If the diagnosis is uncertain, direct microscopy of a potassium hydroxide preparation of a skin scraping (known as a KOH test) can confirm the diagnosis of athlete's foot and help rule out other possible causes, such as candidiasis, pitted keratolysis, erythrasma, contact dermatitis, eczema, or psoriasis.[13][23][27] Dermatophytes known to cause athlete's foot will demonstrate multiple septate branching hyphae on microscopy.[13]
Toenail fungus, also know as onychomcosis, is characterized by inflammation, thickening, swelling, yellowing, and pain of the toenail and toe. Another symptom is crumbling of the toenail. It’s caused by an abnormal PH of the skin, which can happen because of poor hygiene, a bad immune system, exposure to high levels of moisture, and/or poor circulation. These toenail fungus treatments will prevent or get rid of the problem.

Wei, Y.-X., Xu, X.-Y., Xu, & Song, X. (2017). A review of antifungal natural products against the pathogenic fungi causing athletes' foot disease. Current Organic Chemistry, 21, 1–13. Retrieved from https://www.researchgate.net/profile/Xun_Song/publication/319128408_A_Review_of_Antifungal_Natural_Products_Against_the_Pathogenic_Fungi_Causing_Athletes'_Foot_Disease/links/59931c65458515c0ce61efa1/A-Review-of-Antifungal-Natural-Products-Against-the-Pathogenic-Fungi-Causing-Athletes-Foot-Disease.pdf


Cultured dairy or fermented foods (ideally organic and raw) — these are beneficial for replacing good bacteria in the gut since they provide probiotics. Probiotics help control yeast and also have numerous immune-enhancing effects. For other sources of probiotics, in addition to yogurt or kefir try cultured foods like kimchi, kombucha or sauerkraut.
Garlic has antifungal properties useful to foot fungus treatment, thanks to its compounds such as allicin and ajoene. These natural compounds work to treat the toenail fungus. Mix crushed up garlic or garlic oil with white vinegar. Apply the mixture on and around the infected area and then cover it with a bandage. Leave the bandage on for a few hours. Repeat daily until the toenail fungus clears. Plus, learn about the other signs of disease your feet can reveal.
Fungus can infect the skin and nails of your feet. A fungal infection of the skin is also known as Athlete’s Foot, which causes itching, burning, and flaking. This infection can spread to the toenails if it’s not treated. Both types of foot fungus are extremely contagious, both in your own body as well as to other people through contact. Therefore, it’s essential to treat the infection and prevent its recurrence.
One way to contract athlete's foot is to get a fungal infection somewhere else on the body first. The fungi causing athlete's foot may spread from other areas of the body to the feet, usually by touching or scratching the affected area, thereby getting the fungus on the fingers, and then touching or scratching the feet. While the fungus remains the same, the name of the condition changes based on where on the body the infection is located. For example, the infection is known as tinea corporis ("ringworm") when the torso or limbs are affected or tinea cruris (jock itch or dhobi itch) when the groin is affected. Clothes (or shoes), body heat, and sweat can keep the skin warm and moist, just the environment the fungus needs to thrive.
Modern treatments made surgery a last resort. “Before we had these 21st century medications, we didn’t have a good choice in how to deal with toenail fungus,” said Dr. Hinkes. “Oftentimes patients would come in, and out of frustration and lack of any real significant clinical cure with medication, they would ask for their nails to be permanently removed.”
The US Food and Drug Administration (FDA) has approved several medicines as topical applications to help treat foot and toenail fungus and prevent the fungus from recurring. PROFOOT anti-fungal products containing Tolnaftate 1% are clinically proven to cure and prevent fungal infections on skin around, adjacent to, and under nails, making it easy to treat fungal infections all day, every day, until they have cleared. ProClearz Fungal Shield is a safe and effective clear formula that dries quickly with no unpleasant odor. The 1 oz. bottle comes with a brush-on applicator designed to reach skin areas around and under nails.
The Internet is filled with anecdotal information on how to cure toenail fungus using home remedies. Vinegar is a commonly recommended home remedy. Some people apply various oils such as tea tree oil, coconut oil, essential oils, and oil of cedar leaf (such as Vicks VapoRub) to their nails as well. The effectiveness of these home remedies is highly doubtful. Application of household bleach and hydrogen peroxide is also not recommended due to lack of evidence that these treatments work. These agents can also cause unwanted skin irritation. Thickened nails that have been affected by fungus can be difficult to trim. Using topical urea cream will soften the nail and make it easier to trim. These creams do not require a prescription.
Making a few simple lifestyle changes can help prevent a fungal infection of the nails. Taking good care of your nails by keeping them well trimmed and clean is a good way to prevent infections. You should also avoid injuring the skin around your nails. If you’re going to have damp or wet hands for an extended amount of time, you may want to wear rubber gloves.

Topical treatment (polish or cream) isn’t likely to get rid of a fungal nail infection. Treatment with tablets is considerably more effective and takes less time. But some people can’t take tablets because of the very rare, yet serious risks. How you feel about the pros and cons of the different treatment options is a personal matter. You can also discuss the options with your doctor.

Keeping socks and shoes clean (using bleach in the wash) is one way to prevent fungi from taking hold and spreading. Avoiding the sharing of boots and shoes is another way to prevent transmission. Athlete's foot can be transmitted by sharing footwear with an infected person. Hand-me-downs and purchasing used shoes are other forms of shoe-sharing. Not sharing also applies to towels, because, though less common, fungi can be passed along on towels, especially damp ones.
Topical nail-bed fungus treatments are a safe option that almost anyone can use. They work best when the infection is treated in its earliest stages. However, these medications do not heal the nail itself, only the fungus growing on the nail bed and surrounding area. Only oral medications, which come with many contraindications and may not be safe for everyone, can treat the nail itself.

Because fungus needs an acidic environment to flourish, alkaline baking soda actually prevents toenail fungus from spreading by creating an uninhabitable environment for it.  Borax is a naturally occurring mineral that is also a powerful fungicide.  These two combined create a remedy that can cure nail fungus fast.  Mix equal parts borax powder and baking soda with just enough water to form a paste.  Wet feet and gently rub the mixture onto infected nails.  Do this twice daily and continue for at least two weeks after fungus appears to have cleared up.


Your physician may perform a simple test called a potassium hydroxide (KOH) preparation for microscopic fungal examination in the office or laboratory. This test can be used to confirm the presence of a fungal infection. This test is performed by using a microscope to examine small flakes of skin from the rash. Many dermatologists perform this test in their office with results available within minutes. Rarely, a small piece of skin may be removed and sent for biopsy or fungal culture to help confirm the diagnosis.
Walking barefoot in wet, dark areas frequented by many other individuals like indoor swimming pool decks, communal showers, and locker rooms result in frequent exposure to pathogenic fungi (dermatophytes) that cause athlete’s foot. Wearing occlusive footwear is thought to play a significant role in the increased frequency of tinea pedis. Exposure to moisture either from excessive sweating or from an external source is a risk factor. Wearing the same shoes and socks for an extended period may damage the skin. Patients with diabetes are predisposed to develop tinea pedis. Some believe that eczema (atopic dermatitis) can predispose one to tinea pedis. It appears that many more men have tinea pedis than women. Pedicure performed in contaminated environments can spread disease.
When visiting a doctor, the basic diagnosis procedure applies. This includes checking the patient's medical history and medical record for risk factors,[11] a medical interview during which the doctor asks questions (such as about itching and scratching), and a physical examination.[11] Athlete's foot can usually be diagnosed by visual inspection of the skin and by identifying less obvious symptoms such as itching of the affected area.
Topical nail-bed fungus treatments are a safe option that almost anyone can use. They work best when the infection is treated in its earliest stages. However, these medications do not heal the nail itself, only the fungus growing on the nail bed and surrounding area. Only oral medications, which come with many contraindications and may not be safe for everyone, can treat the nail itself.
Because athlete's foot may itch, it may also elicit the scratch reflex, causing the host to scratch the infected area before they realize it. Scratching can further damage the skin and worsen the condition by allowing the fungus to more easily spread and thrive. The itching sensation associated with athlete's foot can be so severe that it may cause hosts to scratch vigorously enough to inflict excoriations (open wounds), which are susceptible to bacterial infection. Further scratching may remove scabs, inhibiting the healing process.
Before taking action and finding the best nail fungus treatment for you, it is important to note that toenail fungus and skin fungus, such as athlete’s foot, often manifest together. For the best results, both should be treated at the same time to prevent an ongoing infection. You can recognize athlete’s foot by the dry, scaling, peeling skin on the bottom of the feet. Your feet may also itch, or exude a noticeable odor.
Patience is key, as treatment duration varies from 2-3 months for oral treatments to up to 12 months for topical treatment. Because the nails take a long time to grow (6 months for fingernails and 12-18 months for toenails), it will take some time for the infection to resolve and the nail appearance to improve, regardless of the type of treatment used. Sometimes treatment may not be successful and your doctor may prescribe a different medication.
Candida albicans is a common yeast that grows inside the human body. In healthy people, other bacteria and immune cells keep this yeast under control so it doesn’t cause any problems, but in some people candida can become overgrown and cause infections in various areas. One of the ways candida shows up is through the skin where it can cause noticeable reactions or infections. Other ways are on the mouth, vagina and anus.
Over-the-counter toenail fungus treatments can cure existing infections, but only products which include 1% Tolnaftate can prevent a recurrence of the condition. Tolnaftate is the only ingredient approved by the US Food and Drug Administration for the prevention of fungal infections. Treating toe nail area fungus is only part of the solution. Preventing further outbreaks using a product with 1% Tolnaftate will keep you looking and feeling your best.
Use tea tree oil. Tea tree oil is a natural anti-fungal. One study showed that tea tree oil may be effective for nail fungus. 18% of patients who used tea tree oil twice daily for 24 weeks were cleared of the infection.[13] To treat nail fungus with tea tree oil, use a 100% solution because lower concentrations have not been proven to be effective for this particular infection.[14]

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]


Rotate your shoes – Change your shoes often. Even though you may have that favorite pair that you like to wear all the time, it is better for your feet to switch up your shoes from time to time. Even wearing the same pair of shoes two days in a row can elevate your risk for toenail fungus. Place shoes that you are not wearing in an area where they will get plenty of air.
High heeled shoes push too much body weight toward the toes and then squeeze them together. Over time, the result can be hammertoe (early stage, lower right), abnormal bends in the toe joints that can gradually become rigid. Surgery is sometimes needed to relieve the pain of severe hammertoe. Crowding can cause other toe deformities, along with continuous shoe friction, leading to painful corns and calluses.
Cultured dairy or fermented foods (ideally organic and raw) — these are beneficial for replacing good bacteria in the gut since they provide probiotics. Probiotics help control yeast and also have numerous immune-enhancing effects. For other sources of probiotics, in addition to yogurt or kefir try cultured foods like kimchi, kombucha or sauerkraut.
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.
×