Toenail fungus (onychomycosis) is caused by a group of fungi known as dermophytes. This group thrives on skin and on keratin, the main component of hair and nails. The fungus gets under the nail and begins to grow, damaging the nail so it discolors, becoming white, brown or yellow. Eventually, the nail might thicken, harden, become brittle and even fall off.
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.

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.
Athlete's foot, known medically as tinea pedis, is a common skin infection of the feet caused by fungus.[2] Signs and symptoms often include itching, scaling, cracking and redness.[3] In rare cases the skin may blister.[6] Athlete's foot fungus may infect any part of the foot, but most often grows between the toes.[3] The next most common area is the bottom of the foot.[6] The same fungus may also affect the nails or the hands.[4] It is a member of the group of diseases known as tinea.[7]
Vicks VapoRub is a topical ointment. Although designed for cough suppression, its active ingredients, camphor and eucalyptus oil, may help treat toenail fungus. A 2011 study found Vicks VapoRub had a “positive clinical effect” in the treatment of toenail fungus. To use, apply a small amount of Vicks VapoRub to the affected area at least once a day.
Whitish or yellowish nails can occur due to onycholysis. This means separation of the nail from the nail bed. The color you see is air beneath the nail. The treatment is to trim the nail short, don't clean under it, polish if you want to hide the color, and wait two to three months. Persistent onycholysis can make the nails susceptible to fungal infection.

Physical exam alone has been shown to be an unreliable method of diagnosing fungal nails. There are many conditions that can make nails look damaged, so even doctors have a difficult time. In fact, studies have found that only about 50% of cases of abnormal nail appearance were caused by fungus. Therefore, laboratory testing is almost always indicated. Some insurance companies may even ask for a laboratory test confirmation of the diagnosis in order for antifungal medicine to be covered. A nail sample is obtained either by clipping the toenail or by drilling a hole in the nail. That piece of nail is sent to a lab where it can by stained, cultured, or tested by PCR (to identify the genetic material of the organisms) to identify the presence of fungus. Staining and culturing can take up to six weeks to get a result, but PCR to identify the fungal genetic material, if available, can be done in about one day. However, this test is not widely used due to its high cost. If a negative biopsy result is accompanied by high clinical suspicion, such as nails that are ragged, discolored, thickened, and crumbly, it warrants a repeat test due to the prevalence of false-negative results in these tests.

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.

I fully believe in natural remedies as well as safe, pharmaceutical ones. I have all of the ingredients and essential oils necessary to make my own potions, but as a busy, working Mom I chose the easy route of purchasing the potion already made up. I used this religiously for over a month. I cleaned and trimmed my affected 4 toenails constantly through the process. I saw absolutely no results. Yes, the painted on 2nd step does temporarily improve the appearance of the nail instantly, but that's because of the glossy sheen. Any oil will do that. Once soaked in, my nail looked and remained the same. Perhaps my failure was a result of dipping the brush I used on my infected toes and back into the bottle repeated times. Doesn't that seem counter productive given a fast-spreading fungus? They're slowly growing out but the fungus remains in the grow out and my nails are still thin and fragile. I would have given this product one more star with a pat on the back and a "nice try" but the huge number of immediate, 5-star reviews left me with the instant feeling of being mislead. I may have even given it more time with more realistic reviews.
Athlete's foot was first medically described in 1908.[9] Globally, athlete's foot affects about 15% of the population.[2] Males are more often affected than females.[4] It occurs most frequently in older children or younger adults.[4] Historically it is believed to have been a rare condition, that became more frequent in the 1900s due to the greater use of shoes, health clubs, war, and travel.[10]
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.
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.
Onychomycosis, also known as tinea unguium, is a fungal infection of the nail.[2] Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed.[2][3] Toenails or fingernails may be affected, but it is more common for toenails to be affected.[3] Complications may include cellulitis of the lower leg.[3]
Onychomycosis, also known as tinea unguium, is a fungal infection of the nail.[2] Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed.[2][3] Toenails or fingernails may be affected, but it is more common for toenails to be affected.[3] Complications may include cellulitis of the lower leg.[3]
Walking barefoot in wet, dark areas frequented by many other individuals like indoor swimming pool decks, communal showers, and locker rooms result in frequent exposure to pathogenic fungi (dermatophytes) that cause athlete’s foot. Wearing occlusive footwear is thought to play a significant role in the increased frequency of tinea pedis. Exposure to moisture either from excessive sweating or from an external source is a risk factor. Wearing the same shoes and socks for an extended period may damage the skin. Patients with diabetes are predisposed to develop tinea pedis. Some believe that eczema (atopic dermatitis) can predispose one to tinea pedis. It appears that many more men have tinea pedis than women. Pedicure performed in contaminated environments can spread disease.
Topical antifungal agents can be used but are often ineffective. Oral terbinafine is considered to be the first-line treatment for confirmed onychomycosis; the treatment course is generally 6 weeks for fingernails and 12 weeks for toenails.9 Azoles can also be used. Surgical debridement or removal of the affected nail is also a consideration for cases that are resistant to antifungals, and laser treatments for onychomycosis appear to be a promising area for future study.10
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.
Satchell, A. C., Saurajen, A., Bell, C., & Barnetson, R. StC. (2002, July 19). Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: A randomized, placebo-controlled, blinded study [Abstract]. Australasian Journal of Dermatology, 43(3), 175–178. Retrieved from http://onlinelibrary.wiley.com/doi/10.1046/j.1440-0960.2002.00590.x/full

Medical treatment of onychomycosis is suggested in patients who are experiencing pain and discomfort due to the nail changes. Patients with higher risk factors for infections such as diabetes and a previous history of cellulitis (infection of the soft tissue) near the affected nails may also benefit from treatment. Poor cosmetic appearance is another reason for medical treatment.
There are several doctors who can provide nail fungus treatment. Your primary care provider, a dermatologist, or a podiatrist can treat nail fungus. Any one of these doctors can provide proper diagnosis and prescribe medications specific to fungal infection. A podiatrist or dermatologist may shave the top layer of the nail off or even remove part of the nail.
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.
Ringworm, also called tinea corporis, is not a worm, but a fungal infection of the skin. It can appear anywhere on the body and it looks like a circular, red, flat sore. It is often accompanied by scaly skin. The outer part of the sore can be raised while the skin in the middle appears normal. Ringworm can be unsightly, but it is usually not a serious condition.
Anti-fungal properties of lavender oil make it an effective remedy for mild cases of toenail fungus.  Apply a few drops of 100% pure lavender essential oil to the infected nails every night and let it soak in while you sleep.  To prevent the oil from rubbing off, you can optionally cover your feet with a pair of wool socks.  Just be sure not to use socks made of synthetic fibers as this will only worsen the infection.  Remember, a nail that looks healthy may still be hiding traces of fungus.  It is best to continue topical treatments such as this one for at least a few weeks after the infection appears to be gone.
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.
Yeast onychomycosis: This type is caused by a yeast called Candida and not by the Trichophyton fungus named above. It is more common in fingernails and is a common cause of fungal fingernails. Patients may have associated paronychia (infection of the cuticle). Candida can cause yellow, brown, white, or thickened nails. Some people who have this infection also have yeast in their mouth or have a chronic paronychia (see above) that is also infected with yeast.
Onychomycosis, also known as tinea unguium, is a fungal infection of the nail.[2] Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed.[2][3] Toenails or fingernails may be affected, but it is more common for toenails to be affected.[3] Complications may include cellulitis of the lower leg.[3]
Following effective treatment, recurrence is common (10–50%).[2] 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.[31] Infection of the bone is another rare complication.[6]
The fungi (molds) that cause athlete's foot require warmth and moisture to survive and grow. There is an increased risk of infection with exposure to warm, moist environments (e.g., occlusive footwear—shoes or boots that enclose the feet) and in shared humid environments such as communal showers, shared pools, and treatment tubs.[17] Chlorine bleach is a disinfectant and common household cleaner that kills mold. Cleaning surfaces with a chlorine bleach solution prevents the disease from spreading from subsequent contact. Cleaning bathtubs, showers, bathroom floors, sinks, and counters with bleach helps prevent the spread of the disease, including reinfection.

Swelling and redness of the skin around the nail is called paronychia. This is an infection of the skin at the bottom of the nail (cuticle). If the infection is acute (has a rapid onset), it is usually caused by bacteria. It may respond to warm soaks but will often need to be drained by a doctor. A chronic paronychia occurs when a cuticle becomes inflamed or irritated over time. Sometimes, yeast will take advantage of the damaged skin and infect the area as well. Therapy begins with keeping the skin dry and out of water. If the problem continues, a physician should be consulted. Antibiotics are not often used but may be necessary in severe infection.
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