Liam Carter
Toenail fungus is a common fungal infection that occurs when fungi get between the toenail and the tissue underneath, known as the toenail bed. This usually happens through a crack or cut in the toe, and fungi thrive in moist, dark, and warm environments, making toenails more susceptible to infection than fingernails. While it's typical to have some fungus under the nails, toenail fungus can progress and cause cosmetic concerns and, in some cases, severe health issues.
| Characteristics | Values |
|---|---|
| Type of infection | Fungal nail infection |
| Infection location | Toenails, though can also infect fingernails |
| Cause | Fungi getting between toenail and toenail bed through a crack or cut in the toe |
| Appearance | Toenail may change colour (white, yellow, brown, green or black), look chalky or cloudy, thicken, crack, become misshapen, separate from nail bed, or crumble |
| Symptoms | Not typically painful, but can cause self-consciousness. Can become painful if untreated and affect ability to walk |
| Treatment | Oral antifungal medication (e.g. terbinafine, itraconazole, fluconazole), topical antifungals, laser treatment, photodynamic therapy, removal of the nail |
| Prevention | Keep nails short and trimmed, wash hands and feet often with soap, wear socks that absorb moisture, change socks regularly, use antifungal powder or spray on feet and shoes, throw away old closed-toe shoes |
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What You'll Learn
Toenail fungus causes
Toenail fungus, medically known as onychomycosis, is a widespread fungal infection that affects toenails and, less commonly, fingernails. It is caused by several types of fungi that thrive in moist, warm environments, such as sweaty socks, shoes, or unwashed shower floors. These fungi can enter through microscopic openings or cuts in the nail or the skin surrounding it.
Dermatophytes, a type of mold, are the primary cause of toenail fungus, accounting for 90% of infections. They feed on keratin, a protein that strengthens nails, making them hard. Toenail fungus typically affects older adults, with estimates suggesting that it impacts one in two people over the age of 70.
Fungal nail infections often develop slowly, usually starting at the edge of the nail and gradually spreading. The nail may become thickened, discoloured (white, yellow, or brown), chalky, cloudy, or misshapen. In some cases, the nail can separate from the nail bed, leaving space between the nail and the underlying skin.
Risk factors for developing toenail fungus include having athlete's foot, walking barefoot in communal areas like showers or gyms, wearing nail polish (as it traps moisture underneath), and having a weakened immune system. Additionally, family history may play a role, as having relatives with nail fungus increases the likelihood of developing the condition.
If left untreated, toenail fungus can lead to complications such as cellulitis, a serious infection that requires prompt medical attention. Therefore, it is important to seek treatment guidance from healthcare providers or pharmacists, especially if the infection causes discomfort or affects your appearance.
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Diagnosis and treatment
Toenail fungus, or onychomycosis, is a widespread fungal infection that affects the toenails. It is caused by a type of mold called a dermatophyte, which feeds on keratin, a protein that makes nails hard. Dermatophytes cause 90% of toenail fungal infections, with the condition being referred to as tinea unguium.
Toenail fungus can be tricky to treat and often requires several months of treatment. It is also common for the infection to recur. Diagnosis is made by taking a small sample from underneath the nail for analysis under a microscope. If the initial test is negative, a scraping can be sent for culture to confirm the presence of fungus and identify the specific type. Treatment options should be discussed with a dermatologist or podiatrist. For mild cases that do not cause any bother, treatment may not be necessary. However, if treatment is required, oral antifungal medications such as terbinafine (Lamisil), itraconazole (Sporanox), or fluconazole (Diflucan) may be prescribed.
It is important to note that wearing nail polish can trap moisture in the nail bed, providing an ideal environment for fungi to thrive and potentially worsening the infection. Therefore, it is recommended to avoid nail polish during treatment. Toenail fungus can also lead to a rare but serious infection called cellulitis, which requires prompt treatment. If you experience any circulation problems, redness, pain, pus near the toenail, or have a weakened immune system, seek guidance from a healthcare provider.
Toenail fungus is highly contagious and can be spread through direct contact or by touching infected surfaces. It is commonly found in warm, moist, and dark places, including the perimeters of swimming pools. To prevent the spread of infection, avoid walking barefoot in these areas and wear footwear that protects your feet from potential exposure. Good foot hygiene practices, such as keeping your feet clean and dry, trimming your nails straight across, and avoiding sharing personal care items, can also help prevent and manage toenail fungus.
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Moisture and nail polish
Toenail fungus, or onychomycosis, is a widespread fungal infection that affects toenails and, less commonly, fingernails. It occurs when fungi get between the toenail and the nail bed, usually through a crack or cut in the toe. Fungi thrive in moist environments, and nail polish can trap moisture from the nail bed, potentially worsening a fungal infection. Therefore, it is important to understand the relationship between moisture and nail polish when treating toenail fungus.
Nail polish can create a moist environment beneath the nail, promoting the growth of fungi. This is because nail polish forms a barrier that prevents moisture from escaping, providing an ideal environment for the fungi to flourish. As a result, wearing nail polish while having a fungal infection is generally not recommended.
However, there are specific types of nail polishes designed to treat toenail fungus. These are known as topical treatments and usually contain antifungal ingredients such as amorolfine or ciclopirox. They are applied directly to the affected nail after cutting and filing it down as much as possible. While these nail polishes can help inhibit fungal growth, they may not be as effective as other treatment options, such as oral antifungal medications or tablets.
Topical treatments with nail polish can take a considerable amount of time, sometimes up to a year, to show results. Additionally, they may not completely eliminate the fungal infection. Oral medications, such as terbinafine, itraconazole, or fluconazole, are often more effective in treating toenail fungus. However, they also come with potential side effects and risks that should be considered.
It is important to note that treating toenail fungus can be challenging, and the infection may persist or recur even after successful treatment. Therefore, it is always advisable to consult a healthcare provider, such as a dermatologist or podiatrist, to determine the best treatment option for your specific case. They may recommend a combination of approaches, including nail polish with antifungal properties, oral medications, or other topical treatments, to effectively address the infection.
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Signs and symptoms
Toenail fungus, or onychomycosis, is a widespread fungal infection that affects the toenails. It occurs when fungi get between the toenail and the toenail bed, usually through a crack or cut in the toe. Toenail fungus is very common, especially among older adults, and can be challenging to treat.
- Discolouration: The nail may turn white, yellow, or brown.
- Brittleness and crumbling: The nail becomes brittle and crumbly, making it prone to cracking or breaking.
- Thickness and distortion: The nail thickens and may appear misshapen or distorted.
- Chalky or cloudy appearance: Spots on the nail may look chalky or cloudy.
- Nail separation: The nail may separate from the nail bed, creating a space between the nail and the underlying skin.
- Nail lifting and breakage: In severe cases, the whole nail can lift off or break off, causing the surrounding skin to become swollen and painful.
- Circulation problems: Toenail fungus can affect circulation in the affected toe.
- Redness, pain, or pus: In some cases, there may be redness, pain, or pus near the toenail, indicating a possible secondary bacterial infection.
- Weakened immune system: Individuals with weakened immune systems, such as those who have undergone organ transplants or are undergoing chemotherapy, are more susceptible to fungal nail infections.
It is important to note that toenail fungus is typically not painful, but it can cause cosmetic concerns. If you experience any of these signs or symptoms, it is advisable to consult a healthcare provider or pharmacist for guidance on treatment options.
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Prevention and self-care
Toenail fungus, or onychomycosis, is a common fungal infection that can affect both toenails and fingernails. It occurs when fungi get between the toenail and the nail bed, usually through a crack or cut in the toe. While anyone can get toenail fungus, it becomes more prevalent with age, affecting 50% of people over 70.
Keep Your Feet Clean and Dry
Fungi thrive in moist environments, so it's essential to keep your feet clean and dry, especially after activities that cause sweating. Wash your feet regularly with soap and water, ensuring you dry them thoroughly, paying extra attention to the areas between your toes.
Choose the Right Footwear and Socks
Wear shoes that fit properly and are made of breathable materials, such as canvas or leather. Avoid wearing tight-fitting shoes that can cause friction and damage your toenails. Additionally, opt for socks made of moisture-wicking materials, like cotton or wool, to help absorb sweat and keep your feet dry.
Practice Good Nail Hygiene
Trim your toenails straight across and not too short. Avoid cutting into the corners of the nails, as this can lead to ingrown toenails and provide an entry point for fungi. Use a clean, sharp nail clipper, and disinfect it after each use, especially if you've cut an infected nail, to prevent spreading the fungus to other nails.
Avoid Nail Polish
Nail polish traps moisture from the nail bed, creating an ideal environment for fungi to thrive. If you have toenail fungus, avoid wearing nail polish, as it can worsen the infection and make it more challenging to treat.
Wear Footwear in Public Spaces
When using public showers, pools, or locker rooms, wear flip-flops or shower shoes to protect your feet from coming into direct contact with surfaces that may be contaminated with fungi.
Treat Any Cuts or Injuries Promptly
If you have any cuts or injuries to your toes or toenails, clean and bandage them to prevent fungal spores from entering and taking hold.
While these preventive measures significantly reduce the chances of getting toenail fungus, it's important to remember that complete prevention cannot be guaranteed. However, practicing good foot hygiene and self-care can help keep your feet healthy and lower your risk of developing toenail fungal infections.
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