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Toe Fungus – Treatment, Symptoms & Causes

Reviewed by
Dr. Benjamin Weaver

There are two types of toe fungus—the type found on the skin and the type found on the nails. The type that occurs on the skin is commonly known as athlete’s foot. The type that occurs on the nails is medically known as onychomycosis, but is more commonly known as toenail fungus.

All toe fungus feeds on keratin. Keratin is a protein nutrient found in the cells of our skin and nails. The fungus begins to attack immediately and spreads quickly due to the breakdown of the keratin. The breakdown causes the skin to become scaly and flaky and the nails to become discolored and crumbly.

Fungal infections usually affect the top layer of skin, hair, or nails and are usually caused by a group of fungi calleddermatophytes. Fungi are plant organisms known as eukaryotes, which are related to yeast and mold.

Fungal infections are contagious and easily passed from person to person through physical contact, or by contact with an area (such as a public shower floor) that allows easy transmission of bacteria or fungi.

Studies show toenail fungus doesn’t affect children and adolescents as often as it does adults, especially older adults. It is estimated that 50 percent of people will contract the condition at least once before the age of 70.

The initial stages of a fungal infection can last for years, giving the infection plenty of time to grow and spread.

toe fungus

Toe Fungus Symptoms That May Develop

Symptoms of toe fungus may vary, depending on which type of infection is invading the foot. If the fungus is located on the skin, symptoms may include:

  • Red, cracked skin
  • Peeling skin
  • Itching
  • Burning
  • Stinging sensation
  • Development of small blisters
  • Some bleeding

If the fungus is located on the toenail, symptoms may include:

  • Discoloration of the nail, which may turn yellow or brown
  • Thickening of the nail
  • Foul odor coming from the infected area
  • White marks on the nail
  • Debris that collects under the nail

What Causes Toe Fungus?

Toe fungus is usually caused by an invasion ofdermatophytes on the toes. Fungal infections are usually contagious and spread easily and quickly from person to person.

Fungus thrives in warm, moist places such as public showers, locker rooms, swimming pools, and even personal showers that are shared by family members. Once a person comes into contact with the fungus, it spreads quickly, producing itching, cracked skin, bleeding, and blisters on the toes.

Another cause of toe fungus is hyperhidrosis. People who suffer from this condition have overactive sweat glands. This causes them to sweat excessively, particularly from their palms and the soles of their feet, regardless of the temperature.

If hyperhidrosis is the cause of the toe fungus, it must be addressed or the fungus will recur. Fortunately there are numerous treatments available. Conservative treatments often involve strong antiperspirants and medication, but there are surgical options if these methods do not work.

Diagnosing Toe Fungus – What to Expect

Your doctor’s first priority will be determining which type of toe fungus you have, skin or nail. In order to make a proper diagnosis, your doctor will give you a physical examination.

Your doctor will also ask about what symptoms you are experiencing, what kinds of activities you participate in, what type of shoes you wear regularly, and your medical history.

To rule out skin conditions, he or she will take samples of the scales to test in a laboratory. He or she may take samples of the fungus to examine and identify.

Toe Fungus Treatment Options For You

Because the infection is located on the toes, it may be difficult to treat. Treatment will be based on the severity of the infection and the type of fungal infection you have—skin or nail. Treatment options may include:

  • Prescription drugs
  • Antifungal powder
  • Antifungal medication, either topical or oral
  • Avoiding tight hosiery or improper footwear
  • Changing of footwear
  • Proper daily cleaning of feet
  • Avoiding borrowing footwear from others
  • Medicated toenail polish (used for nail infections)
  • Podiatric laser treatment

Some of the products you may need can be purchased over the counter at affordable prices. Other times, the infection may only be curable with prescription-strength medication.

If you feel you have toe fungus, either of the skin or nails, you should not wait to see a specialist. The longer fungal infections are left untreated, the harder they become to treat.

To learn more about fungal infections on the skin and nails, please click on the titles below:

Athletes Foot

Toenail Fungus

Foot Fungus

Preventing Toe Fungus – It’s Possible!

Here are some tips to help you prevent toe fungus:

  • Do not share towels or nail clippers with someone who has athlete’s foot.
  • In warm weather, wear open shoes such as sandals, or shoes made of breathable materials such as cotton, wool, or other natural, absorbent fibers.
  • Avoid walking barefoot in wet, public places such as locker rooms, pools, gyms, and public showers.
  • While at home, do not wear shoes so that your feet can air out.
  • Avoid wearing thick clothing for long periods during warm weather.
  • Change your socks every day.
  • Keep your nails short, dry, and clean as often as possible.
  • Use antifungal spray or powder if you are at a higher risk for developing toenail fungus.
  • Avoid picking or trimming the skin around your toenails, regardless of whether there is an infection present.
  • Air out your shoes between uses.

Questions to Ask Your Doctor

Here are some questions you may want to ask your doctor about toe fungus:

  • What type of toe fungus do I have?
  • What will be the best treatment for me?
  • Do my feet sweat?
  • Should I see a podiatrist?
  • Does oral Lamisil work?
  • What are the chances I could spread the condition to family members?
  • Based on the severity of my condition, how long will I need to limit my activities?
  • Do you have a brochure I can take home?
  • Which over-the-counter products do you recommend?
  • Do my shoes have anything to do with the fungal growth? (Bring in two or three pairs of shoes if possible)
  • Can the skin fungus transfer to the nails and vice versa? If so, what type of treatment will I receive?

Medical References:

  1. H. Winter Griffith, MD "Complete Guide to Symptoms, Illness & Surgery" (The Berkeley Publishing Group, 2006) 163
  2. American Medical Association "Family Medical Guide" 4th Edition (John Wiley & Sons, Inc. 2004) 123; 1073
  3. Taber's Cyclopedic Medical Dictionary, 21 edition (F.A. Davis Company, 2005) 2324-2325
  4. M. Beers "Merck Manual of Medical Information" 2nd home edition (Pocket Books, 2003) 1225
  5. Berkeley Parents Network: Advice about Toenail Fungus, http://parents.berkeley.edu/advice/health/toenailfungus.html
  6. Mayo Clinic, Nail Fungus, http://www.mayoclinic.com/health/nail-fungus/DS00084

This page was last updated on October 2nd, 2015



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