What Does Toenail Fungus Look Like? & How To Treat Fungal Toenail

Overall, oral antifungal medications may offer the most treatment potential. Pairing oral drugs with topical antifungal medication may make treatment more effective.

Toenail Fungal Infection Treatment: What to Know

Toenail fungus may seem harmless, but healthcare providers say you shouldn’t ignore it.

Updated on November 8, 2022
Medically reviewed by

Susan Bard, MD, is a board-certified general and procedural dermatologist with the American Board of Dermatology and a Fellow of the American College of Mohs Surgery.

For the most part, toenails don’t get much love. Sure, you trim them now and again, and maybe you even paint them bright in the summer. But toenails are one of the more uninteresting parts of our anatomy, and it’s safe to assume hardly anybody even thinks about them—until there’s a problem.

Like it or not, we spend our days living among various microorganisms, including fungi and yeast. Many of those organisms never make themselves known to us, peacefully coexisting in, on, and around our bodies. But some tend to overgrow, causing infection and many symptoms, from painless itching to funky odors.

That’s what exactly happens when dealing with a bout of toenail fungus. Here’s what you need to know about the different fungal toenail infections, what causes them, and how you can treat them.

Fears over not being able to afford health insurance or medical care are among the top reasons why Americans are delaying retirement. From 2000 to 2016, the number of Americans 65 and older working full-time or part-time rose by six% to include almost 9 million people, according to the Pew Research Center.

What Is Toenail Fungus?

Toenail fungus, also called onychomycosis, is the umbrella term for a handful of microorganisms that can infect one or more of your toenails.

The infection is typically the result of a superficial cut, crack, or opening near your toenail. The fungus can sneak in and spread with this window of opportunity, causing an infection.

Infections can range from mild or barely noticeable to severe, affecting multiple toenails and causing pain or nail deformity.

Are There Different Types of Toenail Fungus?

There are three different types of toenail fungus, said William Spielfogel, DPM, a New York-based podiatrist, which include:

• Distal subungual: This is one of the most common types of toenail fungus, accounting for at least 60% of toenail infections, Ashley Jenkins, MD, a dermatologist at the University of Missouri Health Care, told Health. Distal subungual toenail fungus is caused by dermatophytes, which also cause athlete’s foot, and only grow in keratin-producing structures like hair follicles and nails.
• White superficial: This is a non-dermatophyte that infects the top layer of the nail rather than the follicles.
• Candida: This is caused by yeast overgrowth. It’s the least common type of toenail fungus. Still, some studies indicate it’s becoming more common.
• Proximal subungual: This is caused by dermatophytes that infect the base of the nail and sometimes the top of the foot. It is more common in people with human immunodeficiency virus (HIV) than others.

What Does Toenail Fungus Look and Feel Like?

Any toenail fungus causes a range of symptoms, but some of the most common are:

• Nail thickening
• Yellowing, browning, or discoloration
• Nail crumbling
• Abnormal or frequent breakage
• Unusually shaped nails
• Separation of the nail from the nail bed
• Pain
• Odor or bad smell

Different types of infections often cause various symptoms. For example, many mold infections aren’t painful, but yeast infections can be.

And you may notice a dark debris build-up under the nail with distal subungual toenail fungus. On the other hand, you’re more likely to see white spots or patches on the nail’s surface with white superficial toenail fungus.

What Causes Toenail Fungus?

We come into contact with yeast and molds that cause toenail fungus a lot, but there are several reasons why an infection might occur.

Typically, people with cracks in their toenails, or weakened ones, are most at risk. That includes older adults, people with superficial toe injuries, and people with certain skin conditions like psoriasis.

Dr. Jenkins said there are other common risk factors for toenail fungus, such as:

• Diabetes
• A history of athlete’s foot
• A suppressed immune system, either because of an autoimmune condition (such as cancer or HIV) or immunosuppressant medicines and treatments (like chemotherapy)
• Nail infections, injuries, or recent surgeries
• A family history of nail infections
• Poor circulation
• Psoriasis

“If fungus is hanging around [under these circumstances], it will crawl underneath the nail and spread,” explained Dr. Jenkins.

Additionally, some factors that may increase your risk for toenail fungus include:

• Wearing poor-fitting shoes
• Having poor circulation
• Sweating more than usual, especially from your feet
• Smoking
• Spending a lot of time in the water or walking in damp areas (like an indoor swimming pool)

How to Get Rid of Toenail Fungus

First, the bad news: Dr. Jenkins and Dr. Spielfogel said that toenail fungus is tough to treat, especially at home.

“The most effective treatment is an oral systemic antifungal medication, such as Lamisil [terbinafine], once per day for 12 weeks,” explained Dr. Jenkins. “It cures around 75% of patients, but 25% won’t be cured and will need repeat treatment or even a surgical treatment, like removing the toenail.”

For the most part, Dr. Jenkins said Lamisil is safe for use, though it can, in rare cases, cause liver enzyme abnormalities. However, your healthcare provider will monitor those enzymes by performing regular blood work during your treatment. Dr. Jenkins added that the side effect is rarely seen in children.

And if you’re concerned about Lamisil as a treatment option, or you have an existing medical condition that prevents you from safely taking it, your healthcare provider may prescribe a topical treatment. But those take much longer to work (as long as 48 weeks) than Lamisil.

Finally, you can try a home remedy for toenail fungus. While most aren’t highly effective, they don’t have many side effects. If your toenail fungus is mild, you can see results over time.

“[Home remedies] have maybe a 10% cure rate, but could be effective enough if someone is highly motivated,” said Dr. Jenkins, adding that some patients prefer products like Vicks VapoRub, amber-colored Listerine, and tea tree oil.

And if you attempt an at-home remedy, you must give your toenail some extra care.

“Keeping the area clean and dry may help keep the infection under control,” noted Dr. Spielfogel.

Can You Prevent Toenail Fungus?

If your toenail fungus is caused by something in your control (such as an underlying condition), you can take steps to prevent it, including:

• Wear shoes in public areas, especially ones typically wet, like pools and gyms.
• Keep foot injuries clean and covered until they’re healed.
• Protect your overall health by not smoking and maintaining a healthy weight.
• Wear supportive and breathable shoes.

You also may reduce bouts of toenail fungus by keeping your toenails consistently clean, dry, trimmed, and free of nail polish, which can contribute to fungal growth.

However, many causes of toenail fungus are caused by other factors, like age and chronic illnesses (like diabetes), which you cannot modify to prevent fungus.

Dr. Spielfogel recommended using preventative products if you know you’re at risk for fungal infection. For example, Dr.’s Remedy line of nail care products includes an antifungal cuticle oil that you can use nightly to reduce the risk of fungus.

When Should You Visit a Healthcare Provider?

It’s tempting to dismiss toenail fungus as an unsightly but mainly harmless problem. Like so many other health issues, though, ignoring it will only make things worse down the line.

“You should see a podiatrist [or dermatologost] when you notice the problem and treat it early,” advised Dr. Spielfogel. “If left untreated, which is very common, the infection will spread to the rest of the nail and eventually spread to the other nails.”

Once you make an appointment, your podiatrist will give your feet a thorough examination and may take a nail sample to be sent away for testing.

That will help your podiatrist confirm whether you have an infection and figure out precisely what type of infection you have, Dr. Spielfogel explained.

From there, your podiatrist can work with you on a treatment plan to (hopefully) get rid of your toenail fungus for good.

A Quick Review

Common microorganisms cause many types of toenail fungi. The fungus enters your toenails through damage or injury and spreads.

They’re almost impossible to treat at home, but your healthcare provider can suggest some effective options. Additionally, you can prevent toenail fungal infections by keeping your feet clean and protected and being aware of any risk factors you may have.

Was this page helpful?

Thanks for your feedback!

What Does Toenail Fungus Look Like? & How To Treat Fungal Toenail

Toenail fungus is a very common reason for pain in toenails. Though it is a very common issue, there are still questions surrounding what toenail fungus looks like and how to treat fungal toenail.

We’ve put together this article to help you learn more!

First Off, What Is Toenail Fungus?

If you’re showing signs of discolored toenails and other unpleasant symptoms, you may just be dealing with toenail fungus.

A fungal nail infection develops from the overgrowth of fungi in, under, or on the nail. It’s common knowledge that fungi thrive in warm and moist environments, so the nails on your feet have ideal conditions for fungi to naturally overpopulate. Most fungal nail infections are caused by the very same fungi that cause “athlete’s foot”, ringworm, and “jock itch”. The rapid overpopulation of fungi that are already present in your body can cause nail infections. Fungal nail infections are quite communicable, so if you’ve come in contact with someone who had a fungal infection, you may have contracted it too. Toenails tend to be affected more than fingernails, since they’re usually confined to shoes, which are the ideal breeding grounds for these fungi.

Pedicures at nail salons can also lead to fungal nail infections, which is why you need to make sure the tools are cleaned and disinfected regularly and well. Tools like nail cutters and files can very easily spread fungal nail infections from person to person if they’re not sanitised properly.

Toenail fungus is a form of infection that basically travels through the cracks in your nail / the cuts on your skin. It can change the colour of your toenail and make it much thicker than normal. It can also be very painful to deal with. Since toes are usually kept warm and may be damp due to sweat, they act as the perfect breeding ground for fungus, allowing it to thrive in these conditions. There are different types of fungi and even yeast that can affect the different parts of your nail. When left without treatment, the fungus can spread to your skin, the other toenails, and sometimes even your fingernails!

What Does Toenail Fungus Look Like?

A very common question that gets asked is “what does toenail fungus look like?” It’s good to know the symptoms so you can know how to treat your fungal toenail.

What does toenail fungus look like, you ask? Here’s your answer:

• A change in colour of your toenail, to either yellow, brown, and even white
• Thickened and often misshapen looking toenail
• Chalkiness / cloudiness in spots on your toenail
• Your toenail is separated from your nail bed
• Lots of breaks and cracks in one or multiple spots on your toenail

There are many ways toenail fungus can alter the visual appearance of your toenails. That’s why it’s important to know what it looks like, so you can treat it before it gets more serious.

If you find yourself noticing any of the above symptoms, you may just be dealing with toenail fungus and you should seek treatment with a podiatrist accordingly.

Am I At Risk For Fungal Toenails?

If you’re wondering whether you’re a candidate for toenail fungus, we’re here to answer your question. Just like all infections and diseases, certain people tend to be more at risk when it comes to contracting fungal nail infections.

You’re at higher risk of contracting fungal nail infections if you:

• Have diabetes
• Are over 65 years of age
• Wear artificial nails / regularly get pedicures
• Have a disease that causes poor circulation
• Have a nail injury
• Swim in public swimming pools often
• Have a skin injury around your nail
• Wear close-toed shoes often
• Have a weakened immune system
• Leave your toes moist for extended periods of time

If you check yes under any of the above, don’t ignore your discolored toenails and see a podiatrist for treatment!

How to Treat Fungal Toenail

It is very important to know how to treat fungal toenail, so you can avoid further infection/damage. When left undiagnosed and ignored, fungal toenails can go south very quickly.

If you think you may be dealing with toenail fungus, here are some home remedies to help treat it:

• Snakeroot Extract: Sometimes the best solutions are found in nature. The extract of this antifungal plant can be used to treat fungal nail infections, and has proved to be as effective as ciclopirox, a drug-store anti-fungal treatment.
• Ozone Oils: Oils like sunflower oil and olive oil are oils that contain the same gases that exist in the ozone layer. Many studies have been conducted that have concluded that these “ozonized” oils are effective when it comes to treating nail fungus and may just be the best home remedy on how to get rid of a nail infection. In fact, a study took place in which sunflower oil had higher clinical effects than a common antifungal medication called ketoconazole.
• Oregano Oil: Another proof of the effectiveness of nature is oregano oil. It contains “thymol”, a naturally occurring phenol that is said to have antifungal properties. In treatments, this oil is also combined with tea tree oil, but this increases the risk of negative side effects, irritation, and allergic reaction.

Not all of these at-home remedies may be best suited to you. The effectiveness of treatment truly depends on your symptoms and situation. Seeing a professional podiatrist will ensure a proper diagnosis which will lead to better treatment. In general, podiatrists will prescribe you with oral antifungal medications. These medicines are very effective and show the most potential in toenail fungus treatment. Apart from oral medicines, you may even be prescribed a topical antifungal cream. Pairing these two is usually your best bet for swift treatment.

Conclusion

We hope this article helped answer your questions surrounding toenail fungus. If you think you may be dealing with any issues related to your feet, book an appointment with Bucks Foot Clinic! We’d be happy to help you.

Toenail Fungus

With toenail fungus, your nail becomes thick and yellow and may show white spots and streaks. A type of mold called a dermatophyte causes tinea unguium, the most common nail fungus. Tinea unguium most frequently targets your toenails, but it can also affect your fingernails. Onychomycosis is another name for the condition.

• Questions 216.444.2538
• Appointments & Locations
• Request an Appointment
• Find a Primary Care Provider

Overview

What is toenail fungus?

Toenail fungus is a widespread fungal infection that affects your toenails. Less commonly, nail fungus can infect your fingernails. Toenail fungus happens when fungi get between your toenail and your toenail bed (the tissue right underneath your toenail). This usually happens through a crack or cut in your toe.

What is tinea unguium?

When a dermatophyte causes toenail fungus, the condition is called tinea unguium. A dermatophyte is a mold that needs a protein called keratin to grow. Keratin is the main structural material of your nails that makes them hard. Dermatophytes cause 90% of toenail fungal infections. Tinea unguium is also known as onychomycosis.

Who does toenail fungus affect?

Anyone can get toenail fungus. It often affects older adults, especially people over 60.

You may have a higher risk of getting toenail fungus if you have:

• Athlete’s foot (tinea pedis).
• Diabetes.
• Hyperhidrosis (a disorder that makes you sweat a lot).
• A nail injury.
• Poor blood circulation due to peripheral vascular disease.
• Psoriasis.
• A weakened immune system, such as from an autoimmune disorder or HIV.

How common is toenail fungus?

Toenail fungus is very common, especially as people start to age. Medical experts estimate that onychomycosis affects 1 in 10 people overall. That number jumps to 1 in 2 (50%) for people older than 70.

Symptoms and Causes

What does tinea unguium look like?

Tinea unguium can change your toenail’s appearance in more than one way. Your toenail may:

• Change color, looking white, yellow or brown.
• Look chalky or cloudy in some spots.
• Thicken and possibly look misshapen.
• Separate from your nail bed (leaving space between your nail and the skin underneath).
• Crack or break in one or more spots.

Is toenail fungus painful?

Not typically. Toenail fungus can be unsightly to look at, but it usually isn’t painful.

What causes tinea unguium?

A type of mold called a dermatophyte causes tinea unguium. Dermatophytes are fungal microorganisms (too tiny to see with the naked eye). They feed off of keratin, a protein found in your fingernails and toenails. Keratin makes nails hard.

Dermatophytes are the cause behind 90% of toenail fungal infections. But other types of fungi can infect your toenails as well.

Is tinea unguium contagious?

Yes, many types of toenail fungi, including tinea unguium, are quite contagious. You can spread the fungus to someone else through direct contact. You can also get toenail fungus by touching an infected surface.

What are common ways you can get toenail fungus?

Nail fungi like warm, moist, dark places. You can get toenail fungus by:

• Walking around the perimeters of swimming pools.
• Using a public locker room or shower.
• Walking barefoot in a public area.

Can toenail fungus spread to other areas of your body?

Yes. But toenail fungus usually doesn’t spread beyond your toe.

Some dermatophyte fungi spread easily to your skin. (Your skin and scalp also contain keratin.) When dermatophyte fungi affect your skin, the condition is called ringworm.

Toenail fungus may spread to:

• Other toenails.
• Skin between your toes (called athlete’s foot).
• Groin area (called jock itch).
• Scalp (skin on top of your head).

Diagnosis and Tests

How is toenail fungus diagnosed?

Your healthcare provider will first look closely at the affected toenail to evaluate your symptoms. They may be able to identify toenail fungus simply by looking at your toe. However, your provider may order tests to confirm a fungal infection.

What tests will be done to diagnose toenail fungus?

Your healthcare provider will probably take a small sample from underneath your nail to further analyze it. Viewing the cells under a microscope can confirm a toenail fungus diagnosis. If the initial test is negative, a scraping can be sent to see if the fungus grows out in a culture. This also helps your healthcare provider identify the type of fungus.

Management and Treatment

How is toenail fungus treated?

Toenail fungus is notoriously tricky to treat. You may need to treat tinea unguium for several months to get rid of the fungus. Still, toenail fungus often comes back.

A skin specialist (dermatologist) or foot doctor (podiatrist) can explain your treatment options. If you have a mild case that doesn’t bother you, your healthcare provider may recommend no treatment.

Tinea unguium treatment options include:

Oral antifungal medication

You can take a prescribed oral antifungal medication to treat the fungus. Options include terbinafine (Lamisil®), itraconazole (Sporanox®) or fluconazole (Diflucan®). You’ll need to take the medication every day for several months (or longer). Your healthcare provider may use blood tests to check for potential medication side effects. These medications can affect your liver and interact with other medications, so oral antifungals aren’t for everyone.

Topical medication

You can regularly apply a topical medication right onto your nail. The medication treats the fungus over time. Topical medications are most effective when paired with oral medications.

Laser treatments

Your healthcare provider will direct a high-tech laser beam and special lights at your toenail to treat the fungus. Lasers are U.S. Food and Drug Administration (FDA) approved for “temporary increase of clear nail” in nail fungus, but they’re not a cure. Cure rates for laser treatment are lower than oral and topical mediations. Your healthcare provider won’t typically use lasers as first-line treatments for nail fungus.

What is the most effective treatment for toenail fungus?

The most effective toenail fungus treatment for you will largely depend on your symptoms and situation. Your healthcare provider will consider several factors before recommending a treatment plan. They’ll customize a treatment plan for you.

Overall, oral antifungal medications may offer the most treatment potential. Pairing oral drugs with topical antifungal medication may make treatment more effective.

Prevention

How can I prevent toenail fungus?

There’s no way to guarantee you won’t get toenail fungus. But you can take several steps to help prevent it:

• Avoid going barefoot in communal areas such as public showers, locker rooms and swimming pools. Most people pick up fungus in these situations. It helps to wear flip flops in these public areas.
• If you have a family member with foot fungus or nail fungus, try to use a different shower or wear flip flops in the shower to avoid coming in contact with it.
• Trauma due to accidental or aggressive clipping of the nails can turn into portals of entry for the fungus.
• Clean your nail trimmer before using it.
• Don’t tear or rip your toenails on purpose.
• If you have diabetes, follow all foot care recommendations from your healthcare provider.
• Keep your feet dry. Make sure to fully dry your feet after a shower.
• Soak toenails in warm water before cutting them. Or you can cut your nails after a shower or bath.
• Trim toenails straight across (don’t round the edges).
• Wear shoes that fit correctly. They shouldn’t be too loose or tight around the toes.

Outlook / Prognosis

What can I expect if I have a toenail fungus?

While toenail fungus is common, it’s usually not harmful. Symptoms mostly affect the look of your toenail.

Toenail fungus may spread to the skin between your toes or other areas of your body. When getting dressed, put your socks on first to reduce the chance of spread.

Treating toenail fungus takes a long time, and it doesn’t always work. Even then, toenail fungus often returns. Discuss the pros and cons of treating toenail fungus with your healthcare provider to determine what’s best for you.

Practicing good hygiene and foot care reduces the chance toenail fungus will come back. If you have diabetes, getting regular foot exams may help you address foot problems before they get serious.

Living With

Can I wear nail polish if I have toenail fungus?

You may feel tempted to cover up a discolored toenail with nail polish. But if you’re using a topical antifungal, you probably shouldn’t use polish. Your healthcare provider may tell you not to wear it in any case.

Nail polish traps in moisture from your nailbed (the tissue below your toenail). Because fungi thrive in moist environments, wearing nail polish may make a fungal infection worse. However, your nail continues to grow with or without polish.

When should I see my healthcare provider?

In rare cases, toenail fungus can cause an infection called cellulitis. Without prompt treatment, cellulitis may pose a serious danger to your health.

You should seek treatment guidance from a trusted healthcare provider if you have:

• Circulation problems.
• Diabetes.
• Redness, pain or pus near your toenail.
• A weakened immune system.

What questions should I ask my healthcare provider?

If you have toenail fungus, you may find it helpful to ask your healthcare provider:

• What type of infection do I have?
• Do you recommend I treat it? Why or why not?
• How long will I need treatment?
• What steps can I take to stop it from coming back?
• Should I be aware of any potentially serious complications or treatment side effects?

A note from Cleveland Clinic

Toenail fungus (tinea unguium) is an incredibly common infection that can be difficult to treat. Tinea unguium usually isn’t painful, but it may make you feel self-conscious about how your foot looks. If it bothers you, talk to your healthcare provider about your treatment options. A trained specialist (such as a dermatologist or podiatrist) can provide guidance on what’s most likely to address your concerns while protecting your overall health.