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Toenail Fungus: Everything You Need to Know

By on September 8, 2012

Onychomycosis is the official term for toenail fungus. Approximately 12 percent of people in the US are afflicted with toenail fungus. Toenail fungus is a condition in which a fungus has invaded and infected the toenail itself or the tissue that lies beneath it.

What is it, and What Does it Do?

There are various types of toenail fungus, each marked by their own characteristics and caused by different types of fungus. The fungus Trichophyton rubrum and Trichophyton mentagrophytes are generally the most common cause.

Toenail fungus can also be caused by mold and yeast. Since fungus, mold, and yeast flourish in damp, warm, and dark places, the toes can be a breeding ground, especially if you wear closed-toe shoes majority of the time. Fungi can invade the nail if there is any tiny cut or opening in or around the nail. They can also invade if there is a tiny opening between the nail and the nail bed.

Some of the different types and levels of toenail fungus are:

● Distal subungual onychomycosis: This type of infection occurs when the toenail is slightly lifted up, usually from pressing against shoes, and allowing fungi to infect the tissue. This is easily caused by tight fitting shoes that cause the nails to constantly press against the shoe. It is also called a distal toenail infection.
● Yeast infection: The yeast Candida albicans can easily infect the toenail. Yeast infections in the toenail are most commonly found in children.
● Proximal subungual onychomycosis: When a fungus invades the nail from the cuticle, or proximal area, it results in a proximal infection. This type of infection spreads from the cuticle to the top of the nail and is most common in people that have immune disorders such as cancer.
● White superficial onychomycosis: This type of infection happens when the fungus invades the top layers of the nail. It is often referred to as ‘white islands’ because it gives the appearance of tiny white islands on the top of the nail. This type of fungus starts at the top of the nail and works its way down to the bed.

Symptoms and Diagnosis

Onychomycosis is usually diagnosed by a podiatrist, but can also be diagnosed by any other doctor, such as a family practitioner. A diagnosis can come from a simple look at the toenail.

A culture can be ordered to determine the exact bacteria or fungi that is causing the infection. By knowing the exact fungi causing the infection, the doctor can determine the best course of treatment.

There are a lot of symptoms that may be present if you have a toenail fungus. Some symptoms to look out for in nails are:

● thickening of the nail
● a change in shape
● becoming more brittle
● darkened color
● dull in appearance

Contributing Risk Factors

Some factors increase your risk of getting a toenail infection. These include:

● wearing closed-toed shoes for extended periods of time
● having diabetes
● having psoriasis
● having a vascular disease
● having a weakened immune system
● being on immunosuppressant medications
● aging
● having a family history of toenail fungus
● being a man
● having
● being in a humid environment most of the time
● being a heavy sweater

Even if you don’t have any of the indicated risk factors, you could still get a toenail fungus. You should consult your doctor if you feel like you have having any of the symptoms of a toenail fungus, or notice any change in any of the toenails. The toes usually afflicted first are the innermost toes, also called the ‘big toes’.

Preventative care can be taken to try to avoid getting a toenail fungus. You should always wear clean socks and wash your feet each night. If you are prone to sweaty feet, you can carry an extra pair of socks on you to change midday. You can also purchase sprays that can be used on and in shoes to kill any bacteria or fungi that could cause an infection.

Course of Treatment

When toenail fungus is caught early enough, it is almost always treatable, and rarely results in serious complications. Treatment is necessary if you have a toenail fungus, as it will rarely resolve itself. Toenail fungus infections are usually persistent and won’t go away on their own because majority of the time the body doesn’t know there is an infection. Since the toes receive less circulation that other parts of the body, the immune system doesn’t usually detect the infection.

Toenail fungus can be hard to treat sometimes. Usually prescription medications are required. Types of treatments that can be used to cure the toenail fungus include oral medications, topical medications, and antifungal lacquer. Surgery is usually a final option if the infection is especially severe, usually resulting in the nail being removed.

Long Term Effects and Leaving Toenail Fungus Untreated

If left untreated, there can be serious complications. The fungus can cause permanent damage to the nail and surrounding area. The infection can spread to other areas of the body, possibly infecting the blood stream or the bones. The spreading of infection is most common in those suffering from immune deficiency.

Generally when an infection first sets in the nail will become discolored, usually with a yellowish tint or with white spots, such as with white superficial onychomycosis.

Left untreated, the fungus will continue to invade the nail deeper, causing it to become darker in color, generally a brown or yellow. At this point the nail will emit a bad smell and start to grow thicker.

Towards the end of the invasion, the fungus starts to kill the nail. The nail will start to lift up and away from the tissue and die. Bacteria and other debris can become trapped between the nail and the nail bed, causing infection. If it is still left untreated, the infection could become so bad it spreads to other parts of the body, the toes or foot could be left disfigured, or amputation might be required.

If you think you might have a toenail infection, you should see a doctor immediately. The doctor can advise you on the proper course of action and help get the infection under control.