Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

If you notice any redness, increased swelling, bleeding,or if your infection is not clearing up, see your health care professional. If a bacterial infection is also occurring, an antibiotic pill may be necessary. If you have fungal nail involvement, are diabetic, or have a compromised immune system, you should also see your physician for treatment.
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.
Ultra-high heels force the feet into a position that puts stress on the ball of the foot. At this critical joint, the long metatarsal bones meet the pea-shaped sesamoid bones, and the toe bones (phalanges). Too much pressure can inflame these bones or the nerves that surround them. Chronic stress to the foot bones can even lead to hairline fractures.

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.
If you can consume a diet that’s high in good fats and proteins along with some quality fiber — and really reduce the sugar and starches — then you’ll be on the path to eliminating candida in your body, and therefore signs of toenail fungus. Here are some more details on which types of foods to limit or remove from your diet in order to combat yeast and fungal overgrowth …
Fungal nail infections and the resultant nail destruction can promote other sources of infection like cellulitis (a bacterial skin infection) and other forms of tinea, and aggravate foot problems resulting from other illnesses such as diabetes. Diagnosis is usually confirmed by looking at nail clippings through a microscope or other tests before starting treatment.

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.


Globally, fungal infections affect about 15% of the population and affects one out of five adults.[2][21] Athlete's foot is common in individuals who wear unventilated (occlusive) footwear, such as rubber boots or vinyl shoes.[21][23] Countries and regions where going barefoot is more common experience much lower rates of athlete's foot than do populations which habitually wear shoes; as a result, the disease has been called "a penalty of civilization".[35] Studies have demonstrated that men are infected 2–4 times more often than women.[2]
^ Jump up to: a b American Academy of Dermatology (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Dermatology, retrieved 5 December 2013. Which cites:*Roberts DT, Taylor WD, Boyle J (2003). "Guidelines for treatment of onychomycosis" (PDF). The British Journal of Dermatology. 148 (3): 402–410. doi:10.1046/j.1365-2133.2003.05242.x. PMID 12653730.
Fungal infection occurs when the organism invades through an opening in the nail, meaning fungi will usually attack nails that are already damaged. After infection occurs, the growth of the fungi leads to mild inflammation, which causes the nail to thicken and the nail plate to detach from the nail bed. The space underneath the nail can then serve as a reservoir for bacteria and moulds, which can cause the nail to become discoloured.
​The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find an Orthopaedic Foot & Ankle Surgeon" tool at the top of this page or contact your primary doctor. 
Mouthwash kills bacteria and germs in your mouth, so why not use it to kill bacteria and germs on your feet? Its antiseptic properties work to keep away harmful bacteria and fungi. Combine equal parts white vinegar and mouthwash and soak the infected area for 30 minutes, then scrub the toenail area gently. Repeat once or twice daily until the foot fungus clears. Make sure you know these home remedies for athlete’s foot.
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.
If you love the look of ballet flats, over-the-counter inserts (shown here) may help prevent mild foot pain. Heel pads can provide extra cushioning for achy heels. And custom orthotics can ease a whole range of foot pains and problems. Podiatrists prescribe these inserts to provide arch support and reduce pressure on sensitive areas. Prescription orthotics can be pricey, but are sometimes covered by insurance.
Ingrown toenails are caused by the growth of the toenail into the surrounding nail fold. Symptoms and signs include toe pain, swelling, redness, and yellow drainage. Treatment at home involves soaking the affected foot in diluted white vinegar or Epsom salts, elevating the foot, and trimming the nails straight across. Surgery is also an option for severe cases. Prevent ingrown toenails by wearing shoes with a wider toe box and avoiding repeated injury to the toenails. Avoid curving or cutting the nails short at the edges.
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.

Not all cases of OM require treatment with medication but if your doctor has confirmed you have OM and require treatment, they may prescribe an oral antifungal medication (terbinafine, itraconazole*) based on the type of fungus causing the infection. If you are unable to take oral antifungals or have a mild-to-moderate case of OM, your doctor may opt for a topical therapy (ciclopirox, efinaconazole*) that is applied to the affected nail(s) directly.
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]
Many individuals with athlete's foot have no symptoms at all and do not even know they have an infection. Many may think they simply have dry skin on the soles of their feet. Common symptoms of athlete's foot typically include various degrees of itching, stinging, and burning. The skin may frequently peel, and in particularly severe cases, there may be some cracking, fissuring, pain, and itching in the toe webs. Occasionally, athlete's foot can blister.

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.

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