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.


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Starts at the ends of the nails and raises the nail up: This is called "distal subungual onychomycosis." It is the most common type of fungal infection of the nails in both adults and children. It is more common in the toes than the fingers, and the great toe is usually the first one to be affected. Risk factors include older age, swimming, athlete's foot, psoriasis, diabetes, family members with the infection, or a suppressed immune system. It usually starts as a discolored area at a corner of the big toe and slowly spreads toward the cuticle. Eventually, the toenails will become thickened and flaky. Sometimes, you can also see signs of athlete's foot in between the toes or skin peeling on the sole of the foot. It is often accompanied by onycholysis. The most common cause is T. rubrum.
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]
There are many possible causes of foot rashes. Additional causes include irritant or contact dermatitis, allergic rashes from shoes or other creams, pompholyx (dyshidrotic eczema), psoriasis, yeast infections, and bacterial infections (gram negative toe web infection and erythrasma). Since these conditions are often indistinguishable on superficial visual examination, it is important for your doctor to do his best to identify the precise cause. Since fungal infections are potentially curable, it is important not to miss this diagnosis.
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.

Athlete’s foot infections can be mild or severe. Some clear up quickly, and others last a long time. Athlete’s foot infections generally respond well to antifungal treatment. However, sometimes fungal infections are difficult to eliminate. Long-term treatment with antifungal medications may be necessary to keep athlete’s foot infections from returning.
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.
If you have diabetes or a weakened immune system, treatment is especially important. After getting a fungal nail infection, people who have diabetes have an increased risk of developing sores that do not heal. Sores that do not heal can lead to a serious health problem. It’s important to see a dermatologist (or other doctor) at the first sign of a nail problem. A dermatologist can tell you whether you have a nail infection or something else.
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