Onychomycosis, also known as tinea unguium, is a fungal infection of the nail.[2] Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed.[2][3] Toenails or fingernails may be affected, but it is more common for toenails to be affected.[3] Complications may include cellulitis of the lower leg.[3]
Research suggests that fungi are sensitive to heat, typically 40–60 °C (104–140 °F). The basis of laser treatment is to try to heat the nail bed to these temperatures in order to disrupt fungal growth.[37] As of 2013 research into laser treatment seems promising.[2] There is also ongoing development in photodynamic therapy, which uses laser or LED light to activate photosensitisers that eradicate fungi.[38]

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.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Oral antifungal therapy has a high cure rate, depending on the medication. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back. Currently, an oral antifungal therapy is considered the best treatment for toenail fungus because of higher cure rates and shorter treatment duration compared to topical therapy.

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).


There are many topical antifungal drugs useful in the treatment of athlete's foot including: miconazole nitrate, clotrimazole, tolnaftate (a synthetic thiocarbamate), terbinafine hydrochloride,[17] butenafine hydrochloride and undecylenic acid. The fungal infection may be treated with topical antifungal agents, which can take the form of a spray, powder, cream, or gel. Topical application of an antifungal cream such as terbinafine once daily for one week or butenafine once daily for two weeks is effective in most cases of athlete's foot and is more effective than application of miconazole or clotrimazole.[23] Plantar-type athlete's foot is more resistant to topical treatments due to the presence of thickened hyperkeratotic skin on the sole of the foot.[13] Keratolytic and humectant medications such as urea, salicyclic acid (Whitfield's ointment), and lactic acid are useful adjunct medications and improve penetration of antifungal agents into the thickened skin.[13] Topical glucocorticoids are sometimes prescribed to alleviate inflammation and itching associated with the infection.[13]
Trim infected nails. Using large toenail clippers and/or nail nippers, keep your toenails well-trimmed by cutting them straight across to the toe line. Thin thickened nails by gently scraping away the crumbly debris under the nail with a file. This will get rid of some fungus and help reduce pain by alleviating pressure on the nail bed and toes. Soak your toes first to soften the nails or trim after a shower.
For some people, a fungal infection of the nails can be difficult to cure and the first round of medication might not work. The nail infection can’t be considered cured until a new nail that’s free from infection has grown in. Although this indicates that the nail is no longer infected, it’s possible for the fungal infection to return. In severe cases, there may be permanent damage to your nail, and it may have to be removed.

Trichophyton rubrum is the most common dermatophyte involved in onychomycosis. Other dermatophytes that may be involved are T. interdigitale, Epidermophyton floccosum, T. violaceum, Microsporum gypseum, T. tonsurans, and T. soudanense. A common outdated name that may still be reported by medical laboratories is Trichophyton mentagrophytes for T. interdigitale. The name T. mentagrophytes is now restricted to the agent of favus skin infection of the mouse; though this fungus may be transmitted from mice and their danders to humans, it generally infects skin and not nails.
White superficial onychomycosis (WSO) is caused by fungal invasion of the superficial layers of the nail plate to form "white islands" on the plate. It accounts for around 10 percent of onychomycosis cases. In some cases, WSO is a misdiagnosis of "keratin granulations" which are not a fungus, but a reaction to nail polish that can cause the nails to have a chalky white appearance. A laboratory test should be performed to confirm.[15]
Candida albicans is a common yeast that grows inside the human body. In healthy people, other bacteria and immune cells keep this yeast under control so it doesn’t cause any problems, but in some people candida can become overgrown and cause infections in various areas. One of the ways candida shows up is through the skin where it can cause noticeable reactions or infections. Other ways are on the mouth, vagina and anus.

There are many topical antifungal drugs useful in the treatment of athlete's foot including: miconazole nitrate, clotrimazole, tolnaftate (a synthetic thiocarbamate), terbinafine hydrochloride,[17] butenafine hydrochloride and undecylenic acid. The fungal infection may be treated with topical antifungal agents, which can take the form of a spray, powder, cream, or gel. Topical application of an antifungal cream such as terbinafine once daily for one week or butenafine once daily for two weeks is effective in most cases of athlete's foot and is more effective than application of miconazole or clotrimazole.[23] Plantar-type athlete's foot is more resistant to topical treatments due to the presence of thickened hyperkeratotic skin on the sole of the foot.[13] Keratolytic and humectant medications such as urea, salicyclic acid (Whitfield's ointment), and lactic acid are useful adjunct medications and improve penetration of antifungal agents into the thickened skin.[13] Topical glucocorticoids are sometimes prescribed to alleviate inflammation and itching associated with the infection.[13]

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.

Prescription oral antifungals such as terbinafine (Lamisil) or fluconazole (Diflucan) are traditionally used to treat toenail fungus. These treatments are often effective, but they may cause serious side effects ranging from upset stomach and dizziness to severe skin problems and jaundice. This may be why many people try home remedies instead. Here are 10 of these popular at-home treatments.
×