Many people don’t realize they have a fungal nail problem and, therefore, don’t seek treatment. Yet, fungal toenail infections are a common foot health problem and can persist for years without ever causing pain. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish. Left untreated, however, it can present serious problems, and extreme disfigurement.


Also referred to as onychomycosis, fungal nails are infections underneath the surface of the nail, which may also penetrate the nail. Fungal nail infections will sometimes lead to a secondary bacterial infection, which produces pain and is ultimately responsible for discovery of the fungus. Symptoms may include discoloration, brittleness, loosening, thickening, crumbling of the nail, and sometimes pain.

There are many types of fungi capable of infecting the nail, but most frequently it is a select group called dermatophytes. Usually, when fungal organisms take hold, the nail will become thicker, yellowish-brown, or darker in color, and foul smelling. Debris may collect beneath the nail plate, white chalky marks may appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.

Nail bed injury may make the nail more susceptible to all types of infection, including fungal infection. The injury to the nail doesn’t have to be severe, it can be nothing more than shoes that rub the toes, or mild but repeated injury during running or hiking. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete’s Foot or excessive perspiration.

You can prevent fungal nail infections by taking these precautions:

  • Exercise proper hygiene and regularly inspect your feet and toes.
  • Keep your feet clean and dry.
  • Wear shower shoes in public facilities whenever possible.
  • Clip nails straight across so that the nail does not extend beyond the tip of the toe.
  • Use a quality foot powder (talcum, not cornstarch) in conjunction with shoes that fit well and are made of materials that breathe.
  • Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to “wick” away moisture faster than cotton or wool socks, especially for those with more active lifestyles.
  • Disinfect home pedicure tools and don’t apply polish to nails suspected of infection.

Fungus of the toenail, it is hard to get rid of. Depending on the type of infection you have, over-the-counter liquid antifungal agents may not be adequate. A prescription topical or oral medication may need to be prescribed. Many patients, by the time they present to our office, have already tried OTC meds, and home remedies. Be skeptical of simple remedies that claim to cure advance nail fungus. In many cases, use of oral antifungal medication is the only chance of a cure.

Also, In severe cases, surgical debridement may be required to remove the heavily infected portions of nail.