When fungi infect a nail, the result can be an infection of nail fungus called onychomycosis. A white or yellow spot appearing under the tip of the nail may be the first sign of a nail fungal infection. The nail may become discolored, thickened and develop brittle crumbling edges as the fungus goes deeper into the nail. The condition is usually not painful and often has no other symptoms, but it is unsightly and can be painful for some people. If the nails become very thick, wearing shoes may be uncomfortable unless you trim down the thickness. However, you must use great care when trimming the thickened nail, because excessive bleeding may occur if you cut into the quick.
When a nail is infected, a condition called onycholysis may also develop, which causes the nail to separate from the nail bed. Onycholysis may cause pain in fingertips or toes and produce a faint odor. Toenail fungus can also cause serious complications for people with diabetes or for people with suppressed immune systems.
Toenail fungus infections are often hard to treat, because it is difficult to reach the infection that embeds itself inside the nail. Nails may clear up for a time after treatment only to have the condition recur later. However, there are various home remedies as well as medications available to treat nail fungus. A complete cure of the condition may take as long as a year and sometimes longer.
- Nails with distorted shapes
- Thickened nails
- Nails with crumbly, ragged or brittle edges
- Nails with a dull appearance
- Debris build up under the nails causing them to become discolored or to darken
After a fungal infection gets started in a nail, it will usually remain indefinitely unless it is treated, so begin to treat the condition at the first sign of nail fungus.
- Living in a warm climate
- Working in a damp or humid location
- Shoes and socks that do not absorb perspiration and that hamper ventilation
- Walking in damp public shower rooms, gyms and swimming pools without shoes on your feet
- Heavy perspiration
- Family history of the condition
- Older age
- Being in poor health
- Having athlete’s foot or psoriasis
- A weak immune system, poor circulation or diabetes
- An injured nail, injured skin or an infection
Older people usually have reduced blood circulation, and their nails grow slower and get thicker as they age, causing a greater risk for infection. Men tend to be more prone to toenail fungus than women, especially if they have a family history of the condition.
People with immune systems weakened by AIDS, leukemia, cancer treatments or other medication and those who have diabetes or have had an organ transplant should see a doctor immediately if they have symptoms of nail fungus. These infections can spread to other areas of their bodies and cause serious problems. Diabetics frequently have an impaired nerve supply to their feet because of poor blood circulation and have a greater risk of developing a serious skin infection called cellulitis. Even a seemingly minor injury or nail fungal infection can cause potentially serious consequences for people with diabetes.
Even people who do not have weakened immune systems may experience pain and permanent damage to their nails from fungal infections.
Molds and yeasts or a group of fungi called dermatophytes can cause nail fungal infections. These fungi are microscopic organisms and can survive without sunlight. The warm, moist environments in showers and swimming pools are ideal places for these microscopic organisms to live, and they can attack your skin even through invisible cuts or a tiny separation between your nail and nail bed.
They typically cause infections only when your exposure to warmth and moisture is continuous. Toenail fungus occurs more frequently than fingernail fungus, because shoes provide a perfect warm, moist environment for fungi to flourish, and the blood does not circulate in the toes as well as it does in the fingers, so your immune system does not fight against the infection as effectively in the toes. People over 60 years old usually have a slightly weakened defense against the invasion of fungi, so they are more prone to develop toenail fungus as they age.
It is always better and easier to prevent an infection than to attempt to cure it, so here are a few tips to help prevent toenail fungus:
- Always use good hygiene, keep nails clean and wash your hands after touching a nail that has infection to prevent spreading it to other nails.
- Keep nails trimmed short and straight across, and file thick areas of your nails.
- Dry your toes well after swimming or bathing.
- Wear synthetic socks to draw moisture away and to help keep your feet dryer than they would be if you wore wool or cotton socks. During cold weather, you can wear wool or cotton socks over the synthetic socks to keep your feet warm. If your feet perspire, change your socks frequently. Remove your shoes periodically, and wear open-toed shoes occasionally.
- Do not cut or tear the skin around your nails to help prevent germs from invading.
- Wear shoes or flip-flops in public showers and around pools.
- Treat your feet and the insides of your shoes with anti-fungal powder or spray.
- If you get pedicures, either bring your own instruments, or ensure that your nail salon sterilizes their instruments before using them on your toes.
- Do not trap moisture on your nails by wearing polish or artificial nails.
Tests and Diagnosis
Psoriasis, contact dermatitis, yellow nail syndrome, nail bed tumor and other conditions can appear to be a nail fungal infection, so your doctor will need to scrape some of the debris from under your infected nail and analyze it to identify the cause of your infection. Your doctor can examine the debris under a microscope or culture it in a lab. Yeast and bacteria microorganisms as well as fungi can infect your nails, so your doctor can decide on the best treatment when he or she knows what is causing your infection.
Cures and Remedies
Toenail fungus is usually hard to heal, and it often recurs after healing. You can get non-prescription ointments and creams to treat it, but they usually are not very successful in curing the infection.
If your infection is not severe, your doctor may prescribe ciclopirox, an anti-fungal nail polish called Penlac, for you to apply to your nails and skin every day for about a year. You should apply the polish daily for a week, and then use alcohol to wipe off the layers of Penlac and start the process again, keeping it up for a year. It has been effective in clearing some toenail fungus infections when used as directed, and it is usually more effective when used in combination with topical urea cream. Ciclopiroxolamine and butenafine are also used to treat nail fungus and are effective when used every day for a year or longer.
Topical Medications and Lotions
Your doctor may advise you to use other topical anti-fungal medications, and apply them along with a non-prescription lotion that contains urea, which helps them absorb faster. Your doctor may decrease the amount of infected nail to treat with a process called debridement – filing the surface of your nail. That process may increase the topical medications effectiveness. Topical medications normally do not cure the toenail fungus unless you use them in combination with oral medications.
Your doctor may recommend an oral anti-fungal medication like terbinafine – Lamisil, or itraconazole, – Sporanox. Studies show that these products are the most effective for treating toenail fungus. When you take these medications for six weeks to three months, you should grow a new nail without infection, taking the place of the infected nail. It may take more than four months to get rid of an infection with these medications, and the infection may return if your feet remain in a warm, moist environment. When you use terbinafine in conjunction with amorolfine nail lacquer, it can be more successful and produce more cost effective results.
Oral medication is frequently recommended for people who experience pain or discomfort due to a nail infection, have diabetes or cellulitis and for those who dislike the appearance of their infected toenails and want an effective treatment for it.
Possible side effects of anti-fungal drugs can be as minor as skin rashes or as severe as liver damage. Consequently, doctors may advise people who have liver disease, congestive heart failure or are taking certain medications not to take anti-fungal drugs.
If you have a very painful or acute nail infection, your doctor may recommend surgical removal of your nail. You will probably grow a new nail to take its place, but it may be a year long process for it to completely grow back. After removing the infected nail, your doctor may treat the nail bed with ciclopirox to help prevent recurrence of the infection.
Photodynamic therapy involves using a laser to irradiate the nail after treating it with an acid. The laser light source kills fungus in the nail bed. Physicians have been using a Noveon-type laser for some types of cataract surgery, and it is now proving to be quite effective at treating toenail fungus with no pain. Even common laser pointers can aid the appearance and growth of an infected nail when they are pointed close to the nail for a few minutes each week.
Some people prefer to treat toenail fungus with home remedies because they are less expensive, and the medical treatments are not always effective. These home remedies have no controlled clinical trials to prove their effectiveness, but some people have reported that they helped or cured their nail fungus. As with all toenail fungus treatments, it can take a long time six months to a year for any remedy to work, so do not become discouraged and stop the treatment too quickly. If you are persistent, you may find relief for your condition.
Studies have shown that vinegar hampers the growth of certain bacteria. Experts recommend that you soak your feet in a solution of one part vinegar to two parts warm water for 15 to 20 minutes every day. After soaking, rinse and dry your feet well. If the vinegar soak causes irritation, make the solution weaker, or soak for a shorter time or less frequently.
People with toenail fungus have reported that applying Vicks VapoRub to the affected area has helped with the condition. Your doctor can advise you about how to use this remedy to gain the most benefit from it.
Some people have reported that applying hydrogen peroxide to infected nails daily helps the condition to some extent. The peroxide helps to control the excessive bleeding that occurs if you trim a nail too closely.
You may be able to cure toenail fungus with household bleach diluted in water and applied to the toenail.
Use toenail clippers to trim your nails as short as you can without cutting into the quick. This assures that the bleach will reach more of the fungus. File the toenails down from the top, using care not to go through the nails. There are several different methods for treating toenail fungus with bleach.
- Mix one part of bleach with ten parts of water and apply to your infected toenails with a cotton swab. Leave the mixture on your toenails, and apply a fresh coat of the solution twice a day.
- Use a bleach pen to apply bleach to your toenails after bathing, and do not rinse it off.
- Mix one part of bleach to ten parts of water and soak your feet in the solution for 15 to 20 minutes every day. Thoroughly rinse and dry your feet after soaking.
- You may soak your feet in the mixture for 30 minutes one time a week if your condition is less severe, or to eliminate the possibility of recurrence after a cure.
Keep soaking your feet for at least three months to be certain that your fungus is completely eliminated. If you do not see improvement in a few months, continue the treatment for at least a year before giving up. If you are not consistent with the treatment and let it lapse, the fungus may get stronger, and you will have to start over.
Some natural ingredients are successful in helping to heal fungus, but they may not work very quickly or be as effective as you would like them to be. However, there have been some very effective products developed recently, and they seem to produce successful results rather quickly. The following products were tested and proved to remove toenail fungus and improve toenail appearance dramatically.
ZetaClear has proved to be effective in treating toenail fungus with all natural ingredients. The product proved to be 100% effective in tests, and most users reported improvement in about two weeks. Their toenails were free of fungus after about three months, but some people kept using the product for a while longer to ensure that the infection would not recur. They reported clear, shiny healthy looking nails after using the product. ZetaClear uses natural oils in its formula and is extremely potent, but it does not cause skin irritation.
Fungisil is another highly effective product and produces the same results as ZetaClear, but it may take about a month longer for some people to eliminate toenail fungus. Fungisils success rate is also 100% and leaves users with healthy nails after treatment.
Another natural treatment for toenail fungus is Nail-Rx by Native Remedies. It has a 90% rate of success and provides excellent results for most users. The fungal infection was completely gone after only three months of use for 80% of those tested.
The following remedies have no scientific verification, but have been effective in treating toenail fungus for some people.
- Some people report curing toenail fungus with Australian tea tree oil, but there is no verification of its effectiveness.
- Some studies show that Thyme oil has the potential to be effective in treating toenail fungus.
- Some people believe that grapefruit seed extract is a natural antimicrobial, but studies show that the antimicrobial activity in the extract may be due to contamination with synthetic preservatives that were probably not made from grapefruit seeds.
Cost of Treatment
- The cost of laser treatment can be from $1000 to $2500, and insurance policies usually do not cover the procedure.
- Oral medication may have a cost of around $1000.
- Natural remedies can cost from about $100 to $200, and many of them are highly effective.
- Non-prescription creams and ointments are fairly inexpensive sometimes costing less than $20 – but are usually not very effective.
- Alternative remedies usually cost less than $50, but there are no studies proving their effectiveness.
- Home remedies are very economical and usually use products that you already have in your kitchen.
It does not seem to matter whether you use prescription medication, natural products or home remedies to treat toenail fungus it takes at least a minimum of three months to cure, and sometimes the process takes over a year. Depending on the method of treatment you choose, it can also be quite expensive. Whichever remedy you decide to use, be patient and persistent, use good hygiene and common sense and then finally say good-bye to toenail fungus.