungus Treatment

Onychomycosis can be treated fairly easily at home, but these options are not always effective cures for toenail fungus. Some people have great success with over the counter antifungal creams. Keeping the nails trimmed and clean during treatment also helps. Filing off any odd colored spots that start arising on the top of the nail can be beneficial, as well as opening up the nail to allow the medication to work farther in than the surface.

When these fail, doctors may prescribe an oral antifungal medication. Prescription nail polishes and creams are also available. Laser and light therapies are currently being tested for efficaciousness, and are largely used in tandem with other treatment options for toenail fungus cures. In some very rare and severe cases, surgery may be necessary to remove the nail. It will eventually grow back, but it can take quite some time.  

Toenail Fungus Risk Factors

Obviously, walking barefoot in fungus-friendly environments presents an immediate risk of contraction. Likewise, working in these environments or in a position that makes your feet sweaty or frequently wet increases the chances of infection. Other risk factors include excessive sweating, being a male (especially if other members of your family are prone to onychomycosis), or living with those that have a fungal infection. 

Health factors that play a role in the likelihood of developing onychomycosis include having athlete’s foot or a wound on the foot or nail, no matter how small. Preexisting nail and skin conditions, like psoriasis, pave the way to toenail fungus, too. Underlying medical conditions can also increase the risk. Blood circulatory disorders and autoimmune diseases, especially diabetes, make it even more difficult for the body to fight the invading organisms. Children with Down’s Syndrome also face an increased risk. 

Age also plays a heavy factor, for several reasons. As you age, your blood doesn’t flow as well as it used to, and your nails don’t grow as quickly. Additionally, because it can take years for the symptoms to become troublesome, the older you are, the longer you’ve had to be exposed to such fungi. 

Toenail Fungus Prevention

It’s difficult but not impossible to keep such tiny invaders away. Since topical anti-fungal medication is not always an effective cure, preventing contraction in the first place is one of the best ways to combat toenail fungus. Wearing shoes in areas where fungus thrives is very important. Additionally, choose shoes that offer plenty of ventilation for sweaty feet, and use antifungal sprays or powders regularly. Treating any shoes you wore during an infection will also help prevent reinfection.

Wash your hands after touching your own or someone else’s infection, and don’t pick at the skin around the nail bed, which creates open wounds. Choose cosmeticians with care, as even these places can be a hotbed of fungus. And remember that hiding the infection under fake nails or polishes can just make the situation worse. 

Last Updated: May 18, 2017