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]
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.
The first step is to take a history of the problem,” said Mark Hinkes, DPM, CEO of HappyFeet LLC, and a podiatrist with 40 years experience. “In other words, I want to know how long have you had this and what previous treatment you’ve had.” A podiatrist needs to understand the extent of the problem, and also any other medical factors which may influence their choice of treatment.
You can also try itraconazole (Sporanox), which is usually prescribed with a dose of 200 mg a day for 12 weeks. Side effects can include nausea, rash, or liver enzyme abnormalities. It should not be used if you have liver issues. Sporanox also has interactions with over 170 different drugs such as Vicodin and Prograf. Check with your doctor to ensure any medication you are taking does not interfere with it.[7]
You can help prevent the return of toenail fungus by adopting some basic habits. Replace old shoes and socks regularly. Wear clean socks each day, and consider using a medicated shoe spray after every use. Wearing shower shoes in hotels, gyms, public pools, and showers is also very important to prevent reinfection.  Going to a nail salon that uses plastic liners in the whirlpool, bringing your own tools and disposing of files, buffers is also highly recommended.
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.

Select shoes that fit right –  Choosing the correct footwear is a must if you want to avoid toenail fungus. Shoes should not touch your toenails at all. Don’t jam your feet into shoes that are too big either – this will cause you to jam your toenail into the front of the shoe causing damage. According to the American Academy of Physicians, the best shoes have a wide toe box.
Scratching infected areas may also spread the fungus to the fingers and under the fingernails. If not washed away soon enough, it can infect the fingers and fingernails, growing in the skin and in the nails (not just underneath). After scratching, it can be spread to wherever the person touches, including other parts of the body and to one's environment. Scratching also causes infected skin scales to fall off into one's environment, leading to further possible spread.
A number of different types of fungus can cause onychomycosis including dermatophytes and Fusarium.[3] Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function.[3] The diagnosis is generally suspected based on the appearance and confirmed by laboratory testing.[2]
Onychomycosis – commonly known as toenail fungus – is characterized by inflammation, pain, and swelling of the toe, as well as yellowing, thickening, and crumbling of the nail itself.  Toenail fungus can be the result of abnormal pH of the skin, continuous exposure to moisture, wearing synthetic socks, compromised immune system, sweat build-up in shoes, poor foot hygiene, or weak circulation such as that caused by diabetes.
Caprylic acid, one of the medium-chain fatty acids in coconut oil, has the ability to penetrate the durable cell wall of candida and other fungi.  Without its protective coating the cells of the fungus dissolve, effectively destroying the infection.  Apply a thin layer of coconut oil to infected areas and let it soak in for at least fifteen minutes.  Coconut oil is great for skin health, so there is no limit to how often you can use this treatment.  Just make sure you aren’t allergic to coconuts before applying this product to sensitive tissue.
Food intolerances — Some yeast infections are due to food allergies. Try to avoid foods that cause negative reactions of any kind and pay attention to symptoms you experience when eating things like dairy, eggs, certain nuts, wheat-containing foods and grains. If you think you have a food allergy or sensitivity, try an elimination diet to figure out what foods are causing intolerance and work on removing those foods.
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]
Once it takes hold, the bacteria and yeast thrive off of sugar molecules entering the digestive tract through the foods you eat. That’s exactly why you need to eliminate the underlying cause, which is likely stemming from your diet (and possibly also your lifestyle to some degree). This will help ultimately restore your body’s pH balance, improve your immune function and boost the presence of good bacteria in your gut.
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.

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


Before buying new shoes, have a professional measure the length and width of your feet at the end of the day, while you're standing. For unusually flat feet or high arches, an exam by a podiatrist may be warranted. These conditions can increase the risk of osteoarthritis. Early treatment and use of proper footwear may help to avoid unnecessary wear and tear on the joints of the foot.

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.”
I fully believe in natural remedies as well as safe, pharmaceutical ones. I have all of the ingredients and essential oils necessary to make my own potions, but as a busy, working Mom I chose the easy route of purchasing the potion already made up. I used this religiously for over a month. I cleaned and trimmed my affected 4 toenails constantly through the process. I saw absolutely no results. Yes, the painted on 2nd step does temporarily improve the appearance of the nail instantly, but that's because of the glossy sheen. Any oil will do that. Once soaked in, my nail looked and remained the same. Perhaps my failure was a result of dipping the brush I used on my infected toes and back into the bottle repeated times. Doesn't that seem counter productive given a fast-spreading fungus? They're slowly growing out but the fungus remains in the grow out and my nails are still thin and fragile. I would have given this product one more star with a pat on the back and a "nice try" but the huge number of immediate, 5-star reviews left me with the instant feeling of being mislead. I may have even given it more time with more realistic reviews.
You can also try itraconazole (Sporanox), which is usually prescribed with a dose of 200 mg a day for 12 weeks. Side effects can include nausea, rash, or liver enzyme abnormalities. It should not be used if you have liver issues. Sporanox also has interactions with over 170 different drugs such as Vicodin and Prograf. Check with your doctor to ensure any medication you are taking does not interfere with it.[7]
Nine out of 10 women are wearing shoes that are too small. The consequences aren't pretty – calluses, blisters, bunions, corns, and other problems. The constant rubbing can irritate the joints in the foot and lead to arthritis. Research suggests many kids are also wearing the wrong shoe size, which puts them at risk for foot deformities as they grow.
One of the best remedies for toenail fungus, apple cider vinegar can be used topically, internally, or both. Mix one part ACV and one part Epsom salts with six parts hot water.  Let the water cool so that it is still warm to the touch, but not so hot as to be damaging to your skin.  Soak feet up to twice daily for at least thirty minutes to kill fungus.  Mix two tablespoons of organic apple cider vinegar with eight ounces of warm water and add a teaspoon of honey to sweeten the beverage.
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.
Fungal nail infections can be difficult to treat. Talk with your doctor if self-care strategies and over-the-counter (nonprescription) products haven't helped. Treatment depends on the severity of your condition and the type of fungus causing it. It can take months to see results. And even if your nail condition improves, repeat infections are common.
Occlusive shoe materials, such as vinyl, which cause the feet to remain moist, provide an excellent area for the fungus to proliferate. Likewise, absorbent socks like cotton that wick water away from your feet may help. Some individuals who sweat excessively benefit from the application of antiperspirants like 20% aluminum chloride (Drysol). Powders can help keep your feet dry. Although counterintuitive, if your feet can be soaked in a solution of aluminum acetate (Burow's solution or Domeboro solution) and then air dried with a fan, this can be very helpful if performed three or four times within 30 minutes. A home remedy of dilute white vinegar soaks, using one part vinegar and roughly four parts water, once or twice a day (as 10-minute foot soaks) may aid in treatment followed by evaporation can be helpful.
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.

Before buying new shoes, have a professional measure the length and width of your feet at the end of the day, while you're standing. For unusually flat feet or high arches, an exam by a podiatrist may be warranted. These conditions can increase the risk of osteoarthritis. Early treatment and use of proper footwear may help to avoid unnecessary wear and tear on the joints of the foot.

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.”
There are several doctors who can provide nail fungus treatment. Your primary care provider, a dermatologist, or a podiatrist can treat nail fungus. Any one of these doctors can provide proper diagnosis and prescribe medications specific to fungal infection. A podiatrist or dermatologist may shave the top layer of the nail off or even remove part of the nail.
Athlete’s foot—the most prevalent foot fungus—thrives in warm, sweaty places like the insides of your athletic shoes, which is how it got its name. However, foot fungus can develop in multiple environments, natural and man-made, as long as there is lots of moisture where fungi can grow. These include shared areas at gyms or pools, soil and grass, or even shared items such as shoes, socks, or towels from household members who are infected.  
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.

Athlete's foot is divided into four categories or presentations: chronic interdigital athlete's foot, plantar (chronic scaly) athlete's foot (aka "moccasin foot"), acute ulcerative tinea pedis,[11] and vesiculobullous athlete's foot.[2][12][13] "Interdigital" means between the toes. "Plantar" here refers to the sole of the foot. The ulcerative condition includes macerated lesions with scaly borders.[11] Maceration is the softening and breaking down of skin due to extensive exposure to moisture. A vesiculobullous disease is a type of mucocutaneous disease characterized by vesicles and bullae (blisters). Both vesicles and bullae are fluid-filled lesions, and they are distinguished by size (vesicles being less than 5–10 mm and bulla being larger than 5–10 mm, depending upon what definition is used).

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.


One way to definitively get rid of toenail fungus is by surgery. Surgical treatment of onychomycosis involves nail removal. However, this often only provides temporary relief, and recurrence is common unless additional antifungal medication (oral or topical) is simultaneously used. However, surgical removal may be warranted when the affected nail is associated with other factors such as trauma and or infection.
Sometimes people with a fungal nail infection are offered laser treatment. This involves shining infrared or ultraviolet (UV) light on the nail in order to kill the fungi. Laser treatments haven’t been proven to work in good quality studies. Because statutory health insurers in Germany don’t cover the costs of this treatment, people have to pay for it themselves.
You can use simple home remedies to get rid of toenail fungus. Or a podiatrist can take care of toenail fungus, particularly if it is caught early. Topical or oral treatments can also work on toenail fungus, as well as the removal of the infected nail. A temporary removal can work to treat the area, but a permanent removal so that the bad nail won’t grow back can also be performed.
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]
If you observe any abnormal nail changes it is important to visit your doctor for prompt assessment. In addition to being cosmetically unappealing, OM can also lead to more serious complications, including the possible loss of your nail, bacterial infections, or cellulitis. Speak with your healthcare provider to determine what the best treatment plan is for you.
Athlete's foot is divided into four categories or presentations: chronic interdigital athlete's foot, plantar (chronic scaly) athlete's foot (aka "moccasin foot"), acute ulcerative tinea pedis,[11] and vesiculobullous athlete's foot.[2][12][13] "Interdigital" means between the toes. "Plantar" here refers to the sole of the foot. The ulcerative condition includes macerated lesions with scaly borders.[11] Maceration is the softening and breaking down of skin due to extensive exposure to moisture. A vesiculobullous disease is a type of mucocutaneous disease characterized by vesicles and bullae (blisters). Both vesicles and bullae are fluid-filled lesions, and they are distinguished by size (vesicles being less than 5–10 mm and bulla being larger than 5–10 mm, depending upon what definition is used).
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]

Tinea pedis, also known as athlete's foot or foot fungus, can cause recurrence of fungal nails. Therefore, it is important to manage this condition. One can apply over-the-counter (OTC) antifungal medicines such as clotrimazole (Lotrimin) or terbinafine (Lamisil) cream as directed to affected skin. Keeping footwear and socks clean can be helpful. You can also use portable UV light sanitizers to disinfect shoes.
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.

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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