Toenail Fungus: Causes, Treatment, and Care

Toenail Fungus
Toenail Fungus

Nail fungus is a common condition that begins as a white or yellow spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, nail fungus may cause your nail to discolour, thicken and crumble at the edge. Nail fungus is also called Onychomycosis. Fungus is normally present on the body, but if it overgrows, it can become a problem.

Three stages of development of fungal infection on nail of the toe


Most commonly, a group of fungi called dermatophytes (such as Candida) is responsible for nail fungal infections. They do not require sunlight to survive so can thrive in these areas. Pathogens that cause nail fungus infection usually enter the skin through tiny cuts or small separations between the nail and nail bed. The fungi grow when the nail provides a suitably warm and moist environment.


Nails that are infected with fungus typically are:

  • thickened
  • brittle
  • crumbly
  • ragged
  • distorted
  • dull
  • darker or yellowish in color

There may be also be:

  • scaling under the nail – hyperkeratosis
  • yellow or white streaking – lateral onychomycosis
  • yellow spots at the bottom of the nail – proximal onychomycosis
  • infected nails may separate from the nail bed

Nail fungal infections can result in pain in the toes or fingertips, and they may even emit a foul odor.


One of the simple methods of prevention for nail fungal infection is keeping nails short and clean.

Treating nail fungus infections can be a long and expensive process. There are oral antifungal medications, topical ointments, and alternative therapies. Over the counter creams and ointments are available, but they have not proved very effective.

Oral medications for nail fungus infection include:

  • terbinafine
  • itraconazole
  • fluconazole

These typically take up to 4 months before fully replacing the infected nail with uninfected nail.

In some extreme cases, a physician will opt to remove the entire nail.

Home Remedies

Topical nail fungus treatments can appear clear nail fungal infections, but often do not completely cure the infection.

Other home remedies shown to have potentially promising clinical effects on nail fungus include:

  • Vicks Rub: This is normally used to treat coughs. However, a study published in 2011 suggests that it could be beneficial in nail fungus treatment.
  • Snakeroot extract: A 2008 study demonstrated that this naturally antifungal plant can be as effective as ciclopirox, a prescription antifungal treatment, in treating nail fungus.
  • Oregano oil: This contains thymol, which is said to have antifungal properties.Oregano oil is sometimes combined with tea tree oil in treatments, but side effects can be potent and combining them can increase the possibility of an allergic reaction or irritation.
  • Ozonized oils: Olive oil and sunflower oil are examples of oils that have been infused with the same gases present in the ozone layer. There are numerous studies confirming the benefits of this type of oil in treating nail fungus.
  • Other alternative medicines used to treat nail fungal infections include Australian tea tree oil, vinegar, listerine, and grapefruit seed extract. However, there is no scientific evidence supporting the use of these products.


Preventing nail fungus infections requires hand and foot hygiene. Some suggestions include:

  • keeping nails short, dry, and clean
  • wearing socks that breathe, usually synthetic
  • using antifungal sprays or powders
  • wearing rubber gloves to avoid overexposure to water
  • refraining from picking or biting nails
  • wearing shoes or sandals in public places and pools
  • ensuring that your manicure or pedicure salon properly sterilizes tools
  • using artificial nails and nail polish less often
  • washing hands after touching infected nails
  • avoid sharing shoes and socks

Risk Factors

Anyone can get a fungal nail infection, but they are more common in men than women and the elderly than the young. Some additional traits or factors raise the risk of nail fungal infection, these include:

  • diminished blood circulation
  • slow growing nails
  • a family history of fungal infection
  • heavy perspiration
  • humid or moist work environment
  • wearing artificial nails
  • wearing socks and shoes that prevent ventilation
  • walking barefoot in damp public places, such as swimming pools, gyms, and shower rooms
  • previous injury or infection to the skin or nail
  • Diabetes, AIDS, circulation problems, a weakened immune system
  • tight footwear with crowding of toes
  • exercise that causes repeated minor trauma to the hyponychium, where the fingertip attaches to the nail

Older adults are the most at risk of nail fungus infections as lower blood circulation and slower growing nails are part of the natural ageing process.

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