Modern medicine addresses toenail fungus with topical treatments, oral anti-fungal medicine, and in some cases surgical removal of the nail.  Side effects of these medications may possibly include trouble breathing, swelling of the mouth or face, hives, rashes, blisters, headaches, dizziness, nausea, loss of appetite, liver damage, weight gain, fatigue, heart problems, fever, diarrhea, and more pain – all just to get rid of fungus on your toenails.
Wei, Y.-X., Xu, X.-Y., Xu, & Song, X. (2017). A review of antifungal natural products against the pathogenic fungi causing athletes' foot disease. Current Organic Chemistry, 21, 1–13. Retrieved from https://www.researchgate.net/profile/Xun_Song/publication/319128408_A_Review_of_Antifungal_Natural_Products_Against_the_Pathogenic_Fungi_Causing_Athletes'_Foot_Disease/links/59931c65458515c0ce61efa1/A-Review-of-Antifungal-Natural-Products-Against-the-Pathogenic-Fungi-Causing-Athletes-Foot-Disease.pdf
Keeping socks and shoes clean (using bleach in the wash) is one way to prevent fungi from taking hold and spreading. Avoiding the sharing of boots and shoes is another way to prevent transmission. Athlete's foot can be transmitted by sharing footwear with an infected person. Hand-me-downs and purchasing used shoes are other forms of shoe-sharing. Not sharing also applies to towels, because, though less common, fungi can be passed along on towels, especially damp ones.
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 causative pathogens of onychomycosis are all in the fungus kingdom and include dermatophytes, Candida (yeasts), and nondermatophytic molds.[2] Dermatophytes are the fungi most commonly responsible for onychomycosis in the temperate western countries; while Candida and nondermatophytic molds are more frequently involved in the tropics and subtropics with a hot and humid climate.[10]
Persistent fungal signs can show up slowly but last for years. Getting rid of toenail fungus can take some patience and requires time to fully heal. It can take several months until treatment is successful, but doing things the right way and getting rid of the underlying cause of nail fungus is the only thing that will keep the infection from coming back again.
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.

Whitish or yellowish nails can occur due to onycholysis. This means separation of the nail from the nail bed. The color you see is air beneath the nail. The treatment is to trim the nail short, don't clean under it, polish if you want to hide the color, and wait two to three months. Persistent onycholysis can make the nails susceptible to fungal infection.


Dermatophytes — fungus that grows on the skin, hair and nails but don’t penetrate tissues of the body. Athlete’s foot or Trichophyton rubrum is the most common dermatophyte and can actually infect the toenails. Infection can also begin by touching objects that have dermatophytes on them, such as nail clippers, nail files, socks, shoes, shower floors, etc. Dermatophytes are the cause of most fungal toenail infections.
According to the UK's National Health Service, "Athlete’s foot is very contagious and can be spread through direct and indirect contact."[24] The disease may spread to others directly when they touch the infection. People can contract the disease indirectly by coming into contact with contaminated items (clothes, towels, etc.) or surfaces (such as bathroom, shower, or locker room floors). The fungi that cause athlete's foot can easily spread to one's environment. Fungi rub off of fingers and bare feet, but also travel on the dead skin cells that continually fall off the body. Athlete's foot fungi and infested skin particles and flakes may spread to socks, shoes, clothes, to other people, pets (via petting), bed sheets, bathtubs, showers, sinks, counters, towels, rugs, floors, and carpets.

What triggers candida in the first place? This overgrowth of yeast can develop from a number of factors, including antibiotic use, poor digestion, low immune system function, a high sugar and grain diet, stress or hormonal changes. All these create an acidic environment that encourages yeast growth and the presence of candida. Many people opt for over-the-counter anti-fungal creams or even medications, but they only treat the symptoms, not the environment that allows candida to flourish.


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]
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.
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]
Your physician may perform a simple test called a potassium hydroxide (KOH) preparation for microscopic fungal examination in the office or laboratory. This test can be used to confirm the presence of a fungal infection. This test is performed by using a microscope to examine small flakes of skin from the rash. Many dermatologists perform this test in their office with results available within minutes. Rarely, a small piece of skin may be removed and sent for biopsy or fungal culture to help confirm the diagnosis.
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.

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]
The fungi (molds) that cause athlete's foot require warmth and moisture to survive and grow. There is an increased risk of infection with exposure to warm, moist environments (e.g., occlusive footwear—shoes or boots that enclose the feet) and in shared humid environments such as communal showers, shared pools, and treatment tubs.[17] Chlorine bleach is a disinfectant and common household cleaner that kills mold. Cleaning surfaces with a chlorine bleach solution prevents the disease from spreading from subsequent contact. Cleaning bathtubs, showers, bathroom floors, sinks, and counters with bleach helps prevent the spread of the disease, including reinfection.
The first step in treating toenail fungus is using one of the most effective and natural ways to fight candida. In other words, you’ll likely need to make some changes in your diet and adopt a candida diet. The most crucial tactic for treating candida overgrowth is to eliminate what feeds the yeast and candida virus living in your digestive tract in the first place: sugars and conventional grain products.
Terbinafine can cause gastrointestinal (stomach and bowel) problems and a temporary loss of taste and smell. It can also interact with certain antidepressants and heart medications. Overall, terbinafine has far fewer drug-drug interactions than itraconazole. Nevertheless, it’s still important to tell your doctor if you are taking any other medication. As a precaution, this medication should not be taken during pregnancy or if you are breastfeeding.
Topical agents include ciclopirox nail paint, amorolfine, and efinaconazole.[19][20][21] Some topical treatments need to be applied daily for prolonged periods (at least 1 year).[20] Topical amorolfine is applied weekly.[22] Topical ciclopirox results in a cure in 6% to 9% of cases; amorolfine might be more effective.[2][20] Ciclopirox when used with terbinafine appears to be better than either agent alone.[2]
High heeled shoes push too much body weight toward the toes and then squeeze them together. Over time, the result can be hammertoe (early stage, lower right), abnormal bends in the toe joints that can gradually become rigid. Surgery is sometimes needed to relieve the pain of severe hammertoe. Crowding can cause other toe deformities, along with continuous shoe friction, leading to painful corns and calluses.
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).
Cultured dairy or fermented foods (ideally organic and raw) — these are beneficial for replacing good bacteria in the gut since they provide probiotics. Probiotics help control yeast and also have numerous immune-enhancing effects. For other sources of probiotics, in addition to yogurt or kefir try cultured foods like kimchi, kombucha or sauerkraut.
This foot fungus treatment contains a fungus that is harmless to the body but still kills the infectious fungus. Mix a cup of cornmeal and two quarts of water in a tub big enough to fit your feet. Let the cornmeal sit in the water for an hour and then soak your foot or feet for a half hour or more. Here are more homemade foot scrub recipes to pamper your feet.
Modern medicine addresses toenail fungus with topical treatments, oral anti-fungal medicine, and in some cases surgical removal of the nail.  Side effects of these medications may possibly include trouble breathing, swelling of the mouth or face, hives, rashes, blisters, headaches, dizziness, nausea, loss of appetite, liver damage, weight gain, fatigue, heart problems, fever, diarrhea, and more pain – all just to get rid of fungus on your toenails.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.

Topical nail-bed fungus treatments are a safe option that almost anyone can use. They work best when the infection is treated in its earliest stages. However, these medications do not heal the nail itself, only the fungus growing on the nail bed and surrounding area. Only oral medications, which come with many contraindications and may not be safe for everyone, can treat the nail itself.
Walking barefoot in wet, dark areas frequented by many other individuals like indoor swimming pool decks, communal showers, and locker rooms result in frequent exposure to pathogenic fungi (dermatophytes) that cause athlete’s foot. Wearing occlusive footwear is thought to play a significant role in the increased frequency of tinea pedis. Exposure to moisture either from excessive sweating or from an external source is a risk factor. Wearing the same shoes and socks for an extended period may damage the skin. Patients with diabetes are predisposed to develop tinea pedis. Some believe that eczema (atopic dermatitis) can predispose one to tinea pedis. It appears that many more men have tinea pedis than women. Pedicure performed in contaminated environments can spread disease.
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.
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.
Red or black nails due to a hematoma, or blood under the nail, usually occur from trauma (like whacking yourself on the thumb with a hammer). The discolored area will grow out with the nail and be trimmed off as you trim your nails. If you have a black spot under your nail that was not caused by trauma, you may want to see a dermatologist or a podiatrist if it involves a toenail to make sure it is not melanoma (a type of skin cancer associated with pigmented cells). A simple biopsy can rule out malignancy (cancer).
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