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.
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.[11]

“The medications we use to treat this are expensive and they are not benign,” cautioned Dr. Hinkes. “Lamisil is so powerful it stays in your body six months after you stop using it, and that’s one of the reasons why it works so well. So when we use these medicines, we have to be conscious that we may be affecting a person’s liver, because the liver is the organ that helps to detoxify the body and excretes that medicine.”
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.
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.
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.
Sometimes people with a fungal nail infection are offered laser treatment. This involves shining infrared or ultraviolet (UV) light on the nail in order to kill the fungi. Laser treatments haven’t been proven to work in good quality studies. Because statutory health insurers in Germany don’t cover the costs of this treatment, people have to pay for it themselves.
Diagnosis is made based on clinical exam and can be confirmed by viewing scrapings of the nail under a microscope, or growing the fungus in a culture medium. This is not an easy condition to cure, so rather than trying home treatment with over-the-counter medications, it's best to see your doctor. As with many conditions, nail fungus infections are easier to treat if you catch them early.
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.
Onychomycosis – commonly known as toenail fungus – is characterized by inflammation, pain, and swelling of the toe, as well as yellowing, thickening, and crumbling of the nail itself.  Toenail fungus can be the result of abnormal pH of the skin, continuous exposure to moisture, wearing synthetic socks, compromised immune system, sweat build-up in shoes, poor foot hygiene, or weak circulation such as that caused by diabetes.
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.  
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.
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