Northcoast Footcare FAQs: Toenail Fungus/ Onychomycosis

The medical term for toenail fungus is "onychomycosis," pronounced "on * EE * ko * my * ko * sis". Despite the commonly used term "fungal toenails", onychomycosis describes both fungus and yeast infections in the nail. The prevalence in America is about 2-3%, but some have reported it as high as 13%. Even at a low estimate of 2%, this accounts for 6 million Americans with toenail fungus. Toenail fungus affects men twice as often as it affects women. The prevalence among elderly individuals and diabetics is 25%. In the 1800s, fungal toenails were very rare. The increased prevalence is linked to the increased exposure to fungus through the use of showering facilities in gyms, the use of hot tubs, saunas and public pool areas. There is an increase in occlusive footwear, an increase in sporting activities, an increase in diabetes and increase in age of the general population.

There are many things you can do at home. Over the counter products that you can purchase include bleach, tea tree oil, grapeseed extract, and Vics VapoRub®. With any home remedy or non-prescription topical, you must understand that the effectiveness of the treatment is fairly low, less than 10%. If you do try one of these therapies make sure to use it every day. Roughen up the nail surface with a file and apply the medication with a q-tip. Bleach can cause skin irritation and some individuals have had skin reactions to the Vics VapoRub®. In general these treatments are considered very safe.

The best form of treatment is prevention and preventing the fungus from spreading to other toenails may be the best treatment option. I recommend choosing a topical that you feel comfortable with and use it once a week. No matter which treatment option you choose, you should take the following steps to avoid re-infection.

1. Make sure you rotate your shoes often and keep them in a cool dry place.

2. Change your insoles frequently, and make sure they dry out between use.

3. Place an anti-fungal powder or spray in the shoes to help fight off the fungus.

4. Bleach out the shower on a weekly basis and wash your shower mat regularly in hot water.

5. Make sure your athletic shoes fit well to prevent jamming at the toes. Jamming at the toes leads to microtrauma at the nails and increases the chance for fungal infection.

6. If you belong to a gym or health club, wear sandals in the locker room and don't walk around barefoot.

7. Don't keep your shoes in the gym locker where they cannot dry out.

8. If your feet sweat excessively, try using an antiperspirant spray on your feet before your workout.

9. Cut your toenails straight across. Don't cut too short and cause breaks in the skin. This will increase the chance for fungal infection. Don't let the toenails grow too long or they will jam against the shoe and cause bleeding under the nail, again increasing the chance for fungal infection.

The bottom line is that treating onychomycosis is very difficult. If you have fungal toenails that cause pressure, pain or infection, consider talking to your doctor about prescription medications or nail removal. Make sure you take precautions to prevent re-infection and take multiple approaches to eradicate the problem. If your fungal toenails are only unsightly and don't cause any discomfort, try a weekly application of an over the counter topical along with methods to prevent re-infection.

More information and pictures on toenail fungus.

Product information for toenail fungus treatments.

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Disclaimer: The advice on this website is not intended to substitute for a visit to your health care provider. We will not be held liable for any diagnosis made or treatment recommended. Consult your doctor if you feel you have a medical problem.