What is toenail fungus?

Toenail fungus is a common infection of the nail that happens when fungi get between your nail and nail bed (the tissue right underneath your toenail).

Tinea unguium (also known as onychomycosis) is another name for toenail fungus caused by a dermatophyte, which is a mold that needs keratin to grow. Dermatophytes cause about 90% of fungal infections of the toenail.

Symptoms of toenail fungus

Tinea unguium can change the appearance of your toenail with symptoms like:

  • Discoloration, changing your toenail to look more brown, white, or yellow
  • Causing your nail to look cloudy or chalky in some spots
  • Thickening of the toenail or making them look misshapen
  • Separation of the toenail from your nail bed, leaving space between your toenail and underlying skin
  • Nail brittleness or weakness, causing breaks or cracks

What causes toenail fungus?

Toenail fungus is caused microscopic organisms called fungi. A type of mold called a dermophyte also causes toenail fungus. Dermophytes feed off keratin, a protein found in your fingernails and toenails.

Is toenail fungus contagious?

Many types of toenail fungus, including tinea unguium, are contagious and spreadable through direct contact or touching an infected surface.

Common causes of fungal nail infections

Other types of fungi can cause infections of the nail too. Places that are warm, dark, and moist provide the perfect conditions for nail fungus to grow. Some common ways you can get toenail fungus include:

  • Swimming pools, especially walking around their perimeters
  • Using public locker rooms or showers, like those found at community fitness locations, gyms, or even in schools
  • Walking barefoot in public areas

Risk factors

Some people are at a greater risk of developing toenail fungus. Factors that can increase your risk include:

  • Age: Older people are more likely to get toenail fungus due to slower nail growth and reduced blood flow or circulation
  • Footwear: Wearing shoes that don’t allow for air to flow and circulate around your feet
  • Skin conditions: Things like Athlete’s foot or psoriasis can increase your risk of getting a fungal nail infection
  • Walking barefoot: Walking around without shoes, socks, or some other covering can make you more likely to come into contact with fungi found in public places
  • Certain health conditions: Diabetes, blood flow problems, or a weakened immune system can all make you more likely to get toenail fungus

When should you see a podiatrist for toenail fungus?

You should see a podiatrist for toenail fungus if you notice discoloration, thickening, or brittleness of your nails that doesn’t improve with over-the-counter treatments. If the infection spreads, causes pain, or affects your ability to walk or wear shoes comfortably, it’s important to seek professional care.

How is toenail fungus treated?

Toenail fungus isn’t always easy to treat, can take months to get rid of, and often comes back later on. We take a personalized approach to toenail fungus cases, helping you determine the best treatment options and care for your unique needs.

Antifungal medication

Oral antifungal medications can be an effective way to treat toenail fungus, but they’re not for everyone. These medications can impact your liver health and interact unfavorably with other prescriptions you may be taking. Most antifungal medications need to be taken daily for several months or longer, and include options like terbinafine, itraconazole, and fluconazole.

Topical medication

Topical medications are sometimes paired with oral antifungal medications, which often make them more effective. These medications can be applied directly onto your nail and treat the fungus over time.

Laser treatments

Toenail fungus can also be treated by directing high-tech laser beams and special lights at your nail. Lasers are an approved treatment by the FDA but are not a cure. In fact, laser treatments have been found to be less effective at treating toenail fungus than oral or topical medications and are not typically used as a first-line treatment.

How to prevent toenail fungus

While there’s no way to guarantee you won’t get toenail fungus, there are some things you can do to reduce your risk and steer clear from fungi, including:

  • Wear some sort of foot covering when walking in public places: Flip flops or sandals can keep your feet and nails better protected from fungi found in public locker rooms, showers, swimming pools, and other communal areas or moist environments.
  • Avoid coming into contact with family members or close friends with foot or nail fungus: If it’s someone within your household or that you frequently share certain areas with, wear flip flops or other foot coverings to avoid touching the same surfaces the infected person may have touched.
  • Be gentle with your toenails: Be careful when trimming your nails as trauma from accidental or aggressive clipping can create entry points for fungus to infect your nail. You should also avoid tearing or tipping your toenails on purpose.
  • Practice proper toenail trimming: Trimming your nails straight across and ensuring your nail trimmers are clean before using them can reduce your risk for getting a fungal infection. You should also soak your toenails in warm water before trimming them or wait to do so until after taking a shower or bath can.
  • Let your feet breathe and keep them dry: Make sure to thoroughly dry your feet after bathing, showering, or swimming. This will make it harder for fungus to grow and infect your toenails. You should also make sure to wear shoes that allow for good air circulation, keeping your feet from getting too sweaty and welcoming to fungi.