Toenail fungus

23 October 2025

Toenail fungus is an infectious disease caused by mycotic organisms such as dermatomycetes, molds and yeast-like fungi of the genus Candida.In fact, there are up to 50 species of fungi that can lead to the development of a pathological condition of the nail, but they are all grouped into these three large groups.In addition, in up to 90% of cases, fungi from the group of dermatomycetes, of which there are up to 20 different species, are the cause of nail plate diseases.Yeast fungi of the genus Candida are less likely to cause nail diseases, in around 10% of cases.The remaining small percentage of morbidity is due to infection of the nail by mold organisms.In medical terminology, nail fungus sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite high.Athlete's foot affects up to 20% of the entire world population.The prevalence of the disease in the population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of a particular person, his age, gender and profession.In addition, dermatologists are noticing a steady increase in the number of cases in both adults and children.The likelihood of developing toenail fungus increases with age (the disease is more common in older people over 65 years of age).

Symptoms of toenail fungus

Symptoms of toenail fungus depend on the type of pathogen causing the infection and the extent of damage to the nail plate.The patient's age can affect the speed of recovery.It is known that the nail phalanges are affected significantly less often in childhood than in old age.

Symptoms vary depending on the form of the fungus:

Symptoms of normotrophic nail fungus.The color of the affected panel changes, but the thickness and gloss remain the same.First, stripes and spots appear on the nail - their shape and size vary, the location is the side parts of the nail.The color of such spots is ocher yellow or white;If the disease is not treated, the spots increase and gradually cover the entire surface of the plate.The nail completely changes color and retains its normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in the fact that the plate cannot grow onto the nail bed.This allows the patient to easily remove it - accidentally or intentionally.
Symptoms of hypertrophic nail fungus.In addition to discoloration, this form of the disease is characterized by a thickening of the plate in dimensions of more than 2 mm or more.This increase is due to the increased growth of skin flakes under the nail.The shine is lost, the affected plates become dull and begin to crumble.This causes the nail to become severely deformed.The more advanced the stage of the disease, the greater the degree of deformation.Onychomycosis - the shape of the nail resembling a bird's claw - is a common symptom of the hypertrophic type of the disease.The lateral parts of the nail are the most damaged.The symptom complex that accompanies this form of nail fungus causes a person to feel pain when walking.The nail color becomes dark yellow or gray.
Symptoms of atrophic nail fungus.Initially, patients notice a change in plate color;it becomes brownish gray.The normal shine is lost and the nail surface becomes pale and dull.As the disease progresses, the plate is destroyed.The final stage of the atrophic form of the fungus is the exposure of the nail bed and its complete necrosis.(Also read: Causes and symptoms of necrosis, outcome and prevention) Above the surface of the bed, the patient discovers layers of loose consistency consisting of skin flakes.The atrophy of the plate occurs gradually, starting from the outer end to the growth zone and the nail fold.The growth zone remains intact longer than other parts of the nail.
Symptoms of lateral and distal nail fungus.What these two types of mycotic lesions have in common is that they are often diagnosed in symbiosis and cause the same changes in parts of the nail plate.The affected part of the plate loses its normal color and becomes dull.Transverse grooves run along them, which are yellowish in color.When toenail fungus occurs due to infection with mold and fungal organisms, the nail plates may turn blue-green to black.The nail itself begins to crumble and becomes rough on the sides.Over time, the affected parts die, causing the shape of the plate to deform.The nail bed remains partially exposed.The final stage of the disease is characterized by the complete destruction of the nail and the opening of a bed of skin scales on the top.If the clinical picture of distal nail fungus is complemented by lateral onchomycosis, the ridges surrounding the nail swell, become red and become thicker.A man is suffering from pain.If the pathology is aggravated by a bacterial infection, pus may appear under the nail with slight pressure.
Symptoms of proximal nail fungus.This rare lesion of the nail plate primarily affects the area to the side of the skin fold.The main cause of proximal nail fungus is removal of the eponychium (cuticle).In the area next to the growth zone, the nail plate begins to turn white.The fungus locates its spores and mycelium precisely in the tunnels of the nail, which are located in this zone.As the fungus multiplies, it surrounds the entire nail and destroys it completely.
Symptoms of total nail fungus.If the lateral, distal or proximal form of the disease is not treated, total onychomycosis results.The nail loses its color, begins to crumble, break and is completely destroyed.
Symptoms of white superficial nail fungus.Opal white spots appear in the area of the dorsal pad, which completely cover the entire nail as the fungus multiplies.The spots tend to coalesce and may visually look like scattered fine powder.

Despite the existing differences in the clinical manifestations of various forms of fungal infections, several common symptoms can be identified, including:

nail crumbles;
change plate color;
preparation of the nail phalanx;
Painful sensations that arise in the course of the pathological process;
The area around the nail may become itchy.

Causes of Toenail Fungus

Toenail fungus always occurs as a result of an infection caused by mycotic organisms.The most common are dermatomycetes.Increased keratophilia is a characteristic feature of the fungi belonging to this group.A variety of proteolytic enzymes help them penetrate skin and nails.Dermatomycetes first infect the skin of the feet and then spread to the nail plates.

There are three ways they penetrate deep into the nail:

Under the distal (free, lateral) edge of the nail.In this case, the pathological process is localized under the plate - in the bed, and not in the nail itself. As the fungus multiplies, subungual hyperkeratosis develops.This leads to deterioration of the bed-plate connections and subsequent separation.From the nail bed, fungi penetrate the nail and slowly destroy it.
Fungi penetrate deeper through the dorsal part of the nail much less often.This distribution method is only available to dermatomycetes with pronounced keratolytic abilities.In this case, the process of nail destruction itself will occur much faster.
The rarest route of spread is via the proximal ridge.From the last part of the matrix, the fungus penetrates under the nail plate and into the nail bed or settles in the matrix and from there destroys the collagen structures of the nail phalanx.If the nail lesion is caused by fungi of the genus Candida, first of all the proximal ridge with its swelling and thickening is involved in the pathological process.However, more often such an inflammatory process affects the fingernails.

In order for the fungus to penetrate the nail area, it must first be damaged and killed.

This happens under the influence of the following provoking factors:

Mechanical injuries.
Exposure to chemical factors such as: regular contact with cleaning products with synthetic components, constant contact with water, use of degreasers, etc.
Wear clothing made from synthetic materials and uncomfortable, narrow shoes.This creates a favorable, moist, warm environment in which fungi multiply quickly.
A sympathetic type of autonomic regulation in which a person suffers from increased sweating.This factor refers to the individual characteristics of the body.
Flat feet, or narrow spaces between the toes, as anatomical features of foot development.Such deformations cause the ventilation of the foot to significantly deteriorate.
Nail growth rate.
Failure to comply with personal hygiene rules.
Immune system dysfunction.In addition, nail fungus is not the only disease in which the protective forces weaken.Other organs are also susceptible to mycotic damage.
Varicose veins.
Climatic features of the area where a person lives.Fungal infections more often affect people living in areas with temperate or cold climates.The fact is that there you often have to wear warm clothes and thick and tight shoes, which creates favorable conditions for the fungus to function.Residents of subtropical countries are also at risk, as the development of the fungus is generally favored by high humidity and ambient temperature.
Age-related changes in the human body.Toenail fungus is diagnosed more frequently in increasingly older adults.However, dermatologists and mycologists are noticing an increasing trend in incidence among adolescents and children.Statistics show that for every 10 years of life lived, the risk of infection increases 2.5 times.While the probability of a mycotic infection in children is 3%, this value rises to 50% in older people.Experts attribute such indicators to the fact that with age, the growth rate of the plate slows down, the nutrition of the bed worsens, and angiopathy develops.
Gender.It has been found that men are almost three times more likely to get sick than women.However, it is men who are less likely to seek qualified help.
Costs of the profession.Fungus on the feet occurs more often in miners serving workers at nuclear power plants and in workers at metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas exposure, the higher the risk of infection.In this context, employees in saunas, baths and laundries are increasingly seeing specialists because of fungal infections.Frequent visitors to mycologists are masseurs, orthopedists, employees of rest homes and other representatives of the service personnel.
Associated pathologies.The greatest danger here is diabetes mellitus, foot deformities, obesity, gastrointestinal diseases, metabolic disorders, thyroid diseases, any peripheral angiopathy, for example with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus fivefold.(Also read: Causes, symptoms, diagnosis and prevention of HIV)
Taking antibacterial drugs, corticosteroids and cytostatics.

As for the direct routes of infection, most often this occurs in the following cases:

Visiting saunas and baths, swimming pools and public showers - all public places where people walk barefoot for long periods of time;
The use of general (including family) household items such as washcloths, slippers, pumice stones, carpets;
Carrying out cosmetic procedures, especially pedicures, in beauty salons where hygiene standards are not observed.

It is important to know that the greatest danger in this regard is posed by wooden floors, benches and other items made of this natural material.The fact is that wood has a porous structure and it is almost impossible to wash out the fungal mycelium from there.

Why is athlete's foot dangerous?

It is wrong to perceive toenail fungus as a purely aesthetic problem.This is a serious disease that requires qualified treatment.After all, onychomycosis is one of the most common chronic diseases.Untreated athlete's foot is dangerous due to the following complications:

Spread of mycosis of the skin and its appendages when immune deficiency states occur.
Development of a diabetic foot against the background of diabetes mellitus.
Development of erysipelas of the lower extremities.
Development of elephantism.
Development of lymphostasis.
Development of invasive mycosis in patients receiving immunopressive or cytostatic therapy.
Impaired nail growth and its rotation into surrounding tissue, which is accompanied by severe pain and an inflammatory reaction.
Development of eczema.
In addition, there is a bacterial infection and the development of inflammation.
Loss of the nail plate, exposure of the nail bed.
The development of aspergillosis (i.e. an infection caused by mold), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Athlete's foot never affects the entire nail.

The disease often progresses slowly and goes through several stages of development:

The early or initial stage is a marginal lesion.In this case, any pathological changes are practically invisible.The manifestation of the process is manifested in the appearance of narrow gray stripes in the area of the free edge of the nail.
Stage of normotrophic lesion of the nail plate.If thickening has not yet occurred and there is no subungual hyperkeratosis, but traces of the fungus are visible.They look like stripes and sectors of damaged disks.The phalanx's fragility increases and its color changes.Sometimes serous contents may protrude from under the nail.
Stage of a hypertrophic lesion.First, onychauxis forms - a subungual lesion, the nail thickens and hypertrophy increases.The plate changes color and, depending on the type of pathogen, crumbles, peels off, becomes thinner, stops growing, or deforms.This causes the nail to be completely lost.

The initial stage of toenail fungus

Most often, an infection is preceded by damage to the skin of the feet.Itching occurs in the interdigital folds and cracks, blisters and maceration may occur.As it penetrates deeper into the nail, the fungus begins to affect one or other of its edges.This largely depends on the type of pathogen and the route of infection, which were described above.

The initial stage is usually not amenable to self-diagnosis because there are no obvious clinical symptoms.Streaks and spots on nails are practically invisible to the naked eye.Detection of the disease is possible under laboratory conditions.

Advanced toenail fungus

Advanced athlete's foot is characterized by complete damage to the nail phalanx.If therapy is missed for a long time, the likelihood of not only complete destruction of the nail, but also damage to the skin and spread of the disease to the nails of the hands increases.

The main indicators of the advanced stage of the disease are crumbling, peeling and deformation of the nail.The thinning of the nail body and the change in its color occur gradually over many years.A rapid transition to the general stage of the disease is possible only against the background of existing systemic diseases, which most often occur in old age.The final stage is the destruction of the nail plate or its severe deformation, as well as the development of serious complications that can be caused by fungus on the feet.

How to get rid of toenail fungus

The modern pharmaceutical industry offers people diagnosed with toenail fungus a wide range of effective medications to cope with the problem.There are both local and general measures.

It is the abundance of available antifungal drugs that makes independent drug selection difficult.Ultimately, the fungus can affect not only toenails, but also mucous membranes, organs and tissues.That is why it is so important to undergo a comprehensive diagnosis and seek medical recommendations for the treatment of nail fungus.

The therapeutic tactics are based on four points:

settlement of the affected area;
time that has passed since the onset of the disease;
The nature of the pathological changes caused by the disease;
Presence of concomitant pathology.

Modern drugs not only destroy fungal organisms and stop their development, but also tend to accumulate in the thickness of the nail plate and remain there for a long time.This allows you to significantly shorten the duration of therapy, up to 8 – 16 weeks.This time will be enough to completely eliminate the problem.An integrated therapeutic approach, a combination of local treatment with oral medication, is important.The question arises: how to choose a drug to get rid of toenail fungus?Below we consider all modern types of medicines.

Antifungal nail polish

If the toenail fungus is not yet advanced, only local therapy can be used.For this purpose, special varnishes or solutions with antifungal components can be used.

In addition, to achieve a therapeutic effect, you can use plasters with a peeling effect.To make your nails look more attractive, you can apply manicure varnish over the medical varnish.

To achieve the maximum effect when treating nail fungus with varnish, you must adhere to certain rules:

You should not complete treatment on your own until you have obtained laboratory data indicating that there is no fungus in the nail;
The paint application should be done regularly and without omissions;
Treatment can last a year and is a necessary measure to get rid of the fungus.

Toenails have the ability to accumulate the drug to a greater extent than fingernails.You should not combine varnishes, as their therapeutic effect is lower.

There are also certain contraindications to therapy with antifungal varnishes:

lactation;
Giving birth to a fetus;
Individual intolerance to the components of the drug;
Childhood.

Sometimes redness of the skin areas around the nail is possible.

Rules for using antifungal varnishes:

Using a nail file, you need to remove as much of the affected nail as possible;
Degrease the nail surface with a water and alcohol-based solution or steam the nail with a soap and soda bath.
Apply the remedy;
Once a week it must be removed with a regular solvent.

Means for removing nail fungus

Before applying the nail remover, you need to steam your feet in water containing a teaspoon of liquid soap and soda per 1000 ml.The feet are then dried and the skin around the affected nail should be fixed with an adhesive plaster.The product is applied to the affected area in a thick layer, but without rubbing.The top of the nail is also fixed with an adhesive plaster.

After 4 days, the plaster is removed, the feet are steamed and the nail affected by the fungus is simply scraped off with manicure tools.

Antifungal tablets

In cases where toenail fungus has reached an advanced stage, systemic antibacterial agents are required.Only a doctor can choose the optimal treatment regimen.There are many tablets that can eliminate fungus, but some of them are incompatible with hormonal contraceptives, some are not allowed to be taken in childhood, and some are not allowed to be taken for liver problems.

Local treatment with cream, spray, ointment

If the therapy was chosen correctly and the symptoms of a fungal infection were completely eliminated and the scheme was completed, the affected nail tissue will eventually be replaced with healthy ones.

However, complete recovery can only be verified by tests that patients take 14 and 30 days after completing therapy.If during treatment the skin on the legs peels off and turns red, this is an expression of an allergy that occurs in response to taking the drug.Therefore, it is important to stop treatment on time.

Other means

Oils: Tea Tree and Lavender.Lavender oil can eliminate irritation and tea tree oil helps fight bacteria.However, it is important that the oil is natural;Only in this case can they achieve the desired effect.

Apple cider vinegar, mouthwash, lemon juice.After mixing these three products, you need to soak your feet in the resulting solution for about a quarter of an hour.This is an excellent addition to the main antifungal treatment.

Laser treatment

Treating the disease with a laser beam is a method of physiotherapeutic treatment.It can only be used in combination with antifungal drugs to have an effect.Laser therapy alone cannot completely eliminate nail fungus.This procedure is aimed at improving nail nutrition and increasing blood circulation.This allows the antifungal agent to penetrate the damaged plate better.However, the laser itself cannot kill the fungus.

This method has no contraindications and reduces the risk of disease relapse.Laser therapy is a safe and painless method of fighting fungal nail infections.

Prevention of toenail fungus

If a person's immune system is functioning properly, toenail fungus will not harm them even after infection because the immune system neutralizes it on its own.If a fungal infection spreads along the nail plate, it is necessary to select the best methods of combating it.

This is quite a labor-intensive process, so the following preventative measures can help prevent infection:

You should avoid walking barefoot on the beach;
Closed rubber slippers are ideal shoes for saunas and baths;
Socks for everyday use should be made of cotton fabric;
It is forbidden to put on someone else's shoes;
You should keep your feet dry.