Onychomycosis (toenail fungus) is an infection of the nail and sometimes surrounding tissue. It is extremely common with 20 percent of the general population and 75 percent of people over 60 years old affected. Frequently the problem causes cosmetic concerns, but many patients also experience pain. Sometimes toenail fungus can allow more serious infections to develop.
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

Fungal infection occurs when the organism invades through an opening in the nail, meaning fungi will usually attack nails that are already damaged. After infection occurs, the growth of the fungi leads to mild inflammation, which causes the nail to thicken and the nail plate to detach from the nail bed. The space underneath the nail can then serve as a reservoir for bacteria and moulds, which can cause the nail to become discoloured.
I ditched this product and trusted my instincts. I tried my own home remedy. No, I didn't see "immediate results" but I am gradually noticing a positive change. Mix equal parts of warm water, hydrogen peroxide, and Apple Cider Vinegar with mother in it. Soak for 20-30 minutes or make a paste with these products and baking soda and put it directly on nails. Wash off after about 30 minutes. Put lavender and tea tree oil on for the remainder of the day. At night, cover with Vicks and go to sleep. After a week's time, my nails actually look healthier and seem stronger. The skin around my nails is less red and irritated. Is the fungus gone? No, not yet...but it is moving up with the growing nail, which is much better progress that I had with this product.
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The ease with which the fungus spreads to other areas of the body (on one's fingers) poses another complication. When the fungus is spread to other parts of the body, it can easily be spread back to the feet after the feet have been treated. And because the condition is called something else in each place it takes hold (e.g., tinea corporis (ringworm) or tinea cruris (jock itch), persons infected may not be aware it is the same disease.
Medical treatment of onychomycosis is suggested in patients who are experiencing pain and discomfort due to the nail changes. Patients with higher risk factors for infections such as diabetes and a previous history of cellulitis (infection of the soft tissue) near the affected nails may also benefit from treatment. Poor cosmetic appearance is another reason for medical treatment.
Topical treatment is also usually recommended for children. One reason for this is that most oral medications aren’t suitable for children. Another reason is that children have thinner nails that grow more quickly, so it’s assumed that treatment with nail polish or creams is more likely to work in children than in adults. White superficial onychomycosis is also often treated with a nail polish or cream.
You may first notice a fungal toenail infection as a small white or yellow spot on the tip of your toenail, especially the big toe. As the infection progresses, the toenail can become yellow, brittle—even crumbly—and thick and uneven-looking. In the worst fungal infections, the toenail separates from the nail bed. This is called onycholysis. As fungal infections worsen, the nail beds can be tender to the touch and quite painful. Sometimes women try to pretend the pain is “normal” and ignore it altogether.

​The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find an Orthopaedic Foot & Ankle Surgeon" tool at the top of this page or contact your primary doctor. 


​The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find an Orthopaedic Foot & Ankle Surgeon" tool at the top of this page or contact your primary doctor. 
Some methods of prevention include avoiding walking barefoot in public showers, keeping the toenails short, wearing big enough shoes, and changing socks daily.[4][5] When infected, the feet should be kept dry and clean and wearing sandals may help.[3] Treatment can be either with antifungal medication applied to the skin such as clotrimazole or for persistent infections antifungal medication that are taken by mouth such as terbinafine.[2][4] The use of the cream is typically recommended for four weeks.[4]
“The medications we use to treat this are expensive and they are not benign,” cautioned Dr. Hinkes. “Lamisil is so powerful it stays in your body six months after you stop using it, and that’s one of the reasons why it works so well. So when we use these medicines, we have to be conscious that we may be affecting a person’s liver, because the liver is the organ that helps to detoxify the body and excretes that medicine.”
Sporty, fitted sandals and other "toning shoes" are designed for a more intense workout while walking. The American Council on Exercise says there's no evidence to support that claim, but they may have other benefits. The thick sole keeps your foot off the ground and away from debris. And Brenner points out, "they do have really good arch support." Several have a seal of approval from the American Podiatric Medical Association.
One of the more interesting remedies for toenail fungus is organic cornmeal.  Corn naturally hosts a form of fungus that is harmless to the human body but deadly to Candida – the most common fungal parasite that causes infections in people.  In a container big enough to fit your foot (or both feet if needed), mix one cup of cornmeal and about two quarts of water.  Allow the cornmeal to soak in the water for at least one hour then submerge the infected foot (or feet) in the mixture for a half hour or more.  While the frequency of use for this remedy is up for debate, sources have reported success with treatment performed as seldom as once per week.  Others say to perform it daily.  Because cornmeal is totally harmless to skin and nails, realistically the treatment can be repeated as often as you like.
Efinaconazole (Jublia) is a medication that was approved in 2014. It is a topical (applied to the skin) antifungal used for the local treatment of toenail fungus due to two most common fungal species affecting nails (Trichophyton rubrum and Trichophyton mentagrophytes). Once-daily application is required for 48 weeks. The most common side effects of Jublia are ingrown toenails and application site dermatitis and pain.
Green nails can be caused by Pseudomonas bacteria, which grow under a nail that has partially separated from the nail bed. This infection may cause a foul odor of the nails. The treatment is to trim the nail short every four weeks, don't clean it, polish if you want to hide the color, and wait two to three months. It is also advised to avoid soaking the nail in any sort of water (even if inside gloves) and to thoroughly dry the nail after bathing. If the problem continues, there are prescription treatments that your doctor may try.
Vicks VapoRub is a topical ointment. Although designed for cough suppression, its active ingredients, camphor and eucalyptus oil, may help treat toenail fungus. A 2011 study found Vicks VapoRub had a “positive clinical effect” in the treatment of toenail fungus. To use, apply a small amount of Vicks VapoRub to the affected area at least once a day.
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