Preventing toenail fungus

When you step out of your rain boots and look down at your toes, are your feet sandal ready? Or do you notice some yellowing, thickened toenails that need attention? If you notice any nail changes, toenail fungus may be an issue.

According to the American Academy of Dermatologists, toenail fungal infections affect approximately 12% of people in the United States each year.

What is toenail fungus?

Toenail fungus can appear as a yellow, thickening nail that lifts off of the nail bed. This is often painless at first, and that means it can go for a while without being noticed. 

A fungal infection of the skin around the toes is known as athlete's foot. Many treatments are available for this. But other conditions can make nails change in color and appearance. To rule out other causes, an exam by a doctor and skin sample may be needed.

Toenail fungus spreads easily

You can get toenail fungus by walking barefoot in public places, especially showers and pools. Fungus loves warm, moist places, even if it's your own home. If one person in a household has toenail fungus, it can spread through shared bathrooms and other living spaces.

Tips to prevent toenail fungus:

• Clean bathtubs and tiled floors with antiseptic. Antiseptic kills fungus and prevents its spread.
• Replace old or soiled shoes. If this isn't possible, spray an antimicrobial spray inside of the shoe and allow it to dry for 24 hours.
• Wear flip flops in public showers.

Treatments for toenail fungus

Toenail fungus can be difficult to treat, and getting rid of it can take a long time. Ointments, antifungal pills and laser treatments can be used. The treatments are similar for children and adults, but it can be hard to keep up with daily regimens in children. 

Where to start:

• Over-the-counter options include applying 100% tea tree oil twice daily for six months. You should see improvement in the infection, appearance and symptoms. Most topical treatments take at least this long to work because a new, uninfected nail must come in.
  • Tea tree oil cures fungal toenail infection in about 18% of people who try it. It also improves nail appearance and symptoms in up to 60% of patients after six months of treatment.
  • I don’t advise soaking your toes in tea tree oil or other solutions meant to kill fungus. This has not been proven to kill nail fungus effectively. 
• Prescription strength topicals and antifungal pills. Like any medication, these can have negative side effects. Antifungal pills have the highest cure rate at 80%, but they’re often left for difficult cases. We keep an eye on liver function when these pills are used. 

If more treatment is needed:

• Laser treatment is a newer medical technology for toenail fungus. This fairly painless procedure can result in quicker clearing of the fungus. But it’s still hard to estimate how effective it is. Depending on the study, cure rates range from 25% to 100%.
  • Another downside is that it’s not covered by insurance. We don’t offer laser treatment in our office at this time. But we may in the future if more studies support its effectiveness.
• See a podiatrist (a foot specialist). If you try an over-the-counter treatment and don’t see any improvement after two months, consider making an appointment. A podiatrist can confirm that you have toenail fungus and make sure you’re getting the right treatment. 

By Sarah Burns, DPM, FACFAS

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.