Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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.

A 2003 survey of diseases of the foot in 16 European countries found onychomycosis to be the most frequent fungal foot infection and estimates its prevalence at 27%.[32][33] Prevalence was observed to increase with age. In Canada, the prevalence was estimated to be 6.48%.[34] Onychomycosis affects approximately one-third of diabetics[35] and is 56% more frequent in people suffering from psoriasis.[36]
If the diagnosis is uncertain, direct microscopy of a potassium hydroxide preparation of a skin scraping (known as a KOH test) can confirm the diagnosis of athlete's foot and help rule out other possible causes, such as candidiasis, pitted keratolysis, erythrasma, contact dermatitis, eczema, or psoriasis.[13][23][27] Dermatophytes known to cause athlete's foot will demonstrate multiple septate branching hyphae on microscopy.[13]
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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.
Flip-flops offer very little protection. The risk of getting splinters or other foot injuries is higher when the feet are so exposed. People with diabetes should not wear flip-flops, because simple cuts and scrapes can lead to serious complications. In addition, many flip-flops provide no arch support. Like ballet flats, they can aggravate plantar fasciitis and cause problems with the knees, hips, or back.

Green nails can be caused by Pseudomonas bacteria, which grow under a nail that has partially separated from the nail bed. This infection may cause a foul odor of the nails. The treatment is to trim the nail short every four weeks, don't clean it, polish if you want to hide the color, and wait two to three months. It is also advised to avoid soaking the nail in any sort of water (even if inside gloves) and to thoroughly dry the nail after bathing. If the problem continues, there are prescription treatments that your doctor may try.
Dermatologists specialize in the treatment of skin disorders, including athlete's foot. You may find a board-certified dermatologist through http://www.aad.org. Additionally, family medicine physicians, internal medicine physicians, pediatricians, podiatrists (foot doctors), and other practitioners may also treat this common infection. Most primary care physicians can treat athlete's foot successfully.
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.
Many podiatrists now consider this an effective treatment, but because it’s new, there’s not enough concrete data to compare with other treatments. Dr. Hinkes raises another concern: “A clinical cure and a mycological cure are two different things. With the clinical cure, you look at the nail and it looks fine. It’s pink and shiny and smooth and it looks great. But if you sample the nail, you might find that there’s mold or fungus there, so it does not have what we call a mycological cure—mycology is the study of fungi.
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.

Take oral medication. The most effective way to get rid of nail fungus is systemic treatment with oral prescription antifungals. Treatment with oral medications can take 2-3 months or longer. Oral antifungal prescription medications include Lamisil, which is usually prescribed with a dose of 250 mg a day for 12 weeks. Side effects can include rash, diarrhea, or liver enzyme abnormalities. This medication should not be used if you have liver or kidney issues.


Satchell, A. C., Saurajen, A., Bell, C., & Barnetson, R. StC. (2002, July 19). Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: A randomized, placebo-controlled, blinded study [Abstract]. Australasian Journal of Dermatology, 43(3), 175–178. Retrieved from http://onlinelibrary.wiley.com/doi/10.1046/j.1440-0960.2002.00590.x/full

Athlete's foot, known medically as tinea pedis, is a common skin infection of the feet caused by fungus.[2] Signs and symptoms often include itching, scaling, cracking and redness.[3] In rare cases the skin may blister.[6] Athlete's foot fungus may infect any part of the foot, but most often grows between the toes.[3] The next most common area is the bottom of the foot.[6] The same fungus may also affect the nails or the hands.[4] It is a member of the group of diseases known as tinea.[7]
Anti-fungal properties of lavender oil make it an effective remedy for mild cases of toenail fungus.  Apply a few drops of 100% pure lavender essential oil to the infected nails every night and let it soak in while you sleep.  To prevent the oil from rubbing off, you can optionally cover your feet with a pair of wool socks.  Just be sure not to use socks made of synthetic fibers as this will only worsen the infection.  Remember, a nail that looks healthy may still be hiding traces of fungus.  It is best to continue topical treatments such as this one for at least a few weeks after the infection appears to be gone.
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.

Satchell, A. C., Saurajen, A., Bell, C., & Barnetson, R. StC. (2002, July 19). Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: A randomized, placebo-controlled, blinded study [Abstract]. Australasian Journal of Dermatology, 43(3), 175–178. Retrieved from http://onlinelibrary.wiley.com/doi/10.1046/j.1440-0960.2002.00590.x/full
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.
Healing time depends on the type of treatment used. Prevention of a new infection is important. Orthopaedic foot and ankle specialists recommend good foot hygiene with frequent changing of stockings and rotating pairs of shoes to allow them to completely dry between uses. Also, avoid going barefoot in locker rooms and around swimming pools. If you have a pedicure, make sure the nail salon uses sterilized instruments.
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.
Swelling and redness of the skin around the nail is called paronychia. This is an infection of the skin at the bottom of the nail (cuticle). If the infection is acute (has a rapid onset), it is usually caused by bacteria. It may respond to warm soaks but will often need to be drained by a doctor. A chronic paronychia occurs when a cuticle becomes inflamed or irritated over time. Sometimes, yeast will take advantage of the damaged skin and infect the area as well. Therapy begins with keeping the skin dry and out of water. If the problem continues, a physician should be consulted. Antibiotics are not often used but may be necessary in severe infection.
Oils such as olive oil and sunflower oil contain ozone gas. A 2011 study published in the Brazilian Journal of Microbiology, showed that small doses of this kind of ozone, applied over a short period, can eliminate fungus. A different study, conducted at the National Center for Scientific Research, Cuba, found that sunflower oil was more effective than the prescription drug Xolegel (ketoconazole).
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.
A band of tissue called the plantar fascia runs along the bottom of the foot. It pulls on the heel when you walk -- and it works best with the proper arch in your foot. Walking barefoot, or in flimsy shoes without sufficient arch support, can overstretch, tear, or inflame the plantar fascia. This common condition can cause intense heel pain, and resting the feet only provides temporary relief.

In some cases of suspected nail fungus there is actually no fungal infection, but only nail deformity. A 2003 source gives a figure of 50%[17] whereas a more recent source claims that fungus is present in 65 to 95 percent of cases.[18] Avoiding use of oral antifungal therapy (e.g. terbinafine) in persons without a confirmed infection is a particular concern because of the possible side effects of that treatment.[17] However, according to a 2015 study, the cost in the United States of testing with the periodic acid–Schiff stain (PAS) was about $148. Even if the cheaper KOH test is used first and the PAS test is used only if the KOH test is negative, there is a good chance that the PAS will be done (because of either a true or a false negative with the KOH test). But the terbinafine treatment only cost $10 (plus an additional $43 for liver function tests). In conclusion the authors say that terbinafine has a relatively benign adverse effect profile, with liver damage very rare, so it makes more sense cost-wise for the dermatologist to prescribe the treatment without doing the PAS test. (Another option would be to prescribe the treatment only if the potassium hydroxide test is positive, but it gives a false negative in about 20% of cases of fungal infection.) On the other hand, as of 2015 the price of topical (non-oral) treatment with efinaconazole was $2307 per nail, so testing is recommended before prescribing it.[18]

Toenail injury: There are two types of injuries that can occur to your toenail. The first is acute trauma where the nail is impacted over and over again as in the case of a runner wearing shoes that don’t fit well. The other thing that can happen is blunt trauma where something falls on your toe such as a heavy object and causes an injury. This injury makes your toenail more susceptible to fungus. It is important in both cases to look after your toenails properly to avoid an infection.


Nail infections occur more often in men than in women, and the infections are found in adults more often than in children. If you have family members who often get these types of fungal infections, you’re more likely to get them as well. Older adults are at the highest risk for getting fungal infections of the nails because they have poorer circulation and their nails grow more slowly and thicken as they age.
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