Isla Bennett
Toenail fungus is a common condition that can cause thickened, discoloured, and brittle nails. It occurs when fungi enter through cuts or breaks in the nail, or through repetitive friction or trauma to the nail. While it is not a pressing health concern, it can be difficult to treat and may cause pain and cosmetic concerns. Treatment options range from topical antifungal creams and nail polishes to oral medications and laser therapy, each varying in cost and effectiveness. In some cases, toenail removal may be considered as a last resort. Preventative measures, such as proper foot hygiene and nail care, are recommended to reduce the chances of contracting toenail fungus.
| Characteristics | Values |
|---|---|
| Cause | Fungi entering and taking hold under and between the layers of the nail |
| Risk factors | Wearing shoes that are too small, having a fungal infection on the skin of the foot, diabetes, weaker immune system |
| Diagnosis | Lab test on a scraping from the toenail |
| Treatment | Antifungal drugs, creams, gels, pills, nail polish, laser treatment, oral treatments, topical treatment, home remedies (e.g. apple cider vinegar, Listerine antiseptic mouthwash, tea tree oil) |
| Prevention | Wear flip-flops or shower shoes, use a different shower, change shoes and socks daily, wear breathable and loose-fitting shoes, use sanitized nail tools, clean nail clippers, soak nails in warm water before cutting |
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What You'll Learn
Home remedies for toenail fungus
Toenail fungus, also known as onychomycosis, is a common condition that affects about 14% of the global population at any given time. It is caused by various types of fungi, including dermatophytes, yeasts, and moulds. These microorganisms thrive in warm, moist environments, making sweaty shoes, locker rooms, and public pools prime breeding grounds.
While medical treatments such as antifungal drugs, creams, and laser treatments are available, many people prefer natural or at-home remedies. Here are some home remedies for toenail fungus:
- Practice good foot hygiene: Wash and dry your feet daily, especially between the toes. Soaking your feet in a solution of apple cider vinegar or Listerine antiseptic mouthwash may also help. Additionally, keep your toenails dry, clean, and well-trimmed.
- Choose breathable footwear: Opt for shoes made of materials that allow airflow, such as natural fabric or leather. Mesh shoes or shoes with mesh panels are ideal.
- Change socks regularly: Avoid wearing damp socks for extended periods. Choose sanitised, acrylic socks over cotton ones as they are better at absorbing sweat.
- Use antifungal powder: Sprinkle antifungal powder in your shoes to reduce moisture and inhibit the growth of fungi.
- Apply topical ointments: Vicks VapoRub, a topical ointment originally designed for cough suppression, has been found to be effective in treating toenail fungus. This is due to its active ingredients, camphor and eucalyptus oil. Tea tree oil, derived from the leaves of the Melaleuca alternifolia tree, is another natural antifungal and antiseptic option. Mix a few drops of tea tree oil with a carrier oil such as coconut or olive oil, and apply it directly to the affected nail using a cotton swab twice daily for several weeks.
- Opt for natural antifungals: Snakeroot (Ageratina pichinchensis) extract is an antifungal made from plants in the sunflower family. In a 2008 study, snakeroot extract was found to be as effective as the antifungal medication ciclopirox in treating toenail fungus.
It is important to note that home remedies typically have fewer side effects, but there is less scientific evidence of their effectiveness. Severe cases of toenail fungus may cause pain and irreversible toenail damage, so it is always recommended to consult a doctor or podiatrist if home remedies are not effective or cause side effects.
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Prescription antifungal treatments
Toenail fungus, or onychomycosis, is a common condition that can be identified by white, brown, or yellow spots on the toenail. Over time, the nail may thicken and even start to lift from the toe. While over-the-counter (OTC) treatments are available, prescription antifungal treatments are necessary for moderate to severe cases of toenail fungus.
One example of an oral antifungal pill is terbinafine, which has been the subject of a multicenter trial on its efficacy in treating toenail onychomycosis. Other prescription antifungal pills may include posaconazole and Mycosinate, which have antifungal properties.
In severe cases that do not respond to treatment, surgical removal of the infected nail may be necessary to treat the nail bed and allow a healthy nail to grow back. This procedure is done under local anaesthesia, and a new nail typically grows back within a year. During this time, your doctor may prescribe a cream or other treatment to keep the fungus away.
It is important to note that toenail fungus treatments can take a long time, and it may be several months before you see any improvement. Patience and diligent adherence to the prescribed treatment are key to successfully treating toenail fungus.
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Oral medication side effects
Toenail fungus can be a tricky condition to treat. While there are several home remedies and over-the-counter treatments available, they may not always be effective in eliminating the fungus. Prescription medications are often required to clear the infection completely. Oral antifungal medications, such as terbinafine (brand names: Lamisil®, Terbinex®), are commonly prescribed for toenail fungus. While these medications can be effective, it's important to be aware of their potential side effects:
- Skin reactions: Terbinafine can cause serious skin reactions, such as a red or purple rash that may turn into blisters or skin peeling. It can also cause itching, hives, and swelling of the face, lips, tongue, or throat. These reactions can occur weeks or months after starting the medication.
- Sun sensitivity: Terbinafine can increase sun sensitivity, so it's important to avoid sun exposure, use protective clothing and sunscreen, and avoid sun lamps or tanning beds/booths.
- Liver injury: Signs of potential liver injury include right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing of the skin or eyes, and unusual weakness or fatigue.
- Diarrhoea: Diarrhoea is a possible side effect, and it can impact the effectiveness of contraceptive pills. Speak to a pharmacist or doctor before taking any additional medication to treat diarrhoea.
- Dehydration: Drink plenty of fluids to avoid dehydration, especially if experiencing diarrhoea or vomiting.
- Interactions with other substances: Terbinafine may interact with other medications, herbs, non-prescription drugs, or dietary supplements. Inform your healthcare provider about any other substances you are taking.
- Age-related concerns: Elderly patients may be more likely to experience age-related liver, kidney, or heart problems while taking terbinafine. The safety and efficacy of terbinafine in geriatric populations and children have not been fully established.
- Allergic reactions: Although rare, allergic reactions can occur. Stop taking the medication and seek medical advice if you experience any unusual symptoms.
It is important to follow the instructions provided by your doctor or healthcare provider when taking oral antifungal medications. Do not take a higher dose or use it more frequently or for longer than directed. Always read the medication guide and patient instructions carefully, and do not hesitate to ask your doctor or pharmacist if you have any questions.
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Preventing toenail fungus
Toenail fungus is a common condition that can affect the appearance and health of your nails, making them look yellow, thick, and cracked. It can be challenging to treat, so prevention is essential. Here are some ways to prevent toenail fungus and keep your nails healthy:
Keep Your Feet Clean and Dry
Wash your feet daily with soap and water, especially after physical activities that cause sweating. Pay special attention to the spaces between your toes, as fungus thrives in warm, moist environments. Be sure to dry your feet thoroughly, including between your toes, to prevent moisture buildup.
Choose the Right Footwear and Socks
Select shoes made of breathable materials like leather or mesh, which allow air circulation and help keep your feet dry. Avoid tight-fitting shoes that can trap heat and moisture. Rotate your shoes regularly, and replace old or soiled shoes, as fungus can live in them. When choosing socks, opt for natural fibres like cotton or wool, which absorb moisture and allow your feet to breathe. Change your socks daily, or more frequently if needed, to maintain dryness.
Practice Good Nail Hygiene
Keep your toenails trimmed and short. Cut them straight across, avoiding rounded edges, to prevent fungus from entering through nail edges. Avoid ripping or picking at your nails, as this can create entry points for fungi. Clean and sterilize your nail clippers, files, and other tools after each use to prevent the spread of fungi.
Avoid Barefoot Walking in Public Places
Fungi are easily spread in public areas such as pools, showers, and locker rooms. Always wear flip-flops or shower shoes in these environments to protect your feet from potential fungal exposure. Additionally, if someone in your household has toenail fungus, wear flip-flops at home, especially in shared bathrooms, to reduce the risk of contracting the fungus.
Use Antifungal Products
If you've previously had toenail fungus, use over-the-counter or prescription antifungal creams or sprays as a preventative measure. Apply these products to your toenails and the bottoms of your feet once or twice a week to create a barrier against fungal infections. You can also use antifungal foot powder, which can help protect against athlete's foot and other fungal issues.
See a Podiatrist or Doctor
If you notice any changes in your nail colour, texture, or thickness, don't hesitate to consult a podiatrist or doctor. They can confirm the presence of toenail fungus and provide professional treatment advice. Additionally, if you've tried over-the-counter treatments without success, a podiatrist can help determine the most effective course of action.
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Lab testing for toenail fungus
Toenail fungus is a common condition, but it can be tricky to treat. Lab testing is an important step in confirming a toenail fungus diagnosis and determining the best course of treatment. Here is some information about lab testing for toenail fungus:
Specimen Collection
To perform lab testing for toenail fungus, a healthcare provider will first collect a small specimen from the affected nail. This typically involves taking nail clippings or scraping away a small piece of the nail. The specimen can then be sent to a laboratory for further analysis.
Microscopic Examination
One common laboratory technique for diagnosing toenail fungus is microscopic examination. This involves examining the nail specimen under a microscope to look for signs of fungal infection. Potassium hydroxide (KOH) testing is a quick and inexpensive method that can confirm the presence of fungi in the nails. Another technique is histopathology, which involves examining the microscopic features of nail clippings that have been embedded in paraffin blocks.
Fungal Culture
Fungal culture is another technique used to identify the specific type of fungus causing the infection. In this method, the specimen is cultured in a growth medium, such as Sabouraoud dextrose agar (SDA), to encourage the growth of the fungus. This technique can help identify the specific subtype of the pathogen and guide the choice of treatment.
Advanced Diagnostic Tools
In recent years, advanced diagnostic tools have been developed to improve the detection and diagnosis of toenail fungus. Dermoscopy, for example, is a cost-effective and non-invasive method that allows clinicians to visualize the microscopic features of the infection. Reflectance confocal microscopy enables clinicians to observe the fungus at near-histologic resolution. These advanced tools can enhance the accuracy of diagnosis and facilitate more targeted treatment approaches.
Overall, lab testing for toenail fungus plays a crucial role in confirming the presence of a fungal infection, identifying the specific type of fungus involved, and guiding the selection of appropriate treatment options. Accurate diagnosis is essential to ensure effective treatment and prevent the spread of the infection.
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Frequently asked questions
Toenail fungus is a fungal infection in the toenail. It occurs when a fungus gets into the nail bed from a cut or break in the nail or repetitive trauma to the nail.
The first sign of a fungal toenail infection is usually a small white, yellow or brown spot under the tip of the nail.
There are many treatments for toenail fungus, including antifungal drugs, creams, gels, pills, and laser treatment. Your doctor will be able to advise you on the best course of treatment.
Yes, you can reduce your chances of contracting toenail fungus by following good foot hygiene practices, such as not sharing nail tools, choosing breathable footwear, and changing your socks and shoes regularly.
Toenail removal is usually only considered as a last resort. If you do choose to remove the toenail, it must be followed up with antifungal therapy to prevent the fungus from returning.
