Toenail Fungus

Definition

Toenail fungus, known by physicians as Onychomycosis, affects about half of Americans by the age of 70. It is relatively rare in children, but the incidence increases with age. Fungus infections occur when microscopic fungi gain entry through a small trauma in the nail, then grow and spread in the warm, moist environment inside the patient’s socks and shoes.

Symptoms of toenail fungus, which can be caused by several types of fungi, include swelling, yellowing, thickening or crumbling of the nail, streaks or spots down the side of the nail, and even complete loss of the nail. Toenail color can vary from brown or yellow to white with this condition.

Fungal infections can affect the fingernails as well as the toenails, but toenail fungus is more difficult to treat because toenails grow more slowly. It occurs most often on the big or small toe, but might occur on any toe.

Cause

Toenail fungus can be picked up in damp areas such as public gyms, shower stalls or swimming pools, and can be passed among family members. Athletes and people who wear tight-fitting shoes or tight hosiery that cause trauma to the toes or keep the feet from drying out are at higher risk. The condition can also spread from one toe to another, or to other parts of the body.

Other risk factors include abnormal PH level of the skin, not drying off the feet thoroughly after bathing or exercise, and a compromised immune system in someone who has been exposed to a fungus. Diabetics have an increased risk of contracting a toenail fungus because their immune system is compromised. They should have their nails cut and debrided by a podiatrist.

Treatment and Prevention

Because it is difficult to treat or eradicate toenail fungus, it is a good idea to try to prevent it. It helps to wear protective shoes or sandals in public showers, pool areas and gyms, and to avoid borrowing someone else’s shoes or sharing socks or towels with someone who has toenail fungus. An orthotic device can be used to add cushioning and/or control over-pronation, support the longitudinal arch, and reduce stress on the lower leg muscles.

Wash your feet regularly, and dry them thoroughly when they get wet. Wearing nail polish on the toes is not advised because it can seal in fungus and allow it to grow. Keep toenails trimmed, and be sure to disinfect any pedicure tools before using them.

If you do develop toenail fungus, see your foot doctor. The doctor might remove as much of the nail as possible by trimming, filing or dissolving it. Medicated nail polish might be prescribed for a localized infection, but a serious infection will likely be treated with a prescription oral antifungal medication. These medications can have side effects, so be sure to work closely with your doctor on your treatment plan. Only in severe cases will surgical removal of the nail be recommended.

If you suspect that you have toenail fungus, see your foot doctor.