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Fungal Toenail

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Overview

What Is Toenail Fungus?

A fungal toenail (also known as “onychomycosis”) is a fungal infection of the nail.  It can cause the toenail to become thick, discoloured, brittle and fragile.  As the fungal infection grows, it can crack the nail or even lift it off the nail bed.  This can cause pain and discomfort.  

While not necessarily a serious health condition, toenail fungus is contagious and will progress if not properly dealt with.  Toenail fungus can also be difficult to treat on your own, so it is best to consult a foot specialist as soon as you suspect a problem:  Even if you’re unsure, it’s better to be safe than sorry. 

Symptoms

What Are The Symptoms Of Fungal Toenails

Common signs and symptoms of toenail fungus are:

  • Yellow, brown or white nail discolouration
  • Thickening on the surface of the nail
  • Brittleness, crumbling or flaking on or below the surface of the toenail
  • Fragile or cracked nail
  • Unpleasant odors stemming from the nail or surrounding skin
  • Nail lifting off the nail bed

The symptoms may affect part of a toenail, the whole toenail, or multiple toenails.

While some of these symptoms may not necessarily indicate a problem (after all, it is somewhat normal for our toenails to yellow a bit as we age), it is recommended that you see a foot specialist or medical practitioner as soon as you notice any changes to the nail – just to be on the safe side.

Causes

What Causes Toenail Fungus?

A fungus is a tiny living microorganism.  Yeast, mold and mushrooms are examples of fungi. Fungi are naturally present on the body, but when they begin to overgrow, you can develop an infection. Fungal infections can develop anywhere on the body, but the feet are especially vulnerable because our shoes provide a dark, warm, and moist environment for fungus to thrive. 

A fungal toenail develops when a fungus finds its way into your nail through tiny cracks or skin breaks by the nail.  It then makes itself at home underneath the toenail, where it feeds off nail tissue, grows and reproduces.  As the fungus grows and more spores form, it causes the nail to change in colour, thickness and composition.  Eventually the fungus itself can dislodge the nail off the nail bed.  

There are many species of fungus that can cause toenail fungus.  The most common are called dermatophytes.  Candida (yeasts) and certain molds can also cause toenail fungus.

Athlete’s foot is another common fungal infection that affects the feet; however it is a fungal infection of skin as opposed to the nail.

Treatment

How Do I Treat Fungal Toenails?

Toenail fungal infections are more difficult to treat than athlete’s foot because toenail fungus lives under the nail. The nail essentially traps the fungus beneath it and serves as a barrier to prevent medication from actually penetrating to the fungus. The nail bed also lacks the air exposure to dry out fungus-friendly moisture accumulation.  

Although there are a wealth of over-the-counter antifungal medications, they are not effective at fully curing and eradicating the fungus – they do a better job at maintaining it or addressing the symptoms.  To properly treat and get rid of a fungal infection once and for all, treatment by a medical practitioner or foot specialist is often required.  

A chiropodist can treat your toenail fungus through the following methods:

  • Removing infected parts of the toenail (nail debridement) and directly applying a prescription-strength topical antifungal medication. The medication can then directly penetrate the fungus.
  • Regular nail debridement to remove infected parts of the toenail
  • Prescription topical antifungal medications 

The following can also supplement your toenail fungus treatment by reducing moisture accumulation in the affected area (fungi love moist environments):

  • Moisture-control socks
  • Moisture-control, breathable shoes
  • Open-toed sandals

These items are available at our foot clinic and online shop.

Risk Factors

Why Do I Get Toenail Fungus?

Certain risk factors can make you more prone to developing fungal toenails:

  • A toenail injury that causes a cracked toenail or open sore around the toenail or cuticle
  • Age:  The elderly have the highest risk of developing fungal toenails because as we age, our toenails get brittle and fungus can enter through cracks.  Age also diminishes blood circulation, and poor blood flow makes a person more prone to infection.  
  • Walking barefoot in communal swimming pools, gyms, yoga studios, showers, and locker rooms:  These hot moist areas are breeding grounds for fungus.  Because fungal infections are contagious, if someone else using the facility also had a fungal infection, the fungus will set up shop there, grow and spread to others who come into contact with it. 
  • Sharing towels, shoes, nail clippers, or nail polish with someone who has a fungal infection
  • An existing athlete’s foot infection:  Although athlete’s foot affects the skin, it can cause toenail fungus due to its close proximity to the toenails.
  • Reduced circulation in the feet due to conditions like peripheral vascular disease or diabetes
  • Plantar Hyperhidrosis:  Fungus thrives in moist environments, so if moisture buildup from plantar hyperhidrosis (sweaty feet) goes unchecked, it can make a foot prone to fungal infections.  
  • Wearing socks and shoes that don’t properly ventilate or wick moisture away from the feet and toes.
  • Living in moist, hot, humid environments

Prevention

How Do I Prevent Fungal Toenails?

Here are various foot care solutions for preventing fungal infection in your toenails:

  • When having a pedicure, always ask how often the salon staff sanitizes their tools and how they do it: pedicure tools such as nail clippers can spread toenail fungus from person to person if they are not properly disinfected between uses.  Steam sterilization is the gold standard for infection control and is required by foot care professionals such as chiropodists and podiatrists.
  • Wear moisture-wicking socks and change your socks midday if you have sweaty feet
  • Wear shoes made from breathable materials
  • Wear flip flops or a foot covering when visiting public pools, gyms, yoga studios, and locker rooms
  • Thoroughly dry your feet – including between your toes – after showering, and before putting on your socks and shoes
  • Air out athletic shoes after use to ensure they thoroughly dry before the next wear
  • Maintain good foot hygiene: Keeping your feet clean and dry will help reduce any risk factors for developing fungal infections. Healthy skin and toenails also reduces the likelihood of cuts or abrasions through which infections can enter your skin and toenails. 

Moisture-control socks, shoes, and sandals are available in our clinic store and online shop. 

We are open Mondays to Fridays from 9am to 6pm, and Saturdays from 9am to 4pm.

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