7 Things to Know About Toenail Fungus

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Ashley Festa on March 29, 2021
  • woman applying ointment to foot, low section
    Toenail fungal infections can be tricky to treat successfully.
    Toenail fungus is an infection that develops right under your toenail, on top of the skin. Toenail fungus can strike at any age, but older people have an even greater risk of becoming infected—up to 50% of people older than 70 will develop toenail fungal infections. There are several types of toenail fungus caused by different fungi, such as yeasts or molds. The most common type is dermatophytes, which is a type of mold that feeds off the keratin in your nails.

    Even with the most effective toenail fungus treatment, the condition is notoriously difficult to cure, and toenail fungus often comes back. Find out what you need to know about toenail fungus treatment and prevention.
  • athlete's foot closeup
    1. Toenail fungus can spread to other parts of the foot.
    Toenail fungus, called onychomycosis, begins under the tip of your toenail. It can spread all over the nail, causing the toenail to become discolored, thickened or brittle, and it may begin to crumble at the edge. Toenail fungus can spread to other parts of the foot, too, typically between the toes. When this happens, the condition is called athlete’s foot, or tinea pedis. Onychomycosis can also affect the fingernails, though this is less common.
  • Senior man talking with dietician in home kitchen
    2. If you have other health conditions, getting a toenail fungus can be more problematic.
    If you have health conditions that inhibit your body’s ability to fight infections, such as diabetes or a suppressed immune system, you have an increased risk of complications from toenail fungus. The infection could spread to other parts of your body, potentially causing serious conditions, such as cellulitis. Cellulitis is a bacterial skin infection that can occur on the lower legs, face and arms, and it can also spread to your lymph nodes and bloodstream. When this happens, the condition can be life-threatening. If you notice symptoms of cellulitis—swollen, red and painful skin—call your doctor.
  • woman applying ointment to foot, low section
    3. Toenail fungus treatment options can begin at home.
    If the infection is not painful and it’s relatively mild, over-the-counter fungal treatments are a good place to start. Medicated topical antifungal creams and ointments are available without a prescription. Before you apply the topical treatment, be sure to prep your toenails—file away any surface spots on the nail. Then soak and dry your toenails. If you can, trim and thin your toenails with a file before applying the topical antifungal treatment. This will allow the medication to soak deeper into the nail. Be sure to treat your shoes with an antifungal spray or powder, too. Always wash your hands after treating toenail fungus.
  • Unseen Caucasian man's feet getting pedicure
    4. If home remedies are unsuccessful, you may need a doctor’s help treating a toenail fungus.
    If the infection becomes painful or you have other health conditions that could complicate the condition or its treatment, talk to your doctor. You may need a prescription antifungal treatment, whether an oral drug, topical cream, or medicated nail polish. Oral antifungal drugs are often the most effective toenail fungus treatment, though they can potentially interact with other medications or cause liver problems. People over age 65 may see less success with oral antifungals. Toenail fungus laser treatment is also a consideration, though it’s often less successful than oral or topical treatments. No matter what treatment you use, it can take several months or even a year to see results.
  • Close-up image of toenail fungus (onychomycosis) on a white background
    5. A toenail fungus cure using medication may only be temporary.
    Curing toenail fungus can be a challenge. Even after treating a toenail fungus, it often comes back. In some cases, a doctor may recommend surgically removing the toenail temporarily to apply antifungal underneath the nail. If the infection is severe and very painful, you may need the entire nail permanently removed. Because it’s so difficult to treat, preventing toenail fungus from developing in the first place is your best bet.
  • Podiatry Treatment
    6. Treat your nails like you do your skin.
    You can take steps to prevent toenail fungus. Because fungi are more likely to infect dry, cracked nails, moisturizing your toenails is a good way to prevent infections. Also take precautions in public places where people often go barefoot—wear shoes or flip flops in pool areas and gym showers. Keep your feet sweat-free by changing your socks if they get sweaty and by choosing shoes with ventilation or breathable material.
  • unidentified person scratching itchy feet on grass
    7. Delaying toenail fungus treatment can increase the risk of complications.
    Waiting to treat toenail fungus until it gets worse and bothersome not only makes it even more difficult to cure, it also increases the chance the condition will spread beyond the toenails. The rest of your foot, your hands, your groin and your scalp are at a high risk of getting this type of fungal infection if it begins to spread. Untreated toenail fungus can also permanently damage your toenail or cause other complications. If you have toenail fungus, seeking a doctor or healthcare provider’s care will increase your chances of a successful treatment.
7 Things to Know About Toenail Fungus | Onychomycosis

About The Author

Ashley Festa is a Greenville, S.C.-based freelance writer and editor who has been writing professionally for nearly two decades. In addition to Healthgrades, she also has written for Johns Hopkins School of Nursing, the University of Texas at Arlington School of Nursing and Health Innovation, and Fit Pregnancy magazine.
  1. Nail fungus. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/nail-fungus/symptoms-causes/syc-20353294
  2. How You Can Stop Foot and Toenail Fungus in Its Tracks. Cleveland Clinic. https://health.clevelandclinic.org/how-you-can-stop-foot-and-toe-fungus-in-its-tracks/
  3. Toenail Fungus. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/11303-toenail-fungus
  4. What Is Toenail Fungus? American Podiatric Medical Association. https://www.apma.org/toenailfungus
  5. Fungal Nail Infections. Centers for Disease Control and Prevention. https://www.cdc.gov/fungal/nail-infections.html
  6. Cellulitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cellulitis/symptoms-causes/syc-20370762

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Last Review Date: 2021 Mar 11
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