How to Treat Toenail Fungus
Toenail fungus is one of those potentially embarrassing medical conditions that no one seems to want to discuss. But it’s also one of the more common foot ailments. Learn how it’s contracted, how to prevent it, and how to get rid of it.
Toenail fungus, it’s one of those potentially embarrassing medical conditions that no one seems to want to discuss at the dinner table (except for us doctors – these things don’t phase us in the least). It’s up there with anal itching, dandruff, vaginal discharge, and athlete’s foot (all topics I’ve previously covered). Who would have thought that my anal itching episode would be one of the most popular? Go figure! So I thought I’d tackle something that is even more common than anal itching – toenail fungus.
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How Do You Get Toenail Fungus?
Up to 25% of people “suffer” (and I use that word loosely) from this potentially unattractive condition. The word “fungus” doesn’t even sound pretty. So you can bet that your toenail is not going to look pretty either when infested with fungus. For those of you with obsessive compulsive disorder (OCD), you may want to stop listening/reading at this point. For the rest of you, you should know that fungus is really everywhere. It’s like bacteria in that we all having a certain amount of fungus living on our skin and on household objects, floors, showers, etc. That’s just the way it is.
See also: Virus, Germ, or Bacteria?
There are certain times, however, that fungus can actually take over and set up a bigger shop on your skin and nails. And for those of you who walk barefoot and/or sweat, fungus can certainly wreak havoc on your toenails. Also, toenail fungus is more common in diabetics because fungus thrives on sugar. So if you have diabetes, please tackle your blood sugars and get them under great control so you don’t end up feeding the beast.
Symptoms of Toenail Fungus
Fortunately for patients with toenail fungus, it’s not something that makes them (or their doctors) lose sleep. It’s typically considered a cosmetic condition, one that’s not going to kill you. It’s certainly not too pretty to look at, but not fatal.
Toenail fungus most commonly affects the big toe, but it can also spread its territory to nearby toenails in some. The nail often becomes yellow, thickened, brittle, deformed, and even appear as though it’s “lifting” off of the flesh of the toe. Some patients with toenail fungus also suffer from athlete’s foot, a topic I have covered in the past – these two are often siblings and go hand-in-hand.
Rarely, when the toenail is super deformed, it can become ingrown and painful.
So what can you do to treat toenail fungus?
How to Treat Toenail Fungus
Unfortunately, fungus is not always as easy to eradicate as bacteria is with antibiotics. Antibiotics don’t work for fungi (or for viruses, for that matter); they only work on bacteria, which is a completely different organism. To get rid of toenail fungus, we need to use anti-fungals. These drugs tend to be metabolized heavily through the liver and therefore have a very small risk of liver damage. So when discussing toenail fungus with your doctor, make sure you realize that you are taking this risk (albeit very small) in exchange for a cosmetic issue (albeit unattractive).
The first-line of defense for toenail fungus is a drug called terbinafine – it’s now generic and quite inexpensive. It’s taken once daily for 3 months. Unfortunately, it’s effective only for about 75% of those with toenail fungus. And after the 3 month treatment is over, you may not see the full effects of the drug until the nail is grown out – which can take up to one year. You will also need your liver checked prior to starting treatment and one month into it.
If you decide not to treat your toenail fungus with an oral medication, that’s OK, too. I would suggest over-the-counter terbinafine cream instead – the toenail is thick and hard to penetrate, and you would need to use it twice a day every day for months to even a year to see a difference. But for those with mild toenail fungus, this may be sufficient. Also, a 10-minute foot soak using a mixture of 1 tablespoon of bleach in half a gallon of water every night can aid the process. (Be careful not to overdo the bleach – anymore than 1 tablespoon per half gallon can burn the skin).
Prevention of Toenail Fungus
The best way to manage toenail fungus is to prevent from getting it in the first place. If you have fungus, you are much more likely to get it again if you’re not careful. How do you do that? Here are 5 tips:
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Don’t walk barefoot: That’s right – not even in the house. And don’t forget the flip flops when you use public showers, pools, hotel rooms, etc.
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Don’t sweat it: Apply powder to the foot after you shower to keep the moisture in check, and/or spray an aluminum-based antipersperant to your feet every day. Change your socks (once or even twice) throughout the day if you are on your feet all day and tend to sweat. -
Bleach it: Spray bleach once a week to your shower floors to disinfect the fungus and bleach your socks when you wash them.
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Maintain proper foot hygiene: Don’t forget to take care of your feet – you bathe your entire body every day in the shower (hopefully), so don’t neglect your feet. Clean and scrub them with a foot brush. Learn more about how to properly take care of your feet in my episode How to Care for Your Feet.
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Apply anti–fungal creams: If you’ve already been treated for toenail fungus, it may be a wise idea to apply over-the-counter terbinafine cream once a day to prevent future fungal infections. Think of it like brushing your teeth, but instead of preventing cavities you’re preventing an infestation.
Don’t sweat it: Apply powder to the foot after you shower to keep the moisture in check, and/or spray an aluminum-based antipersperant to your feet every day. Change your socks (once or even twice) throughout the day if you are on your feet all day and tend to sweat.So start thinking on your feet and take good care of them!
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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About the Author
Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women’s health and patient education.
