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Toenail Fungus: Causes, Risks, and Cures

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 8/16/2020

Feet — you either love ‘em or hate ‘em. But one thing’s likely: you have them. 

And whether they’re an afterthought and just something you stick in your shoes everyday, or if you get regular pedicures, you should take care of them. 

Something like toenail fungus may seem very benign, and in many cases, it is. But left alone to fester, and you could have a real problem on your... feet. 

Sorry, we had to.

What Is Toenail Fungus? 

Like mold and mushrooms, toenail fungus is a fungi — though, thank goodness, it doesn’t resemble these other fungus types. 

It’s also known as onychomycosis, and is relatively common. 

Onychomycosis accounts for one third of fungal infections affecting the hair, skin and nails, and one half of all nail diseases.

For most people, toenail fungus is a cosmetic concern — people affected are embarrassed about how it looks. But toenail fungus can impact far more than your appearance. 

Left untreated, it can cause discomfort and difficulty walking. For some people, this can lead to serious complications.

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How to Recognize Toenail Fungus 

When you are afflicted with toenail fungus, several symptoms are possible. The following may indicate onychomycosis: 

  • Nail discoloration, including white, yellow or brown spots

  • Debris building under the nail, lifting it up so it’s no longer firmly attached

  • Thickened nails 

  • Splitting or crumbling toenails 

  • White discoloration that feels soft, dry, and powdery

Toenail fungus generally isn’t painful, but in severe cases it could cause discomfort. You may also experience athlete’s foot — another fungal infection — in conjunction with toenail fungus.

Toenail Fungus Causes and Risk Factors 

Fungus thrives in moist, warm places, like locker rooms, swimming pool decks and your sweaty shoes. 

Walk around in a damp locker room after someone with nail fungus, and you’re at risk of picking it up yourself.

Anytime your feet remain damp for long periods of time, you increase your risk of developing toenail fungus. 

The tiny organisms that cause nail fungus may infect a nail through a small cut in the skin, a cut in your toenail, or the separation between your nail and your toe.

Somethings can put you at a greater risk of contracting toenail fungus or developing a more severe case once infected. Those risk factors include: 

  • Age: toenail fungus incidence increases as you age

  • Living in a hot, humid climate

  • Athlete’s foot

  • Diabetes

  • Cancer

  • Other nail infections

  • Poor circulation

  • Psoriasis

  • Compromised immune system 

  • Organ transplant 

  • A hobby or job that keeps your feet wet throughout the day

  • Smoking 

  • Walking barefoot in places where fungus thrive 

  • Wearing tight-fitting shoes

Toenail Fungus Treatments 

Treating toenail fungus can be tricky. In very mild cases, over-the-counter or prescription topical products may be effective. 

Depending on the medicine, you apply these products regularly while the nail grows out.

One major issue with them, however, is applying them consistently — failing to use them as directed does no good.

Antifungal medications that you take orally can be more effective than topical solutions. These antifungal pills include Lamisil® (terbinafine), Sporanox® (itraconazole) and Diflucan® (fluconazole). These medications must be taken for several weeks for them to be effective and are only available with a prescription.

When medications don’t seem to solve your toenail fungus, surgery may be needed. 

A toenail can be removed in order to directly apply antifungal medications and attempt to stop the infection in its tracks. 

In some cases, a dermatologist or podiatrist may recommend chemical nail removal instead. 

Obviously, in these scenarios, the nail will grow back. If, however, the treatment proves ineffective, a doctor can permanently remove the nail so it does not grow back.

Preventing Toenail Fungus and Complications

Keeping your feet and toenails healthy can prevent complications like severe infections and pain associated with them. 

If you suspect you have a toenail fungus, talk with a healthcare professional. Treating a mild case is much easier than waiting until it is severe. 

Then, prevent further infections or worsening conditions by: 

  • Taking medications as prescribed

  • Wearing flip-flops or other shoes when walking in gyms, locker rooms or other warm moist public areas

  • Wearing clean socks every day and change your socks if they get sweaty

  • Giving your shoes time to dry out before putting them back on

  • Keeping your toenails clipped and clean

  • Sanitizing your nail clipper 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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