Aging

Nail Fungus Treatment: Taking Care of Business

December 28, 2022

Many of us only pay attention to our toes when it’s time to trim our nails. 

Unless you live near the beach, most daily-shoed Americans aren’t much concerned with our feet unless there’s something clearly amiss. 

It’s easy to take your feet for granted — obviously, you know they’re essential for standing up and walking around, but your feet can actually serve as a strong indicator of your overall health! And it’s no surprise that nearly three in every four Americans experience at least one major foot related issue in their life.  Chronic foot pain can be an early sign of diabetes, arthritis, or being overweight

Fungus is another common medical issue for feet. 

Thankfully, toenail fungus treatments are fairly simple regardless of the type of fungus — here’s what you need to know about treating toe fungus effectively.

Man's toes at the beach

What Is Nail Fungus?

Nail fungus is exactly what it sounds like: a fungal infection that primarily affects the toenails. It’s possible for you to experience nail fungus on your fingernails, but fingernail fungus is rare. 

The medical term for nail fungus is onychomycosis, and it’s a common ailment. Experts estimate that as many as one in ten people will experience nail fungus during their life. The odds increase to one in every two for people over the age of 70. 

Nail fungus is characterized by radical changes to the appearance of your toenails. Healthy toenails are typically pink, shiny, and smooth. Nail fungus will cause them to look white, black, brown, or yellow in color. It can also cause them to become thick, brittle, and even start to hurt. 

The fungal infection that causes these symptoms actually occurs underneath your toenail. The fungus attacks the keratin that composes your toenail, and leaving the infection untreated can cause it to spread to your other toenails and even fingernails. It can also result in an embarrassing and foul smelling odor coming from your nails. 

There are four types of onychomycosis:

  • Distal subungual onychomycosis is the most common nail fungus and accounts for around 85% of nail fungus cases. This fungus will create scaling underneath the infected part of the nails, making them thicker, discolored, and brittle.
  • White superficial onychomycosis causes your nails to turn white and start to crumble.
  • Proximal subungual onychomycosis is common for people with suppressed immune systems. This fungus will cause your nail to turn white near the cuticle. 
  • Candidal onychomycosis will cause the toenail to completely separate from your toe.   

What Causes Nail Fungus? 

There are a few causes of nail fungus because there are few types of fungi that can affect your nails. 

The most common cause of onychomycosis is a group of fungi called dermatophytes. These microorganisms are impossible to see without a microscope. Dermatophytes survive by feeding on keratin, which is a protein that gives structure and strength to your nails and hair. 

Your toenails are especially vulnerable to dermatophytes when your bare feet touch damp surfaces. Showers, swimming pools, nail salons, and locker rooms are basically petri dishes for fungi. 

Another common cause of nail fungus is wearing closed shoes and socks for a long period of time. When you wear socks with poor ventilation, your sweat causes moisture buildup, and the socks become a breeding ground for fungus. These conditions are common in the world of sports, which is why the term “athlete's foot” is a nickname for most types of fungal skin infections

Wearing tight shoes can also increase the odds of a fungal infection. The pressure on your toes can damage your nail bed and weaken the bond with your toe nail. Dermatophytes will be able to infect your toenails much easier when this bond has been impaired.  

Chronic health issues and a weak immune system can also increase the risk of developing nail fungus. Diabetes, excessive sweating, and poor blood circulation have all been shown to increase the odds of developing nail fungus. A weak immune system, especially autoimmune disorders or HIV, will also dramatically increase the risk of nail fungus. 

Man working out with shoes on

Is Nail Fungus Contagious?

Nail fungus is very contagious and can quickly spread with direct contact. That’s why you should always wear shower shoes in community showers, swimming pools, or locker rooms. The dermatophytes that cause nail fungus can live on surfaces for months at a time. All it takes is one person with a fungus to potentially infect the entire area and spread it to everyone else. 

Nail fungus can even be contagious to other parts of your body. The largest risk is other toenails and your fingernails. But in some cases, nail fungus can spread to the skin between your toes (athlete’s foot), groin (jock itch), or your scalp. 

In rare cases, dermatophytes can spread to your skin and cause ringworm. These itchy little red rings can spread on your body much easier than nail fungus so you’ll need to treat them quickly. 

How Can You Treat Nail Fungus? 

Nail fungus has noticeable symptoms, but it usually doesn’t cause pain, and unsightly toenails aren't always enough for people to take a trip to the doctor – but that’s where nail fungus can get dangerous. 

It normally takes several months of treatment to completely remove nail fungus. Worst of all, you’ll be at risk of spreading the fungus and infecting others during this entire time. 

Even if you get rid of the dermatophytes, they tend to come back and reinfect. For extensive cases, it may be best to talk with a dermatologist (skin specialist) or podiatrist (foot specialist) to figure out what kind of treatment will be most effective for you.

These are a few of the most effective treatments for nail fungus:

Oral Antifungal Medication

The easiest remedy involves taking a prescription oral medication

Terbinafine (Lamisil®), itraconazole (Sporanox®), and fluconazole (Diflucan®) are commonly prescribed to treat fungal infections. You’ll need to take these medications every day for several months to fight the fungus. 

Taking these medications will help you to grow a new nail that is free of the fungal infection. The new and healthy nail will eventually overtake the infected part and you’ll be rid of the fungus. 

These drugs can interact with other medications and have a significant effect on your liver. Make sure that you tell your prescribing doctor about any other prescriptions you have or if you have issues with your liver.

Topical Antifungal Medication

Topical medications work best when paired with oral antifungals. 

Ciclopirox is nail polish that you’ll apply to your nail and the surrounding skin every day. At the end of a seven day period, you’ll need to use rubbing alcohol to wipe down the area. It can take a year of daily application and weekly wipes to eliminate the fungus. 

Tolnaftate and clotrimazole are ingredients that can be found in over-the-counter products. The directions may vary, but you’ll likely need to apply these medicines daily for a long period of time.    

At-Home Remedies

Some at-home remedies have been shown to help with fungal infections. These should be fine to treat minor infections, but you should visit a doctor if the symptoms haven’t improved or have gotten worse. 

The Takeaway

Nail fungus is a common issue with a variety of gentle treatment options, though they all take weeks to months to take hold. 

Over-the-counter topical options can treat nail fungus, but it takes consistent, regular use for long periods. Oral medications are also effective for treating nail fungus, replacing your infected nail with healthy, clean new nail. A fungal infection in your feet could also be a sign of an underlying medical condition. If you suspect poor circulation or other issues are at the root of your nail infection, talk to a doctor about the right course of action.