Toe infections sound scary, but they’re infections of the nails, most commonly caused by ingrown toenails. The toenail grows into the side of the toe, into the soft tissue there, and the skin begins to grow over it. It can get infected very quickly and is most commonly seen in big toes. This condition is painful, and an infection can be a serious problem.
Before taking action and finding the best nail fungus treatment for you, it is important to note that toenail fungus and skin fungus, such as athlete’s foot, often manifest together. For the best results, both should be treated at the same time to prevent an ongoing infection. You can recognize athlete’s foot by the dry, scaling, peeling skin on the bottom of the feet. Your feet may also itch, or exude a noticeable odor.
Is it nail psoriasis or fungus? Is it nail psoriasis or fungus? Nail psoriasis is the result of a systemic condition in which the skin, and therefore also the nails, grow too fast. Nail fungus is the result of an infection, and it more common in the toenails. It is important to know the difference, so that effective treatment can be provided. Read now
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.
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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.
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.
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.

Starts at the ends of the nails and raises the nail up: This is called "distal subungual onychomycosis." It is the most common type of fungal infection of the nails in both adults and children. It is more common in the toes than the fingers, and the great toe is usually the first one to be affected. Risk factors include older age, swimming, athlete's foot, psoriasis, diabetes, family members with the infection, or a suppressed immune system. It usually starts as a discolored area at a corner of the big toe and slowly spreads toward the cuticle. Eventually, the toenails will become thickened and flaky. Sometimes, you can also see signs of athlete's foot in between the toes or skin peeling on the sole of the foot. It is often accompanied by onycholysis. The most common cause is T. rubrum.


Athlete’s foot—the most prevalent foot fungus—thrives in warm, sweaty places like the insides of your athletic shoes, which is how it got its name. However, foot fungus can develop in multiple environments, natural and man-made, as long as there is lots of moisture where fungi can grow. These include shared areas at gyms or pools, soil and grass, or even shared items such as shoes, socks, or towels from household members who are infected.  


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.
Starts at the base of the nail and raises the nail up: This is called "proximal subungual onychomycosis." This is the least common type of fungal nail. It is similar to the distal type, but it starts at the cuticle (base of the nail) and slowly spreads toward the nail tip. This type almost always occurs in people with a damaged immune system. It is rare to see debris under the tip of the nail with this condition, unlike distal subungual onychomycosis. The most common cause is T. rubrum and non-dermatophyte molds.
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]
Over-the-counter antifungal treatments. Antifungal creams and ointments treat toenail infections while helping to keep new fungus out so new nails can grow. Some treatments must be applied every day, others are applied once a week. It’s a good idea to apply topical treatments to both the foot and nail simultaneously to prevent foot fungus from spreading to the toes. If you trim your toenails well (see above) before applying an antifungal, the medicine can reach deeper into the nailbed.
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.
The vesiculobullous type of athlete's foot is less common and is usually caused by T. mentagrophytes and is characterized by a sudden outbreak of itchy blisters and vesicles on an erythematous base,[7] usually appearing on the sole of the foot. This subtype of athlete's foot is often complicated by secondary bacterial infection by Streptococcus pyogenes or Staphylococcus aureus.[13]
If you have diabetes, you may have reduced blood circulation and nerve supply in your feet. You're also at greater risk of a bacterial skin infection (cellulitis). So any relatively minor injury to your feet — including a nail fungal infection — can lead to a more serious complication. See your doctor if you have diabetes and think you're developing nail fungus.
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