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.

Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time, it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail. 
There are many possible causes of foot rashes. Additional causes include irritant or contact dermatitis, allergic rashes from shoes or other creams, pompholyx (dyshidrotic eczema), psoriasis, yeast infections, and bacterial infections (gram negative toe web infection and erythrasma). Since these conditions are often indistinguishable on superficial visual examination, it is important for your doctor to do his best to identify the precise cause. Since fungal infections are potentially curable, it is important not to miss this diagnosis.
Patience is key, as treatment duration varies from 2-3 months for oral treatments to up to 12 months for topical treatment. Because the nails take a long time to grow (6 months for fingernails and 12-18 months for toenails), it will take some time for the infection to resolve and the nail appearance to improve, regardless of the type of treatment used. Sometimes treatment may not be successful and your doctor may prescribe a different medication.
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.
Garlic has antifungal properties useful to foot fungus treatment, thanks to its compounds such as allicin and ajoene. These natural compounds work to treat the toenail fungus. Mix crushed up garlic or garlic oil with white vinegar. Apply the mixture on and around the infected area and then cover it with a bandage. Leave the bandage on for a few hours. Repeat daily until the toenail fungus clears. Plus, learn about the other signs of disease your feet can reveal.
Snakeroot extract is an antifungal made from plants in the sunflower family. A 2008 study showed that the remedy is as effective against toenail fungus as the prescription antifungal medicine ciclopirox. For the study, snakeroot extract was applied to the affected area every third day for the first month, twice a week for the second month, and once a week for the third month. You can find snakeroot extract online.

Since some people are simply more prone to fungal infections, they are also prone to repeated infection. Preventive measures include keeping your feet clean and dry, avoiding prolonged moist environments, using socks in airport security lines, removing shoes, and allowing the feet skin to "breathe," avoiding walking barefoot, especially in public areas like swimming pools and gyms, avoiding contact with known infected people, and avoiding soaking and contaminated tool usage at nail salons. Weekly applications of a topical antifungal foot cream or sprinkling of antifungal foot powder (Zeasorb Foot Powder) into shoes may also be helpful.
Recognize the signs. Before you can treat toenail fungus, you need to know what to look for. Nail fungus does not necessarily have consistent symptoms. The most common sign that you have nail fungus is tenderness or pain in the nail. Signs of a fungal infection include changes in your nail, such as color changes. The nail will usually get yellow or white streaks on the side of the nail. There is usually due to a buildup of debris under or around the nail, a crumbling and thickening of the outside edges of the nail, a loosening or lifting up of the nail, and nail brittleness.[3]

You may use other antifungal treatments, such as antifungal nail lacquer or topical solutions. These treatments are brushed onto the nail in the same way that you would apply nail polish. Depending on the type of fungus causing the infection, as well as the extent of the infection, you may have to use these medications for several months. Topical solutions are not generally effective in curing toenail fungal infections.
Removal of the nail can reduce symptoms rapidly, but regrowth of the nail can take one year during which time local treatment for fungus can be used. Oral medications include terbinafine (Lamisil), itraconazole (Sporanox), and griseofulvin (Fulvicin). Treatment regimens vary and can last between six weeks and one year. Side effects of systemic treatment include gastrointestinal disorders, liver toxicity, skin rash and other hypersensitivities. These medications should not be taken during pregnancy or if there is a chance you will become pregnant because of effects on the fetus.

^ 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.
The medical name for fungal athlete's foot is tinea pedis. There are a variety of fungi that cause athlete's foot, and these can be contracted in many locations, including gyms, locker rooms, swimming pools, communal showers, nail salons, and from contaminated socks and clothing. The fungi can also be spread directly from person to person by contact. Most people acquire fungus on the feet from walking barefoot in areas where someone else with athlete's foot has recently walked. Some people are simply more prone to this condition while others seem relatively resistant to it. Another colorful name for this condition is "jungle rot," often used by members of the armed services serving in tropical climates.
Because you’re removing the majority of sugars and grains from your diet, in addition to fiber, I also recommend increasing the amount of protein-rich foods you’re eating. Make sure to buy grass-fed meat; organic, cage-free eggs or poultry; raw, unpasteurized dairy; and wild-caught fish — this is key for obtaining enough protein while also reducing toxins in your diet.

There are many possible causes of foot rashes. Additional causes include irritant or contact dermatitis, allergic rashes from shoes or other creams, pompholyx (dyshidrotic eczema), psoriasis, yeast infections, and bacterial infections (gram negative toe web infection and erythrasma). Since these conditions are often indistinguishable on superficial visual examination, it is important for your doctor to do his best to identify the precise cause. Since fungal infections are potentially curable, it is important not to miss this diagnosis.


Onychomycosis does not necessarily require treatment.[3] The antifungal medication, terbinafine, taken by mouth appears to be the most effective but is associated with liver problems.[2][4] Trimming the affected nails when on treatment also appears useful.[2] There is a ciclopirox containing nail polish, but it does not work as well.[2] The condition returns in up to half of cases following treatment.[2] Not using old shoes after treatment may decrease the risk of recurrence.[3]
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.
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
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