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Toenail fungus, or onychomycosis, is a fairly common infection underneath the surface of the toenail that affects about 20% of Americans. Typically, it’s caused by tiny fungal organisms called dermatophytes. (Less commonly, the infection can be caused by molds or yeasts.) Once infected, the toenail often darkens and develops white streaks, becomes thick, and gives off an unpleasant odor. Debris may gather beneath the nail as well.
If left untreated, the infection may spread to other toenails, making it hard to walk. The fungal infection can also travel to your fingernails or skin.
Toenail fungus occurs when any of the following enter your feet through a skin cut or a separation between your nail bed and nail, then grow and thrive:
Even tiny cuts or separations can let in these microscopic organisms. Most commonly, people pick up the microorganisms in warm, moist places such as:
Several factors can make people more prone to toenail fungus. These are:
To following procedures are used in diagnosing toenail fungus:
Though there’s more than one kind of toenail fungus, symptoms are generally similar.
You may have a fungal infection if your toenails are:
Treating toenail fungus can be difficult. The condition is cured by the growth of new, healthy nails, but toenails grow very slowly, which means it can take up to a year for the infection to fully clear. According to the National Institutes of Health, medicines only clear up about half of all cases, and even then, the infection may eventually come back.
Because it can take months for a fungal toenail infection to clear (if it indeed does; half of all cases don’t respond to treatment), you may just have to manage the infected nail.
Here are a few tips:
Depending on the severity of the infection, you and your podiatrist may decide to remove the nail entirely.
Though it is common, toenail fungus is not a disease that is regularly screened for. If you think you have toenail fungus, visit your doctor. She will examine your toenail, and may also take a scraping of the debris beneath it to send to a lab for further testing, and will most likely be able to provide prompt diagnosis and treatment.
Since toenail fungus is so hard to treat, catching it early – or better still, avoiding it in the first place – is important. Regularly inspect your feet and toes, so you spot problems before they become severe.
And practice these healthy habits:
While over-the-counter toenail-fungus medications are available, experts agree they generally aren’t very effective. You physician is more likely to recommend one of these medicines or treatments instead:
Home remedies for toenail fungus haven’t been thoroughly studied, but these two are popular:
Stick with your medications. You may need to take them for up to a year before you see results—but they won’t work at all if you don’t keep taking them as directed.
Practice good foot hygiene, including washing your feet with soap and water and drying them daily; wearing breathable and comfortable shoes, socks, and hosiery; and keeping your toenails trimmed. Wear shower shoes in public bathing areas, and make sure that any grooming tools used on your feet have been disinfected beforehand. These steps can help keep your infection from spreading or worsening, and in some cases may even temporarily make it subside. See additional prevention methods here.
If you’ve already been diagnosed with toenail fungus, call your doctor if:
Occasionally, the affected area can also develop a bacterial infection. If any of these symptoms occur, contact your physician:
Whether your primary care physician focuses on family, internal, or geriatric medicine, talking to him or her is the best place to begin. Your physician can either treat the fungus or refer you to someone who can. Be sure to check with your insurance carrier about which of these professional services are covered. The following health professionals can all diagnose and treat fungal nail infections:
Knowledge is power when it comes to treating and managing your toenail fungus. Some good questions to ask your doctor include:
April is National Foot Health Awareness Month, founded by the American Podiatric Medical Association. There are a number of online resources for people who want to know more about toenail fungus and foot conditions.
For extensive information on the causes treatments and prevention of toenail fungus, as well as general foot-care tips and a directory of podiatrists, visit: The American Podiatric Medical Association
Interested in the very latest studies and research? Find that, as well as a photo gallery and self-care guidelines, here: The National Library of Medicine’s MedlinePlus website
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