Athlete’s foot appears as a scaly red rash on the bottoms or sides of the feet often accompanied by itching, dry or cracked skin, stinging, and odor. You can also have moist, raw skin between your toes. Though athlete’s foot is fairly easy to treat with over-the-counter anti-fungal creams or sprays, this foot fungus is quite contagious and may easily spread to your toenails.
Chronic nail trauma, such as repeatedly starting and stopping, kicking, and other athletic endeavors, can cause damage to the nails that can look a lot like fungal nails. This sort of repetitive trauma can also occur with certain types of employment or wearing tight-fitting shoes. Some traumas may cause permanent changes that may mimic the appearance of fungal nails.

Oral antifungal therapy has a high cure rate, depending on the medication. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back. Currently, an oral antifungal therapy is considered the best treatment for toenail fungus because of higher cure rates and shorter treatment duration compared to topical therapy.

Healing time depends on the type of treatment used. Prevention of a new infection is important. Orthopaedic foot and ankle specialists recommend good foot hygiene with frequent changing of stockings and rotating pairs of shoes to allow them to completely dry between uses. Also, avoid going barefoot in locker rooms and around swimming pools. If you have a pedicure, make sure the nail salon uses sterilized instruments.
Starts at the base of the nail and raises the nail up: This is called "proximal subungual onychomycosis." This is the least common type of fungal nail. It is similar to the distal type, but it starts at the cuticle (base of the nail) and slowly spreads toward the nail tip. This type almost always occurs in people with a damaged immune system. It is rare to see debris under the tip of the nail with this condition, unlike distal subungual onychomycosis. The most common cause is T. rubrum and non-dermatophyte molds.

Athlete's foot is a form of dermatophytosis (fungal infection of the skin), caused by dermatophytes, fungi (most of which are mold) which inhabit dead layers of skin and digests keratin.[2] Dermatophytes are anthropophilic, meaning these parasitic fungi prefer human hosts. Athlete's foot is most commonly caused by the molds known as Trichophyton rubrum and T. mentagrophytes,[21] but may also be caused by Epidermophyton floccosum.[22][23] Most cases of athlete's foot in the general population are caused by T. rubrum; however, the majority of athlete's foot cases in athletes are caused by T. mentagrophytes.[13]


In some cases of suspected nail fungus there is actually no fungal infection, but only nail deformity. A 2003 source gives a figure of 50%[17] whereas a more recent source claims that fungus is present in 65 to 95 percent of cases.[18] Avoiding use of oral antifungal therapy (e.g. terbinafine) in persons without a confirmed infection is a particular concern because of the possible side effects of that treatment.[17] However, according to a 2015 study, the cost in the United States of testing with the periodic acid–Schiff stain (PAS) was about $148. Even if the cheaper KOH test is used first and the PAS test is used only if the KOH test is negative, there is a good chance that the PAS will be done (because of either a true or a false negative with the KOH test). But the terbinafine treatment only cost $10 (plus an additional $43 for liver function tests). In conclusion the authors say that terbinafine has a relatively benign adverse effect profile, with liver damage very rare, so it makes more sense cost-wise for the dermatologist to prescribe the treatment without doing the PAS test. (Another option would be to prescribe the treatment only if the potassium hydroxide test is positive, but it gives a false negative in about 20% of cases of fungal infection.) On the other hand, as of 2015 the price of topical (non-oral) treatment with efinaconazole was $2307 per nail, so testing is recommended before prescribing it.[18]
I can tell you my own mother struggled with toenail fungus on her big toe for over 10 years, and the reason why she originally got it and then continued to struggle with this fungus was the chemotherapy she went through when diagnosed with breast cancer years ago. After going through chemo, she had systemic yeast and candida issues and then developed the toenail fungus. The exact treatment I detail below is what we used with her to successfully erase her fungus.
No one knows where a specific person catches the fungus, as it is everywhere. However, since the fungus does thrive in warm moist areas (like sweaty feet), there are certain areas one should avoid or use with caution. Shower floors, locker rooms, and swimming pools are suspected of being sources of the fungus, although there are no studies proving this fact. Nail polish and acrylic nails also make the nail less "breathable" and make the nail more susceptible to fungal infection. Fungi are everywhere -- in the air, the dust, and the soil. Hygienic measures such as spraying socks and footgear sound sensible, and perhaps these measures can even help a little bit. However, avoiding tight, nonbreathing shoes or steering clear of athletic facility floors may very well be the best prevention available. Daily washing of the feet and drying between the toes can help to prevent nail fungus. The fungi carried on the coats of pets, like cats and dogs, don't often cause nail fungus. Wearing white socks does not help.
Topical agents include ciclopirox nail paint, amorolfine, and efinaconazole.[19][20][21] Some topical treatments need to be applied daily for prolonged periods (at least 1 year).[20] Topical amorolfine is applied weekly.[22] Topical ciclopirox results in a cure in 6% to 9% of cases; amorolfine might be more effective.[2][20] Ciclopirox when used with terbinafine appears to be better than either agent alone.[2]

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The final step to removing fungal and yeast infections is taking supplements, such as the probiotic supplement that I mentioned above. A quality probiotic supplement will help you get rid of the yeast and candida in your system that’s truly causing your toenail fungus. I personally recommend a probiotic supplement that has at the very least 10+ strains of probiotics with at least 15 billion CFUs.
The most common symptom of a fungal nail infection is the nail becoming thickened and discoloured: white, black, yellow or green. As the infection progresses the nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. If left untreated, the skin underneath and around the nail can become inflamed and painful. There may also be white or yellow patches on the nailbed or scaly skin next to the nail,[6] and a foul smell.[7] There is usually no pain or other bodily symptoms, unless the disease is severe.[8] People with onychomycosis may experience significant psychosocial problems due to the appearance of the nail, particularly when fingers – which are always visible – rather than toenails are affected.[9]

Since some people are simply more prone to fungal infections, they are also prone to repeated infection. Preventive measures include keeping your feet clean and dry, avoiding prolonged moist environments, using socks in airport security lines, removing shoes, and allowing the feet skin to "breathe," avoiding walking barefoot, especially in public areas like swimming pools and gyms, avoiding contact with known infected people, and avoiding soaking and contaminated tool usage at nail salons. Weekly applications of a topical antifungal foot cream or sprinkling of antifungal foot powder (Zeasorb Foot Powder) into shoes may also be helpful.
Topical antifungal agents can be used but are often ineffective. Oral terbinafine is considered to be the first-line treatment for confirmed onychomycosis; the treatment course is generally 6 weeks for fingernails and 12 weeks for toenails.9 Azoles can also be used. Surgical debridement or removal of the affected nail is also a consideration for cases that are resistant to antifungals, and laser treatments for onychomycosis appear to be a promising area for future study.10
Dr. Kyoung Min Han is a podiatrist (foot and ankle specialist) practicing in Southern California. Dr. Han completed her undergraduate education at the University of California, San Diego, and went on to the New York College of Podiatric Medicine to pursue her medical training. She returned to her native Southern California to complete a three-year foot and ankle surgical residency, followed by subspecialty training in a sports medicine fellowship.
Starts at the base of the nail and raises the nail up: This is called "proximal subungual onychomycosis." This is the least common type of fungal nail. It is similar to the distal type, but it starts at the cuticle (base of the nail) and slowly spreads toward the nail tip. This type almost always occurs in people with a damaged immune system. It is rare to see debris under the tip of the nail with this condition, unlike distal subungual onychomycosis. The most common cause is T. rubrum and non-dermatophyte molds.
For more severe cases, oral antifungal medications might be required. These include fluconazole (an antifungal agent also commonly used to treat thrush), terbinafine (a broad-spectrum antifungal) and griseofulvin (usually used for skin infections). The latter is a very old drug and carries the risk of causing damage to the liver. Terbinafine is most effective and therefore is the preferred oral treatment. A 12-week course cures 70-80% of cases by causing the fungi’s cells to leak and die. It can, however, cause gastrointestinal side effects and depression.
Many individuals with athlete's foot have no symptoms at all and do not even know they have an infection. Many may think they simply have dry skin on the soles of their feet. Common symptoms of athlete's foot typically include various degrees of itching, stinging, and burning. The skin may frequently peel, and in particularly severe cases, there may be some cracking, fissuring, pain, and itching in the toe webs. Occasionally, athlete's foot can blister.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Whitish or yellowish nails can occur due to onycholysis. This means separation of the nail from the nail bed. The color you see is air beneath the nail. The treatment is to trim the nail short, don't clean under it, polish if you want to hide the color, and wait two to three months. Persistent onycholysis can make the nails susceptible to fungal infection.

Ringworm of the beard, or tinea barbae, is similar to ringworm of the scalp in that the fungus infects both the skin and the hair follicle. The most common type of tinea barbae is an infection deep in the skin that causes very red nodules on the face with pus that drains and tunnels through the skin to other areas close to the nodules. A less common type of tinea barbae is a mild infection on the surface of the skin.
Is it nail psoriasis or fungus? Is it nail psoriasis or fungus? Nail psoriasis is the result of a systemic condition in which the skin, and therefore also the nails, grow too fast. Nail fungus is the result of an infection, and it more common in the toenails. It is important to know the difference, so that effective treatment can be provided. Read now
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