Toenail fungus, otherwise known as onychomycosis, is a common infection of the nail that affects an estimated 10% of adults at some point in our lives.
It can be an unattractive and unpleasant condition. Thankfully, there are various types of antifungal cures on the market, from lasers to creams to prescription medication.
Below is our complete guide to getting rid of toenail fungus, to stop it coming back, and to ensure healthy nails and feet in future.
Use our menu to skip to the most relevant information, or read on for — literally — everything you need (and probably didn’t want) to know about toenail fungus.
- 1 How to Tell If You Have Toenail Fungus
- 2 Types of Toenail Fungus
- 3 What Causes Toenail Fungus?
- 4 Best Toenail Fungus Treatments
- 5 How to Prevent Toenail Fungus
- 6 10 Tips for Healthy Nails and Healthy Feet
How to Tell If You Have Toenail Fungus
There are some very clear symptoms of toenail fungus.
However, a fungal nail infection will develop over time rather than appearing overnight, so it’s best to check your nails regularly to see whether there are any early warning signs of a toenail fungus. Once you do have symptoms, the fungus is definitely in situ and still growing so it’s best to start treatment quickly.
Remember, always consult your doctor if you think you may have a fungal nail infection. They will be able to take a sample from the nail to test for fungus, and advise on the best course of treatment.
In the future, it’s likely that AI will be able to diagnose a nail fungus infection as well as (or better than) any dermatologist. This will lead to remote diagnosis by ‘telemedicine’.
Here are the symptoms to watch for in the meantime:
The first indication of a toenail fungus is usually when a part of your nail starts to change colour – a gradual yellowing is the most common, although white spots, black or even green streaks can also indicate a lurking fungus.
Any shine or appearance of a healthy nail will disappear as the fungus takes hold and dulls the natural colour of your nail.
Nail Thickening and Separation
You may also see the corners and surface of your nail start to thicken to the extent that the nail becomes difficult to trim. If you do manage to clip it, the nail may be brittle or even crumble away.
As the fungus progresses, it will distort the shape and texture of the nail – ridges on the surface may appear and the nail shape will warp as it grows.
At the same time, the nail may separate from the nail bed and come loose – it could even fall off if appropriate action isn’t taken.
Smell and Build-up of Debris
If the nail does start to separate from the nail bed, debris will collect under the nail – usually bits of dead skin and nail.
Combined with the fungus itself, you may detect a foul odour from the nail that’s likely to worsen if you keep it wrapped up in warm and moist conditions like socks and shoes, where bacteria can thrive.
Some fungal nail infections can cause soreness and throbbing, particularly if you’re walking around and putting pressure on the fragile nail.
It’s particularly painful if the nail becomes ingrown (when the nail grows sideways into the skin of your toe) as the fungus warps its shape and growth pattern.
It’s best to consult your doctor if you’re experiencing a lot of toenail pain so they can correct any ingrowing toenails and tend to any subsequent infections.
Those who suffer from diabetes (or a weakened immune system) are particularly susceptible to the risks of a fungal infection. This is due to an increased risk of developing sores, which can be difficult to heal, very painful, and can lead to additional health risks.
Types of Toenail Fungus
There are actually four different types of toenail fungus, which are differentiated according to where the fungus first appears on your nail.
The medical term for fungal nail infections is onychomycosis.
Distal Subungual Onychomycosis
This is the most common type of fungal nail infection that affects both the skin of the nail bed and the nail itself.
It starts at the top of the nail bed near the tip of the toe and can be spotted early by yellow or white streaks and patches appearing at the top of the nail.
As the fungus grows, the nail will thicken, become brittle or crumbly, and perhaps even separate from the nail bed. Skin and nail debris are likely to collect under the nail too.
This type of toenail fungus can keep coming back for some people, and can therefore be difficult to effectively treat.
White Superficial Onychomycosis
This is the second most common fungal nail infection and is easier to treat than the one above as it just affects the surface of the nail but not the nail bed.
Symptoms include discoloured spots on the nail and eventually an all-over chalky or powdery surface as the fungus progresses. As the nail bed is not affected, the nail won’t thicken nor separate from the skin beneath.
If you’re unsure about whether you have white superficial onychomycosis, it’s best to consult your doctor who can test to see if a fungus is present. Some people have mis-diagnosed this condition in the past when they were simply experiencing a reaction to their nail polish.
Although still technically a fungal nail infection, candida onychomycosis is actually a yeast infection that is more likely to affect the fingernails rather than the toes.
People who suffer from this usually have had some prior trauma or damage to the nail and are known to frequently immerse their nails in water. A dish washer, for instance, or a regular swimmer perhaps.
Symptoms include nail discolouration, thickening and visible nail weakness. The nail may separate from the nail bed, and the infection is likely to spread to the skin around the nail too, which may become reddened and tender to touch. Some pain is likely with this type of nail fungus.
Proximal Subungual Onychomycosis
This fungal nail infection starts at the base of the nail where it emerges from the skin.
It is very rare in healthy people but more commonly seen in those with immune deficiencies – HIV positive patients, in particular.
The fungus affects the skin around the nail, often thickening it and showing obvious signs of infection (reddening, tenderness and warmth). The base of the nail is likely to turn white and the nail itself will dull and thicken, possibly separating from the surrounding skin.
What Causes Toenail Fungus?
Most fungal nail infections are caused by dermatophytes – fungi that cause skin, hair and nail infections in animals and humans.
As well as fungal nail infections, they also cause ringworm, athlete’s foot and jock itch.
Yeast fungus can also cause fungal nail infections.
Toenail fungus starts when your nail comes into contact with a fungus. It can enter the nail through a tiny cut or separation between the nail and skin.
The fungus is able to grow and become a nail infection because your toes are often warm and damp from being in shoes all day. These conditions allow the fungus to thrive and take over more of the nail.
It is said that leading factors behind the spread of Onychomycosis include: “occlusive footwear, locker room exposure and the dissemination of different strains of fungus worldwide.”
Who Gets Fungal Nail Infections?
Anyone can get a fungal nail infection but you’re particularly at risk if are at least one of the following:
- Over 65 – your circulation slows as you get older meaning your toenails have less blood cells available to fight off the infection. It is estimated that up to 20-50% of over 60s may suffer from nail fungal infections.
- Diabetic or suffering immunodeficiencies (including HIV) – these diseases worsen circulation and allow less blood flow to the toes and feet
- Suffering from Athlete’s Foot – the same fungus causes fungal nail infections as Athlete’s Foot so it can easily spread to your nails
- A heavy sweater – hot, sweaty feet are a prime environment for funguses to grow and thrive
- Using a public swimming pool – the damp conditions allow all the funguses from people walking barefoot to thrive and transfer to a host of new feet
- Having an injury or skin condition near the nail which can easily let in fungus
Can I Get Toenail Fungus From Pedicures?
Put simply, yes: you can get fungal nail infections from pedicures.
As nail salons see plenty of bare feet coming and going, there’s lots of opportunity for people to bring toenail fungus into the salon, and consequently on the pedicurist’s hands and tools, into the foot baths, and even on the nail polish itself.
If you happen to have a small cut or opening near your nail bed – which is relatively likely if your pedicurist is trimming your cuticles or cutting your nails – then all that fungus from the other customers will be introduced straight into your nail. And if you’re prone to infection, you can expect a fungal nail infection in no time at all.
The best way to avoid this is to choose a really hygienic nail salon that refuses to treat people with visible toenail fungus.
Feel free to ask how they sterilise their tools, if they change their gloves between customers and whether they’ve disinfected the footstools and baths before you use them.
Many nail salons these days use disposable emery boards and pumice stones, while metal tools are put into a sterilising packet and autoclaved.
It’s much harder to avoid fungus from nail polish as the brush obviously can’t be sterilised between customers. Some nail salons will include the cost of a small pot of unopened polish in the cost of a pedicure. It may cost a little more but is likely cheaper than long-term treatment for toenail fungus!
Can I Get Toenail Fungus From My Partner?
Toenail fungus can spread from person to person and there’s plenty of opportunity to pass it on to people that you’re in close contact with – that means you can get a fungal nail infection if your partner has one.
Skin to skin contact is one way for nail fungus to spread, so if you share a bed or other close quarters you may well be exposed to it.
Although toenail fungus can’t spread through sexual activity, you could still catch it if you’re in close proximity with a person with a nail infection or Athlete’s Foot.
The shower and bath are another easy way for toenail fungus to spread in the home. Fungus thrives in a warm and damp bathroom, and you’re likely to be barefoot in there as well – lots of opportunity to pick up fungus!
But, of course, just because your partner has a fungal nail infection doesn’t necessarily mean that you will get one too. Encourage them to start treatment immediately and be proactive with disinfecting the bathroom and regularly washing your bedsheets. You could even ask your partner to wear a sock in bed to try and contain the fungus.
Can I Get Toenail Fungus From The Gym?
You can get toenail fungus from the gym, particularly in the changing rooms and showers.
The changing rooms are the first place where people take off their warm, damp shoes and expose their feet – and their fungal nail infections.
This fungus can then be tracked all over the changing room and into the showers where it’s ready to be transmitted to your toenails.
Fungal nail infections will be relatively common with regular gym-goers. The fungus is easy to pick up in such a communal space, while the fact that they’re sweating in the sneakers provides the right environment for that fungus to grow and pass on to others.
Your best bet to avoid getting toenail fungus at the gym is simply to avoid going barefoot – take some flip-flops or slip-on shoes to wear in the changing rooms and showers.
Best Toenail Fungus Treatments
Despite doctors knowing a lot about the causes and symptoms of toenail fungus, it can be remarkably difficult to get rid of the condition and ensure that it doesn’t come back again.
Indeed, some podiatrists are keen to stress that the condition is one we should aim to manage rather than cure.
Onychomycosis is notorious for being chronic and resistant to treatment. Studies suggest up to 16-25% of patients are not cured by current treatments. However, the flipside to this warning is that many patients are finding success.
Your best course of action is to choose the best treatment style that works for your level of infection.
There are a few different types of toenail fungus treatments on the market:
- Antifungal creams: these are often the first course of action for people with fungal nail infections and work best on mild to moderate infections. These work to break down the cell wall of the fungus, causing it to die. They need to be applied directly under the nail to the fungus itself, if possible. There is evidence to suggest that delivering antifungal medicine through holes in the nail may increase the effectiveness of the treatment.
- Laser treatments: the laser heats and destroys the fungi without hurting the surrounding healthy tissue. These treatments can be expensive and there is debate as to their effectiveness.
- Home remedies: if you want a low cost and low chemical treatment, you could try an anti-fungal home remedy. These usually revolve around the use of essential oils and can take about two months to clear the infection.
- Antifungal pills: oral medication is often the best choice for moderate to severe fungal nail infections, but there is a risk of side effects. Popular treatment options include terbinafine (Lamisil) and itraconazole (Sporanox).
Best Antifungal Creams
Here are our top 3 antifungal creams on the market:
1. Fungus Stop
- A best selling antifungal treatment
- Clinically proven to kill 99.99% of toenail fungus
- Treatment should be complete in just 4 weeks
- A 100% natural product with active ingredient Carvacrol
- It also contains Vitamin C and E to nourish the skin
2. Family Care Clotrimazole Anti Fungal Cream
- It contains 1% Clotrimazole (the antifungal active ingredient)
- This pack contains three 1 oz tubes so is very economical
- It’s very tough on fungal infections and clears them up fast
- Some users see improvements after the first dose
- This works on both common fungal infections and yeast infections
- A full prescription strength cream that’s designed for Athlete’s Foot but many customers have used it to successfully get rid of toenail fungus
- Contains 1% Terbinafine Hydrochloride as the active antifungal
- You need to apply the cream under the nail to the skin below to blast the fungus
Best Fungus Laser Treatments
Laser treatments to tackle toenail fungus are still very much an emerging market, but there are a lot of podiatry clinics that are now offering this service to their affected patients.
If you’d prefer to undertake your treatment at home, you could purchase a compact laser for your own use instead. Although the initial outlay is reasonably expensive, you’ll be able to treat your toenail fungus every day without even having to leave your house.
They’re discreet, easy to use and economical in the long term.
Here’s the best, affordable model on the market right now:
1. Fungus Treatment Laser Device by Cure Ex
- No need to go to a clinic for a pricey appointment – you can tend to your toenail fungus from the comfort of your own home with this device
- Compact design that’s lightweight and discreet
- Powered by rechargeable batteries with a long battery life
- Comes with a 12-month warranty and a 180-day money back guarantee
- Acts fast – just one daily 7 minute session (per affected toe) will ensure you see results within 4 weeks
- It’s pain free
- Easy to use
If you’re happy to splash the cash, take a look at some of the professional toenail fungus laser treatments on offer here.
Best Antifungal Home Remedies
Home remedies for fungal nail infections are very popular with people looking either to ‘top up’ their prescribed or over-the-counter treatment, or with those looking to avoid the chemical-laden products entirely.
Not all home treatments were created equal – some simply won’t work while others will yield only very minimal results like softening the skin on your toes.
If you do want to try antifungal home remedies, you need to pick ingredients that have some antibacterial, antifungal and antiseptic properties that can stop the fungus from growing and even help it to die. If possible, you need the remedy to actually come into contact with the fungus to yield the best results.
These are the most popular home remedies for fungal nail infections:
- Tea Tree Oil
Tea tree is an essential oil that is known for its antifungal and antiseptic qualities.
Add a couple of drops to the end of a cotton bud and insert under and on the surface of your nail; try to apply it to the fungus if you can. Note that tea tree oil is very powerful so you may need to dilute it will a drop or two of coconut oil or olive oil if you have sensitive skin.
This is our favourite brand of Tea Tree Oil; it’s inexpensive, 100% pure and FDA registered.
Vinegar is another natural product that’s widely lauded for its antifungal and acidic properties.
You can either opt for a vinegar soak – fill a foot bath with equal parts vinegar and water and soak for half an hour, twice a day – or make a paste by mixing two tablespoons of vinegar with a tablespoon of baking soda and applying it to the toenail fungus directly.
The paste is said to be more effective at killing the fungus, particularly if you do it twice a day, while the vinegar soak is better for mild infections or to keep the fungus from spreading further.
This Apple Cider Vinegar is the most popular for toenail fungus: it’s raw and unfiltered, so at it’s most potent, plus you get a lot of bang for your buck with this huge, 32 oz bottle.
- Oil of Oregano
Oil of oregano is a very potent essential oil that boasts antifungal, antibacterial and antiseptic features (and more!), and is regularly used to effectively combat toenail fungus.
It is incredibly powerful so a few drops will need to be diluted with a small teaspoon of coconut or olive oil. Apply this mixture to the affected nail (and use a cotton bud to apply it to the fungus, if possible), leave for around 30 minutes, then thoroughly rinse off and dry. Do this twice a day for the best results.
For an inexpensive, 100% pure and therapeutic grade product, try this Oil of Oregano.
- Vicks VapoRub
One of the more bizarre home remedies that many people have found to get rid of toenail fungus is Vicks VapoRub – more commonly used to ease the symptoms of cold.
Researchers have found that the thymol oil (oil of thyme) component of Vicks is effective in inhibiting the growth of dermatophytes and candida, which cause toenail fungus. The eucalyptus oil in the product also has antifungal properties too.
Apply the Vicks to the dry toenail, the skin around the nail, and underneath the nail. You will need to do this twice daily.
You can buy Vicks VapoRub here.
Best Antifungal Pills
Most antifungal tablets have to be prescribed by your doctor as they’re generally very powerful and can carry the risk of some dangerous side effects.
Lamisil is one of the most popular prescribed oral antifungals and is known for being very tough on toenail fungus. Lamisil is simply a brand name for Terbinafine, which you can buy at a multitude of online pharmacies with a valid prescription.
If you have candida onychomycosis – toenail fungus caused by a yeast infection – you will be able to buy tablets online without a prescription that help kill off excess candida (yeast) in your body.
This Purely Holistic Candida Cleanse, for instance, is made in the USA and enriched with oil of oregano.
How to Prevent Toenail Fungus
As with so many things in life, when it comes to toenail fungus – prevention is always better than cure.
Toenail fungus is incredibly common – it’s estimated that 10 to 12% of the world’s population is suffering with it at any one time, and as many as 32 million people have it in the US alone.
If you want to avoid catching it from one of those 32 million people, it’s best to be proactive in fungus prevention.
The number one tip is to look after your toes. You should:
- Wash your feet regularly with an anti fungal soap
- Keep your nails trimmed short
- Always dry your feet and toes thoroughly after getting them wet
- Invest in sweat-absorbent socks. These will keep your toes dry even on a hot day or if you’re exercising
- Avoid going barefoot in public places – take flip flops with you to the gym and swimming pool
- Start treatment as soon as you spot the first signs of toenail fungus. This should stop the fungus spreading to the rest of your nails
- Sprinkle anti-fungal powder in your shoes after use
10 Tips for Healthy Nails and Healthy Feet
In addition to the tips above, you can keep your toenails and feet healthy by always remembering the following:
- Always wear shoes that fit properly: ill-fitting shoes lead to cramped toes and nail trauma, which can encourage toenail fungus and ingrown toenails.
- Cut straight across your toenails: keep your nails trimmed short and cut across to avoid ingrowing toenails.
- Don’t push your cuticles back: they protect the base of your nail becoming infected with fungus and bacteria.
- Keep your feet smooth: use a pumice stone to shed dry skin, and moisturise cracked heels and soles daily.
- Only go to hygienic nail salons: they should thoroughly disinfect tools and not serve those suffering with fungal nail infections.
- Soak your feet regularly: this will keep your skin soft and nails clean.
- Don’t share socks and shoes: you could be passing on fungus from foot to foot if you do.
- Go barefoot where possible: allow as much air to your feet as possible as they can get hot and sweaty in shoes all day.
- Don’t wear nail polish: polish restricts the light getting to the nail bed, giving fungus the perfect dark environment in which to grow.
- Inspect your nails and feet regularly: if you see anything out of the ordinary, consult your doctor and start treatment immediately, in order to stop toenail fungus in its tracks.
We hope this guide has helped.
If you have any tips for curing toenail fungus — or experiences; good or bad — please share them below.
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