Nail Fungus - Causes, Symptoms, and Treatment

This is a picture of toenail fungus.

What is Nail Fungus?

Nail fungus is a prevalent condition. The fungus starts as a yellow or white spot beneath the tip of your toenail or fingernail. Approximately 10 percent of all adults have a nail fungus infection. As the fungus works its way deeper into your skin, your nail may thicken, discolor, and start crumbling around the edges. You can have nail fungus on more than one nail. Nearly 50 percent of all nail abnormalities are fungal infections. If the fungus overgrows, you may have a serious issue.

If you have a mild condition without any symptoms, treatment may be unnecessary. But if your nail has thickened or you are experiencing pain, you should take steps to deal with the fungus. Even if you are treated, there is a possibility the fungus can return. If the fungus is affecting your fingernail or toenails, it is referred to as onychomycosis.

What Causes Nail Fungus?

The cause of nail fungus is a fungus overgrowth on or beneath your nail. Fungi flourish in a moist and warm environment and can overpopulate naturally. Nail infections can result from the same fungi responsible for athletes foot, jock itch, and ringworm. You may already have fungi in your body, which can result in a nail infection. You can contract a fungal infection by merely touching someone who has one. Toenails are affected more than fingernails.

This is because wearing shoes and socks provides fungi with a moist, warm environment. Nail care tools can spread fungal infections from one person to another, including nail clippers, nail files, and emery boards. Sanitizing your tools can help prevent a fungal infection. This is the reason quality nail salons will disinfect tools used for pedicures and manicures.

Symptoms of Nail Fungus

The most common symptoms of a nail fungus include:

  • Yellow, white or brown discoloration
  • Distorted nail shape
  • Slightly foul odor
  • Thickened nails
  • Ragged, crumbly or brittle nails
  • A dark color building beneath your nail

If the steps you have taken have not improved your condition and your nail is still deformed, thickened, or discolored, you should consider making an appointment with your physician. If you have diabetes and suspect nail fungus, you should consult with your doctor as soon as possible.

How To Prevent Nail Fungus

There are steps you can take to help prevent nail fungus including:

  • Do not bite or pick at your nails
  • Avoid nail polish and artificial nails whenever possible
  • Wear sandals or shoes at pools and public places
  • Wear shoes constructed from breathable materials
  • Wear breathable socks
  • Wash your hands and feet on a regular basis
  • Do not share your socks or shoes
  • Change your socks throughout the day
  • Keep your nails clean, short and dry
  • Wear footwear in locker rooms
  • Use a nail moisturizer
  • Wear rubber gloves to protect your nails from water
  • Disinfect your nail tools after you use them
  • Use antifungal powders or disinfectants on your old shoes
  • Use an antifungal powder or spray
  • Make certain your salon is sterilizing their tools correctly

Risk Factors

Your risk of developing a nail fungus increases with the following factors.

  • History of athletes foot
  • Nail injuries
  • Wearing artificial nails
  • Adults over 65 have slower growing nails and a decreased blood flow
  • Skin injury around your nail
  • Swimming in a public pool
  • Walking barefoot in damp areas including public swimming pools, showers and gyms
  • Sweating heavily
  • Moist toes or fingers for an extended period
  • Minor skin conditions including psoriasis
  • Wearing shoes with a closed toe including boots and tennis shoes
  • Circulation issues, diabetes or a weak immune system

More men and adults suffer from nail fungus than women or children. Your risk of nail fungus increases if any member of your family is prone to this condition.


If you have severe nail fungus, the result is often painful. Permanent nail damage is also possible. If your immune system is suppressed due to a medical condition, diabetes, or medication, you can get a severe infection, or the fungus can spread. If you have diabetes, there is a good chance for the nerve supply and blood circulation to your feet to decrease.

Your risk for a bacterial skin infection called cellulitis will increase. This means you can have severe complications from a nail fungus or any minor foot injury. If you have diabetes or suffer from a severe fungal infection, the recommendation is for you to contact your physician as quickly as possible.

Common Types of Nail Fungus

White Superficial Infection:

This type of fungus generally affects your toenails. The attack on the top layers of your nails results in the formation of white spots. The white, flaky, and pitted patches will eventually cover your entire nail, resulting in the nail becoming crumbly, soft, and rough.

Distal Subungual Infection:

This is the most common nail fungus occurring in both the toenails and fingernails. The infection results in a jagged appearance with yellow or white streaks running across your nail. Both the underside and bed of your nail will be infected.

Candida Infection:

Candida causes this kind of infection. If your nail was damaged in the past from an injury or disease, your nails could be affected. Your fingernails are more commonly affected if your hands are frequently soaked in water. The infection generally begins around your cuticle. It will become tender, red, and swollen. Your nail can partially lift from the bed or entirely fall off.

Proximal Subungual Infection:

This type of infection is relatively rare and impacts both toenails and fingernails. As the fungus spreads, you will notice yellow spots on your nail. Your risk increases if your immune system is compromised or you have injured your nail.

Diagnosing Nail Fungus

Physical examinations do not generally diagnose nail fungus. Your nails can appear damaged for a lot of reasons, which makes an accurate diagnosis more difficult. According to studies, only half of all abnormal appearances are caused by a nail fungus. Your best option is laboratory testing. Some insurance companies require a lab test with a positive diagnosis before covering the cost of antifungal medication.

Your nail will either be clipped or have a small hole drilled to obtain a sample. Your nail is then sent to a lab for testing, culture, and staining to identify the organism and determine if a nail fungus is present. It will take approximately six weeks to get the results from culturing or staining. If a PCR test is performed, the fungus can be identified in about one day. Since this test is expensive, it is not performed often.

If your biopsy result was negative but clinical suspicion is high, your test may be repeated. This is because false-negative results are a possibility for this type of testing. Tests are usually repeated if your nail is discolored, crumbly, ragged, and thickened. Unfortunately, the majority of prescription medications have adverse side effects. It would be best if you did not use any prescription until you receive confirmation you have a nail fungus.

You can receive treatment for nail fungus from several physicians, including a podiatrist, dermatologist, or primary care provider. All of these doctors can diagnose your condition correctly and offer the correct treatment for the specific fungus. If you visit a dermatologist or podiatrist, a portion of your nail may be shaved off, such as the top layer.

How To Treat Nail Fungus?

The typical treatment starts by trimming the infected nail to where it is attached to your toe or finger. Any debris beneath your nail may be scraped away by a dermatologist to help remove some of the fungi. The treatment you need depends on the type of fungus and the severity of your infection. If you have a mild nail fungus, applying medicine to your nail might eliminate the infection. This type of treatment helps prevent the growth of new fungus as your nail grows.

Your fingernails usually grow back in four to six months. More time is necessary for toenails with an average of 12 to 18 months. The hardest part of using medication to treat your nail fungus is remembering to use it as prescribed by your doctor. Depending on your prescription, you might need to use it once each week or every day. If you do not use your medication as prescribed, you will not receive the best results. Some medications for the treatment of nail fungus have received approval from the FDA.

If your nail fungus is severe or other treatments are not sufficient, your nail might need to be removed to eliminate the infection. This process is performed by a dermatologist with one of two different techniques. Your nail will either be removed surgically or have a chemical applied to it. Both of these procedures can be performed by your dermatologist in their clinic or medical office. Regardless of which method is used, your nail can eventually grow back.

If the fungus does not go away, your dermatologist's treatment may be necessary to prevent your nail from growing back. Medically treatments generally involve a prescription for strong antifungal medication. Even though these types of medications are effective, they can result in unpleasant side effects, including skin issues, diarrhea, and an upset stomach. For this reason, some individuals prefer to treat nail fungus with a natural remedy, including:

Baking Soda:

If your nail fungus was caused by moisture, you could use baking soda for absorption. A study was conducted regarding the effectiveness of baking soda for the more common fungi responsible for infections. The participants used baking soda inside their shoes and socks to soak up the moisture. The results of the study were positive.

If you have a nail fungus on your finger, you can mix water and baking soda to form a paste. Apply this mixture to your nail for a minimum of 10 minutes before rinsing. You need to repeat the process several times every day until your nail fungus is gone.


Although there is no clinical proof vinegar will clear your nail fungus, some informal evidence shows that vinegar is often useful for treating toenail fungus. Start by filling a bowl with vinegar and warm water. The recommendation is two parts of water and one part of vinegar. It would be best if you soaked your toe directly in the mixture. Repeat the process daily until your fungus has cleared.


You might be able to treat your nail fungus with garlic. There is limited evidence showing the effectiveness of this treatment. You can treat your toenail fungus by chopping a clove of garlic. Apply the garlic directly on your affected nail and do not remove it for approximately 30 minutes. You need to take care when using this remedy because some people experience a chemical burn from placing raw garlic on their skin.


No scientific evidence is available showing mouthwash is effective for treating nail fungus. Certain studies have suggested certain types of mouthwash contain antifungal properties.

Snakeroot Extract:

Snakeroot extract is traditionally used in Mexico to treat nail fungus. This treatment is not used frequently in the United States. Snakeroot or Ageratina is a member of the sunflower family and has antifungal properties. You can purchase snakeroot online or at a specialty store. You need to apply the extract directly to your nail between two and three times every week. You should allow approximately three months for your treatment to work.

Ozonized Oils:

This type of oil is infused using ozone gas. The best examples of ozonized oils you can purchase include olive oil and sunflower oil. You will need the ozonized form. Apply the oil directly to your nail two times every day for approximately three months.

Essential Oil Blends:

You need to make certain your essential oil has antifungal properties or it will not be effective. The most popular blends for the treatment of nail fungus include:

  • Ylang-ylang oil

  • Jasmine oil

  • Lavender oil

  • Clary sage oil

  • Petitgrain oil

Your best options for purchasing this type of oil are health food stores or online. You need to mix your essential oil with a carrier oil first, then apply the mixture directly to your nail.

How To Cure Nail Fungus?

Curing your nail fungus can be difficult. Sometimes natural remedies or medications will not work the first time. Your nail fungus is not completely cured until your nail has grown back with absolutely no infection or fungus. Even if your nail is clear, the fungus may return. If your nail fungus is severe, your nail might need to be removed, or you may have permanent damage. The most common complication of a nail fungus include:

  • You permanently lose your nail
  • The infection spreads somewhere else in your body such as your bloodstream
  • Your nail fungus comes back
  • You develop a bacterial skin infection known as cellulitis
  • Your nail becomes permanently discolored

If you have a nail fungus and diabetes, you should consult with your physician as soon as possible. This is because the risk of developing serious complications due to a nail fungus is much higher for people with diabetes. If you have diabetes and even suspect a nail fungus has developed, you need to talk to your doctor.

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