Caleb Foster
Toenail fungus, or onychomycosis, is a common condition caused by fungi that thrive in warm, dark, and moist environments, such as sweaty shoes or wet pool decks. While there are various treatments available, such as antifungal creams, gels, sprays, and oral medications, severe cases may require more invasive procedures. Toenail removal is one such option, but it is typically a last resort and should always be followed by antifungal therapy to prevent the fungus from returning. While toenails can regrow after removal, it is a slow process, taking up to 18 months.
| Characteristics | Values |
|---|---|
| Medical term | Onychomycosis |
| Cause | Walking barefoot in places like communal showers and gyms |
| Symptoms | White, brown, or yellow spots on the toenail; nail thickening; nail lifting from the toe |
| Treatment | Antifungal pills, creams, gels, sprays, patches, and prescription drugs; laser treatment; toenail removal |
| Prevention | Avoid walking barefoot in public spaces; choose breathable footwear; rotate shoes and change socks frequently; disinfect shoes and shower spaces |
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What You'll Learn
Toenail fungus is common
Toenail fungus, or "onychomycosis", is a very common condition. It occurs when fungi enter and take hold under and between the layers of the nail, often as a result of walking barefoot in warm, dark, and moist places like communal showers, gyms, pools, and locker rooms. Fungi thrive in these environments, and can easily spread from person to person.
You may have a toenail fungus if you notice white, brown, or yellow spots on your toenail. As the fungi grow, the nail may become thickened, brittle, crumbly, and discoloured. Eventually, the nail could even lift from the toe, causing pain when walking.
Toenail fungus can be difficult to treat because of the way fungi burrow into and beneath the layers of the nail. Treatment options include oral antifungal medications, topical antifungal creams, gels, sprays, and patches, and laser treatment. In severe cases, a doctor may recommend nail avulsion, a procedure to remove the entire nail or part of it. However, this is usually a last resort, as the nail will take time to grow back, and the fungus may return if proper antifungal therapy is not administered.
To prevent toenail fungus, it is important to practice good foot hygiene and avoid walking barefoot in places where the fungus is likely to spread. This includes wearing flip-flops or shower shoes in public showers, swimming pools, and saunas, and choosing breathable footwear, such as shoes made of natural fabric or leather. It is also recommended to rotate shoes, change socks frequently, and wash and dry the feet thoroughly, especially between the toes.
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Treatment options
Toenail fungus is a common condition that can be difficult to treat. It is caused by a type of mold called a dermatophyte that thrives in warm, moist environments. The infection causes the nail to become thick, yellow, and show white spots and streaks. If left untreated, it can spread to other nails or even through the body. While it is not usually harmful, it can be challenging to get rid of. Here are some treatment options:
Topical Treatments
Topical antifungal treatments include creams, gels, sprays, and patches. These are available over the counter or by prescription. Examples include clotrimazole (Lotrimin) and terbinafine (Lamisil). Topical treatments are best for mild toenail fungus and may take months to work. They are most effective for surface fungus as they do not penetrate the nail bed. It is recommended to file or cut off any white markings on the nails and to keep the nails dry before applying the medication.
Oral Medications
Antifungal pills, such as itraconazole (Sporanox) and terbinafine (Lamisil), are more effective than topical treatments for moderate to severe cases. They are typically taken for 12 weeks, but the fungus may take up to 10 months or longer to clear completely. These medications have high success rates, but they can have side effects and interact with other medications. For example, terbinafine can affect the liver, so liver function monitoring is necessary during treatment.
Laser Treatment
Laser treatment is an option for those who want to avoid the side effects of oral medications. The laser heats up the nail layers to destroy the fungus's genetic material. Each treatment takes about 30 minutes, and at least two treatments are usually needed. However, studies on the effectiveness of laser treatment are mixed, and it is not covered by insurance.
Surgical Toenail Removal
In rare cases, surgical toenail removal may be considered. This procedure involves numbing the area, loosening the skin around the nail, and removing the nail. A new nail typically grows back within a year, but it is essential to follow up with antifungal therapy to prevent the fungus from returning.
Home Remedies
Some home remedies have been anecdotally reported to help manage toenail fungus, although there is limited scientific evidence to support their effectiveness. These include soaking the feet in apple cider vinegar or Listerine mouthwash, using baking soda as a foot soak or paste, and applying Vicks VapoRub to the affected nail.
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Surgical removal
Surgical nail removal is a procedure that is only performed when a large portion of the nail is diseased, damaged, or causing pain. It is considered a last resort after other treatments have failed. The procedure can be done in a doctor's office or a dermatologist's clinic. Before the surgery, a doctor will conduct a physical examination and discuss the patient's medical history, including other illnesses, surgeries, and medications. On the day of the surgery, the patient can go about their usual routine, including showering, eating, and taking their regular medications, unless advised otherwise by the doctor.
During the procedure, the doctor will first numb the area around the nail to prevent pain. They will then use a special tool to loosen the skin around the nail and separate it from the skin. If only part of the nail is infected, only the diseased portion will be removed. If necessary, the entire nail may be removed. In some cases, to prevent future infections and the regrowth of the nail, the doctor may destroy the nail matrix by applying a chemical to the cuticle area. After the nail is removed, the doctor will apply an antibiotic cream and a bandage to the nail bed to prevent bacterial infection.
After the surgery, patients can expect the area around the nail to feel numb for a few hours, followed by pain, throbbing, swelling, bleeding, or fluid coming from the wound. It is important to keep the area clean to reduce the risk of infection. The wound typically heals within a few weeks, but it may take longer for some people. Fingernails usually regrow in about six months, while toenails can take up to 18 months or longer. During the healing process, patients should follow their doctor's instructions for wound care and may be advised to use antifungal medicine to prevent further fungal growth.
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Preventing infection
Toenail fungus, or onychomycosis, is a very common condition. It is caused by fungi that invade the nail and the nail matrix (the cells responsible for nail growth). The infection usually starts at the edge of the nail and spreads to the rest of the nail, causing it to become thickened, brittle, crumbly, discoloured, and distorted. It can spread to other nails and even through the body if left untreated.
To prevent toenail fungus, it is important to practice good foot hygiene and avoid exposure to the fungus. Here are some ways to prevent toenail fungal infections:
Keep Feet Clean and Dry
Wash your feet at least once daily, especially between the toes, and ensure they are completely dry. Fungi thrive in warm, moist environments, so keeping your feet clean and dry can help prevent the growth of toenail fungus.
Choose Breathable Footwear
Select footwear made of natural fabric or leather, and opt for mesh shoes or shoes with mesh panels to allow air circulation. This helps prevent the build-up of moisture and creates an unfavourable environment for fungi.
Practice Good Foot Care
Rotate your shoes and change your socks frequently throughout the day to prevent prolonged exposure to moisture. When using public showers, swimming pools, or saunas, always wear flip-flops or shower shoes to avoid direct contact with potentially contaminated surfaces.
Disinfect Footwear
Spray Lysol disinfectant or a similar product into your shoes and let it dry completely before wearing them. This helps eliminate any fungal spores that may be present.
Avoid Barefoot Walking in Communal Areas
Fungal nail infections can spread from person to person. Avoid walking barefoot in places like communal showers, gyms, pools, and locker rooms, as these areas are often contaminated with fungal spores.
Don't Share Nail Tools
Avoid sharing nail trimmers, files, or other tools with others. If you get professional pedicures, ask the technician about their sterilisation and disinfection procedures to ensure they are using clean and safe tools.
It is important to note that while these preventive measures can help reduce the risk of toenail fungal infections, they do not guarantee complete protection. If you suspect a fungal infection, it is recommended to consult a healthcare professional or pharmacist for proper diagnosis and treatment.
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Home remedies
Toenail fungus, or onychomycosis, is a common condition that affects about 14% of the global population. It is caused by various fungi, including dermatophytes, yeasts, and moulds, which thrive in warm, moist environments. While there are prescription medications and surgical treatments available for toenail fungus, some people prefer to try home remedies first.
It is important to note that home remedies may not work for everyone, and severe or persistent fungal infections require medical attention. If you have diabetes or a weakened immune system, do not use home remedies and consult your doctor instead.
- Tea tree oil: Tea tree oil has natural antifungal and antiseptic properties. 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.
- Ozonized oils: Ozonized oils are oils like olive oil and sunflower oil that are "injected" with ozone gas. Research has shown that exposure to low concentrations of ozone gas can inactivate fungi.
- Listerine mouthwash: Listerine mouthwash contains menthol, thymol, and eucalyptus, which have antibacterial and antifungal properties. Soak the affected foot in a basin of amber-coloured Listerine for 30 minutes daily.
- Apple cider vinegar: Soak your feet in a solution of apple cider vinegar and water. Generally, a ratio of one part vinegar to one part water is recommended for a foot soak.
- Vicks VapoRub: Vicks VapoRub is a topical ointment that contains camphor and eucalyptus oil, which may help treat toenail fungus. Apply a small amount to the affected area at least once a day.
- Snakeroot extract: Snakeroot extract is an antifungal made from plants in the sunflower family. A 2008 study showed that it is effective against toenail fungus.
- Oregano oil: Apply oregano oil to the affected nail twice daily with a cotton swab. Oregano oil is potent and may cause irritation or allergic reactions.
In addition to these home remedies, there are also some general tips for preventing and treating toenail fungus:
- Wash and dry your feet daily, especially between the toes.
- Choose breathable footwear made of materials that allow airflow, and rotate your shoes regularly.
- Change your socks frequently and avoid wearing damp socks for extended periods.
- Use antifungal powder in your shoes to reduce moisture.
- Avoid walking barefoot in public areas like locker rooms and pools, and always wear flip-flops or shower shoes in these spaces.
- Trim your nails straight across to avoid ingrown nails, which can harbour fungi.
- Don't share nail trimmers, files, or tools with other people.
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Frequently asked questions
Toenail fungus, or onychomycosis, is a common condition where a fungus infects the toenail, causing it to thicken, discolour, crumble and become brittle.
Look out for white, brown or yellow spots on your toenail. Over time, the nail may thicken and lift from the toe. You may also experience pain when walking.
Toenail fungus thrives in warm, moist environments, so you may pick it up from walking barefoot in communal areas like pools, gyms or locker rooms. Fungi can enter through damage to the nail and spread through the layers.
There are various treatments available, including creams, gels, sprays, pills and patches. Your doctor may also recommend trimming and filing the nail to help the treatment penetrate deeper. In rare cases, surgery may be required to remove the nail.
Toenail removal is considered a last resort and is rarely performed. However, if other treatments have failed, your doctor may recommend it. It is important to follow up toenail removal with antifungal therapy to prevent the fungus from returning.
