What Causes Toenail Fungus & How Can It Be Treated?

Toenail fungus (onychomycosis) is a common health problem. Learn about the causes, symptoms, and treatment options.

Children playing at a gym

What is toenail fungus?

Fungal infection, or onychomycosis, is a common foot health problem. A majority of sufferers don’t seek treatment, perhaps because they don’t even recognize the existence of a problem. One reason that people may ignore the infection is that it can be present for years without causing pain. Its prevalence rises sharply among older adults. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish — ugly and embarrassing. It is apparently assumed that since white markings or a darkening of the nail are minor occurrences, the change represents something minor as well, even when the blemish spreads. In many cases, however, that change in color is the start of an aggravating disease that ultimately could take many months to control. It is an infection underneath the surface of the nail, and it can penetrate the nail. This disease can frequently be accompanied by a secondary bacterial and/or yeast infection in or around the nail plate.

Onychomycosis is an infection of the bed and plate underlying the surface of the nail caused by various types of fungi commonly found in the environment. Fungi are simple parasitic plant organisms (such as molds and mildew) that lack chlorophyll and therefore do not require sunlight for growth. A group of fungi called dermatophytes easily attack the nail, thriving on keratin (the nail’s protein substance). When the tiny organisms take hold, the nail may become thicker, yellowish-brown or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even fingernails. Other contributory factors may be a history of athlete’s foot, improper cleansing, anxiety, and excessive perspiration.

Feet with toenail fungus on the big right toe

What causes toenail fungus?

It is very unlikely that a few exposures to an unclean environment will cause a fungal infection. Walking barefoot once or twice in a public shower will not generally spread the infection. Similarly, it is also unlikely that a single visit to a pedicurist will cause the infection. Lengthy exposure to a contaminated environment is often required in order to contract the fungal infection — although individuals may be more susceptible to fungal infections than others.

How to prevent toenail fungus?

Because fungi are everywhere (including the skin), they can be present months before they find opportunities to strike — and before signs of infection appear. By following certain precautions, including proper hygiene and regular inspection of the feet and toes, chances of the problem occurring can be significantly reduced.

  • Regularly clean and dry feet to resist disease. Follow a strict regimen of washing the feet with soap and water.
  • Change socks and hosiery daily and change out shoes on a regular basis.
  • Clip toenails straight across so the nail doesn’t extend beyond the tip of your finger or toenails.
  • Wear socks that are made of synthetic fiber to “wick” away moisture. Cotton and wool socks don’t “wick” away moisture as fast as synthetic fiber does. This can be helpful in denying a hospitable environment for the fungi to grow in.

How do you treat toenail fungus?

Depending on the nature and severity of your infection, treatments may vary. Most over-the-counter treatments are minimally effective at best, but almost none of them have produced a permanent treatment. The main reason for these poor results is that the fungal infection resides deep within the nail or nail bed — and the topical medications have great difficulty in penetrating to this depth. A fungus may work its way through the entire nail, penetrating both the nail plate and the nail bed. Podiatrist Dr. Burns at Arizona Foot Doctors offers penetrative nail fungus treatments to completely remove the fungal infection. Each patient case is unique, so consult with Dr. Burns to find the best treatment option for you. Treatment may include:

  • Topical or oral medication and debridement (removal of diseased nail matter and debris). The newer oral antifungal medications are the most effective (75 percent). Common oral medications are Lamisil and Sporanox. A common topical medication is Penlac nail lacquer.
  • Temporary removal of the infected nail
  • Permanent removal (which may become necessary if the medication doesn’t work)

Oral and topical medicines should be taken for three months. It takes approximately nine months for the new, healthy nail to grow. Current studies show that for a very small percentage of the population there are some unwanted side effects with an oral antifungal; however, these are usually reversible when medication is terminated. Penlac nail lacquer, a prescription medication, is generally less effective than the oral medications and is best used with a limited fungal infection. Penlac is applied approximately three times per week for several months. In some cases, surgical treatment may be required.

Young woman rock climbing

Scottsdale toenail fungus removal

Sick of the pain? Unable to perform simple tasks? Book an appointment for your nail infection (onychomycosis) today. Dr. Burns is dedicated to your care, comfort, and pain relief. Book by calling (480) 661 7572 or by using our online booking tool.

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