Fungal Toenail Infection


Fungal toenail infection, also known as onychomycosis, occurs when fungi invade your toe’s nail bed and other structures. Fungal toenail infections can be difficult to treat, and some of these infections may require the use of anti-fungal medicines. Fungi, including the fungi that invade your toenails, thrive in moist, dark, and humid environments. Consult your podiatrist if you think you have a fungal toenail infection.

Condition Information

People of all ages may develop this health problem, although fungal toenail infections are most common among people 60 years of age and older. Fungal toenail infections occur with greater regularity in people who have diabetes and/or circulation problems, and men are more likely than women to develop this common health problem.

Constricting, closed-toe footwear and time spent in locker rooms are two of the most significant factors contributing to this condition. In some cases, it is difficult to know where or how you acquired your fungal toenail infection. People who wear boots and other footwear that cause their feet to sweat or who walk barefoot in locker rooms should be particularly vigilant about contracting this infection and take the necessary precautions to avoid infection.

It is relatively common that several people in a family will develop fungal toenail infections around the same time. Fungal toenail infections of multiple family members may occur if family members happen to be sick at the same time and their immune systems are unable to combat the infection. Fungal toenail infections may also be spread between family members through the sharing of infected towels.

Causes and Symptoms

Fungal toenail infection usually follows fungal infection of your feet. Some of the most significant factors causing fungal toenail infections, besides exposure to damp floors in public swimming pools, gyms, or public showers, include:

  • Pedicures involving utensils that have been used on infected individuals
  • Minor skin wounds or nail damage
  • Nail deformities and disease
  • Skin that remains moist for prolonged periods
  • Low immune system function
  • Footwear that encourages sweat production

Your doctor can often diagnose your fungal toenail infection simply by examining your affected toenail. Signs and symptoms that most commonly suggest a fungal toenail infection include:

  • Toenails that are white or yellow in color
  • Toenails that are brittle or crumbly at their ends
  • Thick toenails
  • Toenails that detach from your nail bed
  • Toenails that are curled or deformed
  • Debris located under your toenails
  • Decreased toenail shine or luster


Oral prescription medicines may be necessary in some cases, but they are harsh on your liver. Topical application of certain anti-fungal creams or ointments may also help treat your fungal toenail infection, especially when your nail is carefully filed down regularly in order to expose the fungus to the medicine.

Follow these simple steps to help treat your fungal toenail infection using a topical cream.

  • Use an emery board, after your shower or bath, to file down your infected toenail as close to the skin as you can get without irritating the skin under your nail. You may also choose to go to a podiatrist every few months to have your toenails professionally filed down with a rotary file.
  • Apply topical anti-fungal cream or ointment on your toenails when you are getting ready for bed. Wrap plastic wrap around your toenails to help keep the medicine next to your nails all night. If the medicine is not protected, it may rub off your toenails and soak into your sheets.
  • Wear socks to bed over the plastic wrap to help keep the wrap in place all night. Tape or Coban (self-sticking tape) can also be used.
  • Discuss with your podiatrist whether a prescription or over-the-counter anti-fungal product is most appropriate for your personal situation.

Keep in mind that your toenails grow about 1 millimeter per month. You should be able to get rid of your toenail fungus in about 1 year if you follow the topical treatment plan described above.

Once you’ve eradicated the fungus, wearing appropriate footwear—footwear that allows your feet to breathe—is one of the most important preventive health measures for this health problem. Also, change your socks periodically to help mitigate fungal growth. Socks made of newer synthetic materials may help wick moisture away from your skin, which helps inhibit fungal invasion. Also, expose the skin of your feet to light and air as much as possible — this allows your skin to naturally protect itself from infection.

-Dr. Ray McClanahan, DPM, Northwest Foot and Ankle

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