Diagnosis is made based on clinical exam and can be confirmed by viewing scrapings of the nail under a microscope, or growing the fungus in a culture medium. This is not an easy condition to cure, so rather than trying home treatment with over-the-counter medications, it's best to see your doctor. As with many conditions, nail fungus infections are easier to treat if you catch them early.
In normal, healthy people, fungal infections of the nails are most commonly caused by fungus that is caught from moist, wet areas. Communal showers, such as those at a gym or swimming pools, are common sources. Going to nail salons that use inadequate sanitization of instruments (such as clippers, filers, and foot tubs) in addition to living with family members who have fungal nails are also risk factors. Athletes have been proven to be more susceptible to nail fungus. This is presumed to be due to the wearing of tight-fitting, sweaty shoes associated with repetitive trauma to the toenails. Having athlete's foot makes it more likely that the fungus will infect your toenails. Repetitive trauma also weakens the nail, which makes the nail more susceptible to fungal infection.

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.
Oral medications include terbinafine (76% effective), itraconazole (60% effective) and fluconazole (48% effective).[2] They share characteristics that enhance their effectiveness: prompt penetration of the nail and nail bed,[23] and persistence in the nail for months after discontinuation of therapy.[24] Ketoconazole by mouth is not recommended due to side effects.[25] Oral terbinafine is better tolerated than itraconazole.[26] For superficial white onychomycosis, systemic rather than topical antifungal therapy is advised.[27]

When the skin is injured damaged, the natural protective skin barrier is broken. Bacteria and yeasts can then invade the broken skin. Bacteria can cause a bad smell. Bacterial infection of the skin and resulting inflammation is known as cellulitis. This is especially likely to occur in individuals with diabetes, chronic leg swelling, who have had veins removed (such as for heart bypass surgery), or in the elderly. Bacterial skin infections also occur more frequently in patients with impaired immune systems.
Athlete’s foot is one of the most common foot infections. It can be easily acquired, especially by people who often use communal showers and pools, such as those in college dorms or gyms. It grows in warm, damp places like public showers, locker rooms, and pools. It is also common with shoes that are too tight or socks or shoes that are damp. Athletes foot is contracted from getting pedicures with not properly sanitized equipment.
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.

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.
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.
Because fungal spores can remain viable for months in these environments, frequent exposure can increase the risk of infection (and re-infection). Fungal spores can be picked up in many ways – such as wearing shoes that harbour the organism, by walking barefoot in areas where the fungus is prevalent (especially public showers and locker rooms), by wearing wet shoes or socks for long periods, through previous injury to the toe or toenail that opens a path for easy entry of the fungus, or by wearing improperly-fitting shoes.
Because fungal spores can remain viable for months in these environments, frequent exposure can increase the risk of infection (and re-infection). Fungal spores can be picked up in many ways – such as wearing shoes that harbour the organism, by walking barefoot in areas where the fungus is prevalent (especially public showers and locker rooms), by wearing wet shoes or socks for long periods, through previous injury to the toe or toenail that opens a path for easy entry of the fungus, or by wearing improperly-fitting shoes.

Whether they're sky-high or mid-heel, this style is notorious for causing a painful knot on the back of the heel. The rigid material presses on a bony deformity some women have called a "pump bump." The pressure leads to blisters, swelling, bursitis, even pain in the Achilles tendon. Ice, orthotics, and heel pads may provide pain relief -- along with better shoes. The bony protrusion is permanent.
Treatment: Nail fungus is a difficult condition to properly treat due to the average time before seeing results and the general lack of understanding regarding topical treatments. Fungus grows underneath the nail bed, making it extremely difficult to target. Certain nail fungus products, like topical ointments, contain nail penetrating ingredients that treat fungal nail infections underneath the nail bed where it grows.
​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. 
Athlete's foot is a term given to almost any inflammatory skin disease that affects the sole of the foot and the skin between the toes. It is usually scaly and may be a red, raw-appearing eruption with weeping and oozing with small blisters. It affects the feet of athletes and non-athletes alike. Although it is frequently caused by a fungal infection, other causes may be indistinguishable without proper testing.

Multiple fungi species can infect the nail. Fungus grows well in warm, moist environments such as showers. Fungus infection is one of the few foot problems that affect more men than women, perhaps because more men walk barefoot in locker rooms. Age is a factor, too. Half the sufferers are people older than 70. Other risk factors include having certain medical conditions such as diabetes, vascular insufficiency and malnutrition.

The newer drugs are unlikely to cause any liver problems in patients without known liver disease. Blood tests are not needed for once-weekly treatment with fluconazole (Diflucan); however, people taking longer courses often have their liver function tested before starting the medicine and then retested during the course of treatment. It is important to notify the doctor of all side effects while on the medication. You should tell your doctor of all current medications to prevent potential serious drug interactions.
Snake root extract comes from a plant in the sunflower family. A 2008 study conducted by the Centro de Investigación Biomédica del Sur and published in Planta Med, found that applying the extract to the affected nail over three months was more effective than treatment with the prescription anti-fungal Penlac (ciclopirox). Like natural remedies? Here are some more options.
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Snakeroot extract is an antifungal made from plants in the sunflower family. A 2008 study showed that the remedy is as effective against toenail fungus as the prescription antifungal medicine ciclopirox. For the study, snakeroot extract was applied to the affected area every third day for the first month, twice a week for the second month, and once a week for the third month. You can find snakeroot extract online.
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