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Toenail fungus (Onychomycosis)

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Toenail fungal infections are very common and are caused by various types of fungi. The fungi thrive in warm, moist environments, making the toenails the perfect site for an infection.

Continue reading to learn more about causes, diagnosis and treatments.

Dr. Adrian Rawlinson

Medically reviewed by Dr. Adrian Rawlinson

Written by our editorial team Last reviewed 25 January 2024

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What is toenail fungus?

Toenail fungus, also called onychomycosis, is a fungal nail infection underneath the surface of the nail caused by different types of fungi. However, yeast and mold can also cause nail infections.

The most common type of fungal nail infection is a type called dermatophyte. Fungal nail infections caused by dermatophytes are known as tinea unguium. These infections can affect the toenails, fingernails, or both. Fungal toenail infections are more common than fingernail infections.

Although most infections are not serious, patients often want treatments to recover faster and to reduce unpleasant symptoms.

If you leave fungal nail infections untreated, they can spread and make it challenging to work or even walk.

Are fungal nail infections common?

Yes, fungal nail infections are extremely common with most people experiencing one at some point in their lifetime. The CDC reports that this condition affects 14% of the general population.

What causes toenail fungus?

Fungal nail infections are caused by small organisms called fungi. People usually pick up fungi through skin-to-skin contact with someone who has a fungal infection.

Another common way to get a fungal nail infection is by walking barefoot in warm, moist areas where fungi thrive such as swimming pools, locker rooms, or showers.

The fungi usually enter your nail(s) by getting into small cracks in the skin surrounding your nails or cracks in the nails themselves. From here, the infection can then spread to other nails or even your skin.

Is toenail fungus contagious?

Fungal infections are contagious and can spread through direct contact with someone who has the infection. You can also get the infection by touching an infected surface.

Who gets fungal nail infections?

Nail fungus is common, and anyone can get it. Some people are more likely to get a fungal nail infection. These include athletes, older adults (65+), and those with the following medical conditions:

  • A nail injury
  • Diabetes
  • A weakened immune system
  • Cancer
  • Psoriasis
  • Poor circulation in the legs or narrowed arteries resulting in reduced blood flow to the arms or legs
  • Fungal skin infections on other parts of the body (e.g. athlete’s foot)

Risk factors

  • Your risk of getting a fungal nail infection increases if you:
  • Have wet feet or hands often
  • Smoke
  • Spend a lot of time in the water
  • Walk barefoot in damp places like a swimming pool, public shower, gym or locker room
  • Wear tight-fitting, closed-toe shoes, that make your feet sweat heavily
  • Live in a hot, humid climate
  • Sweat a lot

What are the symptoms of a fungal nail infection?

If you get a fungal nail infection, you may see one or more of the following changes to your nails:

  • The entire nail plate (or a part of the nail plate) turns white, yellow, or brown. The nail may also look chalky or cloudy in some areas.
  • Debris builds up under the nail.
  • A nail begins to lift away and separate from the nail bed.
  • The surface of the nail may feel soft, dry, and powdery.
  • The nail may become thin, split, break or crumble.

The resulting thicker nails are harder to trim and may cause pain when walking. The infection can spread to other toenails, the skin, or even the fingernails.

How is it diagnosed?

To diagnose nail fungus, your healthcare provider will ask you about your symptoms and examine your nails and surrounding skin. This is to check if the fungus has spread.

They may also take some samples such as debris from beneath a nail, nail trimmings, or scraping off a bit of nearby skin. These are sent to a lab where they can be examined under a microscope.

How can I prevent toenail fungus?

There are several steps you can take to help prevent getting a fungal nail infection:

  • Avoid going barefoot in communal spaces such as public showers and swimming pools. Consider wearing flip-flops in these areas.
  • If you have diabetes, follow all foot care recommendations from your doctor.
  • Keep your feet dry (dry them well after a shower).
  • Keep fingernails and toenails short and clean.
  • Don’t share personal items such as nail clippers, socks, or towels with others.
  • Change your socks daily and alternate the shoes you wear (let them air out).
  • Wear shoes that fit well and keep your feet dry.
  • Treat any infections straight away.

What are the best toenail fungus treatment options?

Having nail fungus is usually painless in the beginning. However, if treatment is delayed, the fungus can grow and spread. To get rid of the infection, you will need to treat all infected areas.

Fungal nail infections can take a long time to cure, it can take several months to a year for the infection to go away. Treatment is most successful when started early.

If you’re wondering how to get rid of toenail fungus, you can consider the following effective treatment options:

Topical treatments

If you have a mild infection, a solution that you paint on the affected nails may treat the infection.

The Food and Drug Administration (FDA) has approved the following medicines for this purpose:

  • Amorolfine
  • Ciclopirox
  • Efinaconazole
  • Tavaborole

This treatment helps keep new fungus out while the nails grow. Some treatments require daily application whereas others are applied weekly.

Treatment generally lasts months as it takes time for nails to completely grow. Fingernails typically grow out in four to six months. Whereas, toenails usually take 12 to 18 months to grow out. Forgetting to apply these medicines could delay the process.

Antifungal tablets

If you have a more severe infection your doctor may prescribe antifungal tablets. These generally work faster than solutions applied to the nails.

Antifungal drugs are generally taken for 6 weeks to cure fingernail infections and 12 weeks to treat toenail infections. As these work throughout the body, they may cause side effects so your doctor will monitor you closely while you take them.

The FDA has approved medicines such as Terbinafine, Fluconazole and Itraconazole to treat fungal infections of the nail.

Sometimes, if nail fungus is hard to cure, your doctor might suggest combination therapy. This involves taking an antifungal tablet while using a topical treatment.

Nail removal

If you have a severe infection or other treatments don’t work, your doctor may refer you for nail removal to get rid of the infection. This can be done by either chemical or surgical nail removal. The nail can grow back with either procedure.

Home remedies for toenail fungus

Some people have used home remedies such as menthol rub, snakeroot extract, or tea tree oil for toenail fungus. However, the results of these are inconclusive as studies are either small or show mixed results.

Can I buy toenail fungus (onychomycosis) medication online?

You can purchase prescription medicines for toenail fungus online here at SpeedyHealth. You must first complete an online medical consultation before ordering your treatment.

Our doctors will then review your answers to the medical questions to ensure this medication is safe for you to take. If they approve, your order will be sent to you with discreet packaging.

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