The possible side effects of itraconazole include headaches, dizziness, stomach and bowel problems, and rashes. Itraconazole can also interact with a number of other drugs. These include cholesterol-reducing and blood-sugar-lowering medications, as well as certain sleeping pills. It is therefore important to let your doctor know about any medication you take. Itraconazole is not an option for people with heart failure (cardiac insufficiency). It also isn’t suitable for women who are pregnant or breastfeeding.
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.
Fungi that are already present in or on your body can cause nail infections. If you have come in contact with someone else who has a fungal infection, it may have spread to you. According to the American Academy of Dermatology (AAD), fungal infections affect toenails more commonly than fingernails because your toes are usually confined to your shoes, where they’re in a warm, moist environment.
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]
Over-the-counter antifungal treatments. Antifungal creams and ointments treat toenail infections while helping to keep new fungus out so new nails can grow. Some treatments must be applied every day, others are applied once a week. It’s a good idea to apply topical treatments to both the foot and nail simultaneously to prevent foot fungus from spreading to the toes. If you trim your toenails well (see above) before applying an antifungal, the medicine can reach deeper into the nailbed.
Athlete’s foot appears as a scaly red rash on the bottoms or sides of the feet often accompanied by itching, dry or cracked skin, stinging, and odor. You can also have moist, raw skin between your toes. Though athlete’s foot is fairly easy to treat with over-the-counter anti-fungal creams or sprays, this foot fungus is quite contagious and may easily spread to your toenails.
Walking barefoot in public places: Sure, taking your shoes off may feel great but it can also lead to toenail fungus. Toenail fungus starts when moisture gets trapped under the nail. This can easily happen when you walk barefoot.It is also easy to pick up toenail fungus from walking in public places as fungus can survive for up to 6 months on surfaces. The most common public places where you can pick up toenail fungus include swimming pools and public showers. Protect yourself by wearing sandals in public pool areas and public showers.
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.
Treatment options during pregnancy may include dilute vinegar soaks or sprays (roughly one part white household vinegar to four parts water) and Lotrimin cream twice a day for two to three weeks to the soles. Antifungal pills are generally not recommended during pregnancy because of the potential side effects and possible fetal harm. Always check with your OB/GYN before using any medication or treatment during pregnancy.

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.
Nail fungus, or onychomycosis, is a common skin condition where a fungus infects a part of the nail including the bed, matrix, or plate.[1] Nail fungus can result in cosmetic concerns, pain, and discomfort as well as end up affecting your everyday activities. If it is a severe infection, it may cause permanent damage to your nails or may spread beyond your nails.[2] If you know you have toenail fungus, you can follow a few simple steps to get rid of it and return your toenail to its former health.
If the fungal nail infection is severe, tablets can be used in combination with nail polish or cream. For example, if the nail is very thick, urea cream can be used (in addition to taking tablets) to gradually remove or partially file off the affected nail. Combining these treatments may also be an option if there are large collections of fungi beneath the nail. Another option for severe fungal nail infections is professional medical footcare. If the nail is filed off, it’s important to ensure good hygiene and disinfect the area, because the removed nail tissue could contain infectious fungal spores.
The most reliable way to diagnose athlete’s foot is to correctly identify its cause. Fungal athlete's foot is relatively straightforward to diagnose and treat. Visualization of the fungus in skin scrapings removed from the affected areas of the feet is a painless and cost-effective method for diagnosis. Rarely, it is necessary to identify fungi in portions of skin removed during a biopsy. If no fungus is found, other causes of athlete's foot must be investigated.
There are several preventive foot hygiene measures that can prevent athlete's foot and reduce recurrence. Some of these include keeping the feet dry, clipping toenails short; using a separate nail clipper for infected toenails; using socks made from well-ventilated cotton or synthetic moisture wicking materials (to soak moisture away from the skin to help keep it dry); avoiding tight-fitting footwear, changing socks frequently; and wearing sandals while walking through communal areas such as gym showers and locker rooms.[8][13][28]
Ciclopirox (Penlac) topical solution 8% is a medical nail lacquer that has been approved to treat finger or toenail fungus that does not involve the white portion of the nail (lunula) in people with normal immune systems. In one study, ciclopirox got rid of the fungus 22% of the time. The medication is applied to affected nails once daily for up to one year. The lacquer must be wiped clean with alcohol once a week.
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.

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.
When athlete's foot fungus or infested skin particles spread to one's environment (such as to clothes, shoes, bathroom, etc.) whether through scratching, falling, or rubbing off, not only can they infect other people, they can also reinfect (or further infect) the host they came from. For example, infected feet infest one's socks and shoes which further expose the feet to the fungus and its spores when worn again.

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.
For this treatment, the affected toe or finger first has to be soaked in warm water for ten minutes and then dried. After that, the urea-based cream is applied to the nail, and the nail is covered with an adhesive bandage. After 24 hours, the bandage is removed and the toe or finger is held in warm water again. The softened layer of the nail is then scraped off using a spatula, the cream is applied again and the nail is covered with a new bandage. This treatment is carried out over 14 days. Once the infected part of the nail has been scraped away completely, the skin beneath is treated for another four weeks with a bifonazole cream.
Orange essential oil is another natural anti-fungal that can be applied daily to toenails in order to cure an infection.  Apply a drop of Plant Therapy Orange Oil on nails and between toes.  Let the oil soak in for at least one hour.  Orange oil may be too strong for people with sensitive skin.  If you find this is the case for you, dilute the oil with an all-natural carrier such as olive oil.  Also, because citrus allergies are somewhat common, it is recommended to test orange oil on a spot of healthy skin before applying it to infected nails.  (Many health and wellness stores have open ‘testers’ of their products for just such a purpose.)
The vesiculobullous type of athlete's foot is less common and is usually caused by T. mentagrophytes and is characterized by a sudden outbreak of itchy blisters and vesicles on an erythematous base,[7] usually appearing on the sole of the foot. This subtype of athlete's foot is often complicated by secondary bacterial infection by Streptococcus pyogenes or Staphylococcus aureus.[13]
Onychomycosis patients may need to learn new, healthier habits to stop the fungus growing back. These could include protecting toes from sources of infection, wearing correctly fitting footwear, laundering socks in hot water with disinfectant, wearing protective footwear at the pool and gym, keeping nails short, using open-toed footwear and wearing shoes made of breathable material.
The final step to removing fungal and yeast infections is taking supplements, such as the probiotic supplement that I mentioned above. A quality probiotic supplement will help you get rid of the yeast and candida in your system that’s truly causing your toenail fungus. I personally recommend a probiotic supplement that has at the very least 10+ strains of probiotics with at least 15 billion CFUs.
If common remedies do not offer relief within three to four months of consistent use, or if the discomfort worsens, contact your doctor. Extreme infections may require the temporary surgical removal of the nail. A replacement nail will usually grow. As the new nail regrows, it is good practice to treat it with an antifungal cream to prevent reinfection.
Prevent future occurrences. There are many situations that make you more at risk for infection. You are at a higher risk if you are older, have diabetes, have an impaired immune system, or have poor circulation. If you are at high risk, you should take extra care to prevent infection. Preventative measures include wearing shoes or sandals when you are at damp public areas such as swimming pools or gyms, keeping your toenails clipped and clean, making sure your feet are dry, and drying your feet after you shower.
Fungal athlete's foot may cause a rash on one or both feet and even involve the hand. A "two feet and one hand" pattern is a very common presentation of athlete's foot, especially in men. Hand fungal infections are called tinea manuum. Fungal athlete's foot may also be seen along with ringworm of the groin (especially in men) or hand(s). It is helpful to examine the feet whenever there is a fungal groin rash called tinea cruris, or jock itch. It is important to treat all areas of fungal infection at one time to avoid reinfection. Simply treating the soles and ignoring the concurrent fungal infection of toenails may result in recurrences of athlete's foot.
Oral/combination therapy. Some studies have shown that taking antifungal pills and applying antifungals to your nails can be more effective than using either treatment alone. Oral medications can typically treat toenail fungus in three months. In stubborn cases, topical and oral medications may be combined to provide the best possible treatment. Oral medications must be prescribed by your physician or health care practitioner.
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.
When athlete's foot fungus or infested skin particles spread to one's environment (such as to clothes, shoes, bathroom, etc.) whether through scratching, falling, or rubbing off, not only can they infect other people, they can also reinfect (or further infect) the host they came from. For example, infected feet infest one's socks and shoes which further expose the feet to the fungus and its spores when worn again.
When athlete's foot fungus or infested skin particles spread to one's environment (such as to clothes, shoes, bathroom, etc.) whether through scratching, falling, or rubbing off, not only can they infect other people, they can also reinfect (or further infect) the host they came from. For example, infected feet infest one's socks and shoes which further expose the feet to the fungus and its spores when worn again.
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.

Other causative pathogens include Candida and nondermatophytic molds, in particular members of the mold genus Scytalidium (name recently changed to Neoscytalidium), Scopulariopsis, and Aspergillus. Candida species mainly cause fingernail onychomycosis in people whose hands are often submerged in water. Scytalidium mainly affects people in the tropics, though it persists if they later move to areas of temperate climate.


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.

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.
Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time, it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail. 
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.
Chronic nail trauma, such as repeatedly starting and stopping, kicking, and other athletic endeavors, can cause damage to the nails that can look a lot like fungal nails. This sort of repetitive trauma can also occur with certain types of employment or wearing tight-fitting shoes. Some traumas may cause permanent changes that may mimic the appearance of fungal nails.
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