Toenail fungus, a condition known as onychomycosis, is caused by a microorganism called a dermatophyte fungus. These infections can be contagious and are often difficult to eliminate; however, for most adults, toenail fungus does not pose any serious health risks.
Toenail fungus is a common condition that begins as a white or yellow spot on the tip of one of your toes. As the infection grows deeper, the fungus can cause discoloration, thickening, or crumbling at the edge of the nail.
Fungal infections occur more often in toenails than in fingernails because toenails are confined to a dark, warm, moist environment in shoes, where fungus can thrive. Also, blood flow to the toes is less than that to the fingers, making it harder for the immune system to detect and stop the infection, explains dermatologist Dawn Davis, M.D., of the Department of Dermatology at Mayo Clinic in Rochester, Minnesota.
The likelihood of getting toenail fungus increases with age because as you get older, your immune system changes, and, over time, your nails also become more brittle and dry, developing more cracks where fungus can lodge.
Toenails have multiple layers, stacked on top of each other, which can make it difficult to get rid of fungus because it gets inside and between the layers. The fungus can also sit on top of the nail or grow underneath it.
In some cases, the fungus reaches the cells that produce the nail, called the nail matrix, making it very difficult to remove because the cells that make the rest of the toenails are already infected.
The good news, however, is that toenail fungus usually doesn’t turn into serious medical problems. With that in mind, healthy adults with mild toenail fungal infection are not recommended to treat it or only treat it with topical measures.
For example, file the nail down a bit, if possible, so that the fungus has less room to live, as well as keep it short because when the nails are long, they offer more space for the fungus to develop.
If you want to do something more, you can buy over-the-counter nail polish-like lacquers to apply to your toenails. These treatments help prevent the fungus from growing. Your doctor may also prescribe a product containing an antifungal medication to apply once or twice a day to your nail to clear up the infection.
You may have seen advertisements for laser treatments for toenail fungus, but they are not recommended because they are usually very expensive.
In certain specific cases, a more aggressive treatment plan for toenail fungus is suggested. If you have unstable diabetes or your immune system is compromised (for example, you have HIV, have had a transplant, or are receiving cancer treatment), then you require prompt treatment for the fungal infection. If left alone, the fungus can spread to other parts of the body and make you very sick.
In such situations, treatment usually involves applying the above-mentioned topical medications, as well as oral antifungals such as terbinafine or itraconazole. These drugs help the new nail grow out without the infection and gradually replace the infected part.
These types of medications are usually administered for six to twelve weeks, although the results of the treatment are not seen at the end of that period until the new nail has fully grown. This treatment may require several months or more to eliminate the infected nail.