If your toenails are yellowing, thick, and unsightly, you might have onychomycosis, which is a common fungal infection. It’s estimated that millions of adults have this condition, sometimes called fungus yellow toenails.
Toenail fungus can cause pain and discomfort, and it can definitely be embarrassing. If you don’t treat it, the infection can worsen and even spread to other nails or even to other people.
This article will give you an overview of what causes toenail fungus, some things you can do at home to treat it, and when you should see a doctor.
What causes yellow toenails?
Toenail fungus can happen to anyone, but some things make you more likely to get it.
Common fungal organisms
Most of the time, toenail fungus is caused by organisms called dermatophytes. Trichophyton rubrum is the most common one, but other kinds of dermatophytes can also cause the problem.
Sometimes, though not as often, yeast and molds can cause toenail fungus. One example is a Candida species.
Risk factors for developing toenail fungus
Some people are more prone to getting toenail fungus than others.
For example, older adults are more likely to get it because they tend to have reduced blood flow and slower nail growth. Trauma to the nail can also create an opening for fungus to enter. That’s why people who get pedicures need to make sure the tools the salon uses are clean and sterile.
The kind of footwear you choose and your foot hygiene can also play a role. Wearing tight shoes and socks can create a moist environment where fungus can thrive. And if you don’t wash your feet regularly, you’re more likely to get an infection.
Finally, some underlying health conditions, like diabetes and peripheral vascular disease, can make you more susceptible to toenail fungus.
Recognizing the symptoms of toenail fungus
Toenail fungus can be a real nuisance, and it’s important to catch it early. Here’s what to look for:
- Discoloration of the nail: This can look like yellowing, whitening, or even darkening.
- Thickening and distortion: The nail can get really thick and misshapen, and it might even become brittle and hard to trim.
- Separation of the nail from the nail bed (onycholysis): This creates a space under the nail where even more fungus can grow (yuck!).
- Pain or discomfort: Your toe might hurt, especially when you’re wearing shoes or walking around.
- Foul odor: Let’s just say it won’t smell like roses.
If you notice any of these symptoms, it’s a good idea to see a doctor to get a diagnosis and start treatment.
How is toenail fungus diagnosed?
If you think you have toenail fungus, the first step is to see a doctor. They can usually diagnose it just by looking at your toenail. If your doctor isn’t sure from a visual examination, they may order some lab tests to confirm the diagnosis.
To do this, they’ll take a sample of your nail by clipping it or scraping it. Then, the sample will be sent to a lab. There are a few different types of tests they might use:
- Potassium hydroxide (KOH) examination: This test involves placing the sample on a slide with KOH and looking at it under a microscope.
- Fungal culture: This test involves placing the sample in a substance that encourages fungal growth to identify the specific type of fungus causing the infection.
- Periodic acid-Schiff (PAS) stain: This test uses a special stain to make the fungus more visible under a microscope.
It’s important to get an accurate diagnosis, because other conditions can look like toenail fungus.
Treatment Options for Toenail Fungus
Dealing with fungus under your toenails can be a challenge, but there are several effective treatments available. Here’s a breakdown of the options your doctor might suggest:
Topical Antifungal Medications
You can find antifungal creams and lacquers at your local drugstore, and your doctor can prescribe stronger versions. Common examples include ciclopirox, efinaconazole (brand name Jublia), and tavaborole.
These medications are applied directly to the affected nail, kind of like painting your nails. They can work well for mild to moderate infections, but it’s important to be patient and consistent with the application.
Oral Antifungal Medications
For more stubborn infections, your doctor might prescribe oral antifungal medications, such as Diflucan. These are stronger than topical treatments and often more effective. Common examples include terbinafine, itraconazole, and fluconazole.
You’ll typically take these medications for several weeks or even months, depending on the severity of the infection. Because these drugs can affect your liver, your doctor will likely want to monitor your liver function with blood tests during treatment.
Laser Therapy
Laser therapy is a newer approach to treating toenail fungus. It involves using laser energy to target and kill the fungus living under your nail.
While some people have had success with laser therapy, the results can vary. It can also be quite expensive, and insurance doesn’t always cover it.
Surgical Nail Removal
In severe cases, where the infection is particularly stubborn or painful, your doctor might recommend surgical nail removal. This involves removing all or part of the affected nail to allow for direct application of antifungal medications to the nail bed.
The procedure itself is usually straightforward, but recovery can take some time. It’s important to follow your doctor’s instructions carefully to prevent infection and promote healing.
Home remedies for toenail fungus
If you’re looking for solutions you can try at home, here are a few options:
Tea tree oil
Tea tree oil contains compounds that fight fungus. Twice a day, apply a bit of tea tree oil to the surface of the affected nail.
Vinegar soaks
Soaking your feet in vinegar may help keep fungus from growing. Mix one part vinegar to two parts water and soak your feet for 15 to 20 minutes each day.
Other possible remedies
You may have heard about using Vicks VapoRub, baking soda, or other household items to treat toenail fungus. There’s not much scientific evidence to prove that these remedies work. It may be best to talk with your doctor about your options.
Prevention and long-term management
Yellow toenail fungus is a persistent problem, but with a few consistent habits, you can drastically reduce your risk and improve your long-term outlook:
- Foot hygiene: Wash and dry your feet daily, especially between the toes.
- Breathable footwear: Avoid shoes and socks that are too tight, and opt for socks made of moisture-wicking materials.
- Public place precautions: Don’t go barefoot in public places like locker rooms or swimming pools. Wear sandals or shoes.
- Nail care: Trim your toenails regularly and disinfect your nail clippers.
- Address underlying conditions: If you have a medical condition like diabetes, manage it carefully.
In Summary
Toenail fungus can be stubborn. It takes time and consistent treatment to get rid of it.
It’s important to follow your doctor’s advice and take good care of your feet. If you need help, podiatrists and dermatologists can provide treatments that really work.