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Other risk factors include perspiring heavily, being in a humid or moist environment, psoriasis, wearing socks and shoes that hinder ventilation and do not absorb perspiration, going barefoot in damp public places such as swimming pools, gyms and shower rooms, having athlete's foot (tinea pedis), minor skin or nail injury, damaged nail, or other infection, and having diabetes, circulation problems, which may also lead to lower peripheral temperatures on hands and feet, or a weakened immune system.
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.
One way to contract athlete's foot is to get a fungal infection somewhere else on the body first. The fungi causing athlete's foot may spread from other areas of the body to the feet, usually by touching or scratching the affected area, thereby getting the fungus on the fingers, and then touching or scratching the feet. While the fungus remains the same, the name of the condition changes based on where on the body the infection is located. For example, the infection is known as tinea corporis ("ringworm") when the torso or limbs are affected or tinea cruris (jock itch or dhobi itch) when the groin is affected. Clothes (or shoes), body heat, and sweat can keep the skin warm and moist, just the environment the fungus needs to thrive.
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.
Following effective treatment, recurrence is common (10–50%). Nail fungus can be painful and cause permanent damage to nails. It may lead to other serious infections if the immune system is suppressed due to medication, diabetes or other conditions. The risk is most serious for people with diabetes and with immune systems weakened by leukemia or AIDS, or medication after organ transplant. Diabetics have vascular and nerve impairment, and are at risk of cellulitis, a potentially serious bacterial infection; any relatively minor injury to feet, including a nail fungal infection, can lead to more serious complications. Infection of the bone is another rare complication.
No one knows where a specific person catches the fungus, as it is everywhere. However, since the fungus does thrive in warm moist areas (like sweaty feet), there are certain areas one should avoid or use with caution. Shower floors, locker rooms, and swimming pools are suspected of being sources of the fungus, although there are no studies proving this fact. Nail polish and acrylic nails also make the nail less "breathable" and make the nail more susceptible to fungal infection. Fungi are everywhere -- in the air, the dust, and the soil. Hygienic measures such as spraying socks and footgear sound sensible, and perhaps these measures can even help a little bit. However, avoiding tight, nonbreathing shoes or steering clear of athletic facility floors may very well be the best prevention available. Daily washing of the feet and drying between the toes can help to prevent nail fungus. The fungi carried on the coats of pets, like cats and dogs, don't often cause nail fungus. Wearing white socks does not help.
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.
Scratching infected areas may also spread the fungus to the fingers and under the fingernails. If not washed away soon enough, it can infect the fingers and fingernails, growing in the skin and in the nails (not just underneath). After scratching, it can be spread to wherever the person touches, including other parts of the body and to one's environment. Scratching also causes infected skin scales to fall off into one's environment, leading to further possible spread.
Use soap and water to wash your feet, and dry well, including between toes. Trim your toenails -- straight across -- to keep them shorter than the end of your toe. Make sure the tools you use are clean, too. Wash clippers and files with soap and water, then wipe with rubbing alcohol. You might be tempted to cover up discolored nails with polish, but don't. Your nail bed can't "breathe," which keeps fungus from going away.