Toenail fungus

23 October 2025

Toenail mycosis is an infectious disease caused by fungal organisms such as dermatomycetes, molds and yeast-like fungi of the Candida genus.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 together in these three large groups.Furthermore, in up to 90% of cases, the cause of nail plate disease is fungi belonging to the dermatomycetes group, of which there are up to 20 different species.Yeast-like fungi of the genus Candida cause nail diseases not so often, in about 10% of cases.The remaining small percentage of morbidity is due to infection of the nail by fungal mold organisms.Nail fungus in medical terminology sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite large.Foot fungus affects up to 20% of the entire world population.The prevalence of the disease among the population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of a particular person, his age, sex and profession.Additionally, dermatologists note a steady increase in the number of cases among both adults and children.The chance of developing toenail mycosis increases with age (the disease is more common among older people over the age of 65).

Symptoms of toenail fungus

Symptoms of toenail fungus will depend on the type of pathogen causing the infection, as well as the extent of damage to the nail plate.The patient's age can affect the speed of recovery.It is known that in childhood the nail phalanges are affected much less frequently than in the elderly.

Symptoms vary depending on the form of the fungus:

Symptoms of normotrophic nail fungus.The color of the affected plaque changes, but the thickness and shine remain the same.First, stripes and spots appear on the nail: their shape and size vary, the location is the lateral parts of the nail.The color of these spots is yellow ocher or white;if the disease is not treated, the spots increase in size, gradually covering the entire plaque area.The nail changes color completely, maintaining normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists of the inability of the plaque to grow to the nail bed.As a result, the patient can remove it easily, accidentally or intentionally.
Symptoms of hypertrophic nail fungus.In addition to discoloration, this form of the disease is characterized by a thickening of the plaque larger than 2 mm or more.This increase is due to increased growth of skin scales under the nail.There is a loss of shine, the affected plates become dull and begin to crumble.As a result, the nail becomes severely deformed.The more advanced the stage of the disease, the greater the degree of deformation.Onychomycosis - the acquisition by the nail of a shape similar to 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 complex of symptoms accompanying this form of nail fungus leads to the fact that a person begins to feel pain when walking.The color of the nails becomes dark yellow or gray.
Symptoms of atrophic nail fungus.First, patients notice a change in the color of the plaque;it becomes brownish-gray.Normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the plaque is destroyed.The final stage of the atrophic form of the fungus is the exposure of the nail bed and its complete necrosis.(read also: Causes and symptoms of necrosis, outcome and prevention) Above the surface of the bed the patient discovers layers of loose consistency, made up of skin flakes.Plaque atrophy occurs in several stages, starting from the outer end towards the growth zone and the nail fold.The growth area remains intact longer than other parts of the nail.
Symptoms of lateral and distal nail fungus.What these two types of fungal lesions have in common is that they are often diagnosed together and cause the same changes in certain parts of the nail plate.The affected part of the plaque loses its normal color and becomes opaque.Along it run transverse grooves, which have a yellowish color.When toenail fungus occurs due to infection with mold and fungal organisms, the nails may turn blue-green to black in color.The nail itself begins to crumble, becoming rough on the sides.Over time, the affected parts die, causing the shape of the plaque 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 flakes in the upper part.If the clinical picture of distal nail fungus is complemented by lateral onchomycosis, the ridges surrounding the nail swell, turn red and become thicker.A man suffers from pain.When the condition is aggravated by a bacterial infection, pus may escape from under the nail when pressed lightly.
Symptoms of proximal nail fungus.This rare lesion of the nail plate mainly affects the lateral area of the skin fold.The main cause of proximal nail fungus is the removal of the eponychium (cuticle).The nail plate begins to turn white in the area located near the growth zone.The fungus locates its spores and mycelium precisely in the nail tunnels located in this area.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 occurs.The nail loses its color, begins to crumble, break and is completely destroyed.
Symptoms of superficial white nail fungus.Opal white spots appear in the back cushion area, which, as the fungus multiplies, completely covers the entire nail.The spots tend to merge and visually may resemble scattered fine dust.

Despite the existing differences in clinical manifestations in various forms of fungal infection, it is possible to identify several common symptoms, including:

Crumbling of nails;
Change the color of the plate;
Dissection of the nail phalanx;
Painful sensations that occur as the pathological process progresses;
Itching may occur in the area surrounding the nail.

Causes of Toenail Fungus

Toenail fungus always appears due to infection by fungal organisms.Very often they are dermatomycetes.Increased keratophilia is a distinctive feature of the fungi included in this group.They are helped to penetrate the skin and nails by a wide range of proteolytic enzymes with which they are equipped.First, dermatomycetes infect the skin of the feet and then spread to the nails.

There are three possible ways they penetrate deep into the nail:

From under the distal (free, lateral) edge of the nail.In this case, the pathological process will be localized under the plaque, in the bed, and not in the nail itself.As the fungus proliferates, subungual hyperkeratosis develops.This leads to a deterioration of the connections between the bed and the plate, resulting in their separation.From the bed, the fungi penetrate the nail and slowly destroy it.
Through the dorsal part of the nail, fungi penetrate into its depths much less frequently.This distribution method is available only for dermatomycetes with pronounced keratolytic capabilities.In this case, the process of destroying the nail itself will proceed much faster.
The rarest route of spread is through the proximal ridge.From the final part of the matrix, the fungus penetrates under the nail plate and into the bed, or settles into the matrix, from there destroying the collagen structures of the nail phalanx.If the nail lesion is caused by fungi of the genus Candida, the proximal ridge with its swelling and thickening will initially be involved in the pathological process.However, more often such an inflammatory process affects the nails.

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

This happens under the influence of the following provoking factors:

Mechanical injuries.
Exposure to chemical factors, such as: regular contact with detergents containing synthetic components, constant contact with water, application of degreasers, etc.
Wearing objects made of synthetic materials, wearing tight and uncomfortable shoes.As a result, a favorable moist and warm environment is created in which mushrooms multiply rapidly.
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 lead to the fact that the ventilation of the foot deteriorates significantly.
Nail growth rate.
Failure to comply with personal hygiene rules.
Disturbances in the functioning of the immune system.Moreover, nail fungus is not the only disease with a decrease in protective forces.Other organs are also susceptible to fungal damage.
Varicose veins.
Climatic characteristics of the area where a person lives.Most often, fungal infections affect people who live in areas with temperate or cold climates.The fact is that there you often have to wear warm clothes, thick and narrow shoes, thereby creating favorable conditions for the functioning of the fungus.Residents of subtropical countries are also at risk, since the development of the fungus is facilitated by high humidity and environmental temperature in general.
Age-related changes in the human body.More often, toenail fungus is diagnosed in increasingly older adults.However, dermatologists and mycologists note a trend of increasing incidence among adolescents and children.Thus, statistics indicate that every 10 years of life lived increases the risk of infection by 2.5 times.While in childhood the probability of fungal infection is 3%, in the elderly this figure rises to 50%.Experts attribute such indicators to the fact that with advancing age, the growth rate of plaque slows down, bed nutrition deteriorates, and angiopathy develops.
Type.It has been found that men get sick almost three times more often than women.However, it is men who less often seek qualified help.
Costs of the profession.Fungi on the feet are most often found in miners serving nuclear power plant workers and workers at metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas pollution, the higher the risk of infection.In this regard, visits to specialists regarding fungal infections by workers of saunas, baths and laundries are becoming more and more frequent.Frequent visitors to mycologists are masseurs, orthopedists, employees of retirement homes and other representatives of service personnel.
Associated pathologies.The greatest danger in this regard is diabetes mellitus, foot deformities, excess body weight, gastrointestinal diseases, metabolic disorders, thyroid pathologies, any peripheral angiopathy, for example with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus by 5 times.(read also: Causes, symptoms, diagnosis and prevention of HIV)
Taking antibacterial drugs, corticosteroids and cytostatics.

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

Visiting public saunas and baths, swimming pools and showers - any public place where people walk barefoot for some time;
The use of common household objects (including intra-family ones), such as wipes, slippers, pumice stones, carpets;
Performing cosmetic procedures, especially pedicures, in beauty salons where hygiene standards are not respected.

It is worth knowing that the greatest danger in this regard is wooden floors, benches and other objects made from this natural material.The fact is that wood has a porous structure and it is almost impossible to eliminate fungal mycelium from there.

Why are foot fungus dangerous?

It is wrong to consider toenail mycosis 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 foot fungus is dangerous due to the following complications:

Spread of mycosis of the skin and its appendages in the occurrence of immunodeficiency conditions.
Development of the diabetic foot on the background of diabetes mellitus.
Development of erysipelas of the lower extremities.
Development of elephantism.
Development of lymphostasis.
Development of invasive mycosis in patients undergoing immunopressive or cytostatic therapy.
Impairment of the growth of the nail and its rotation into the surrounding tissues, accompanied by severe pain and inflammatory reaction.
Development of eczema.
The addition of a bacterial infection and the development of inflammation.
Loss of the nail plate, exposure of the nail bed.
The development of aspergillosis (i.e. mold infection), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Fungus on the feet never hits the nail all at once.

The disease often progresses slowly, going 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 expressed in the appearance of narrow gray stripes located in the area of the free edge of the nail.
Stage of normotrophic lesion of the nail plate.When the thickening has not yet occurred and there is no subungual hyperkeratosis, but the traces left by the fungus are visible.They look like strips and sectors of damaged plates.The fragility of the phalanx increases and its color changes.Sometimes the serous contents may leak from under the nail.
Stage of hypertrophic lesion.First, onicauxis is formed - a subungual lesion, the nail thickens and hypertrophy increases.The plaque changes color and, depending on the type of pathogen, crumbles, exfoliates, thins, stops growing or is deformed.As a result, the nail is completely lost.

The initial stage of toenail fungus

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

As a rule, the initial stage is not available for self-diagnosis, since there are no obvious clinical signs.Streaks and stains on the nails are practically indistinguishable to the naked eye.Detection of the disease is possible in laboratory conditions.

Advanced toenail fungus

Advanced foot fungus is characterized by total damage to the phalanx of the nail.With a prolonged absence of therapy, the likelihood of not only complete destruction of the nail, but also damage to the skin, as well as the spread of the disease to the nails of the hands increases.

The main indicators of the advanced stage of the disease are crumbling, separation and deformation of the nails.Thinning of the nail body and change in its color occurs gradually over the years.A rapid transition to the total stage of the disease is possible only against the background of existing systemic diseases, which most often occur at an older age.The final stage is the destruction of the nail plate or its severe deformation, as well as the development of serious complications that fungus on the feet can cause.

How to Get Rid of Toenail Fungus

The modern pharmaceutical industry offers people diagnosed with toenail fungus a wide choice of effective medications to address the problem.There are means of both local and general action.

It is the abundance of available antifungal drugs that makes it difficult to independently choose a drug.After all, the fungus can affect not only toenails, but also mucous membranes, any organs and tissues.Therefore, it is so important to undergo a comprehensive diagnosis and receive medical recommendations regarding the treatment of nail fungus.

The therapeutic tactic is based on four points:

Accounting of the affected area;
Time elapsed since the onset of the disease;
The nature of the pathological changes caused by the disease;
Presence of concomitant pathologies.

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

Antifungal nail polish

When toenail fungus has not reached an advanced stage, only local therapy can be used.For this purpose, specialized paints or solutions containing antifungal components can be used.

Also, to achieve a therapeutic effect, you can use plasters that have a peeling effect.To make your nails more attractive, you can apply manicure polish over medicated nail polish.

To achieve the maximum effect from the treatment of nail fungus with varnish, you must adhere to some rules:

You should not complete treatment on your own until you have received laboratory data indicating the absence of fungus in the nail;
The application of the paint must be regular and without skipping;
Treatment can last a year and this is a necessary measure to eliminate the fungal organism.

Toenails have the ability to accumulate the drug to a greater extent than fingernails.You should not combine paints, as their therapeutic effect will be less.

There are also some contraindications to antifungal paint therapy:

Breastfeeding period;
Carrying 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 paints:

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

Remedies to remove nails affected by fungus

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

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

Antifungal tablets

Systemic antibacterial agents are necessary in cases where toenail fungus has reached an advanced stage.Only a doctor can choose the optimal treatment regimen.There are many tablets that can eliminate fungus, but some are incompatible with hormonal contraceptives, others cannot be taken in childhood, and some are prohibited if you have liver problems.

Local treatment with cream, spray, ointment

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

However, complete recovery can only be verified by performing tests that patients are subjected to 14 and 30 days after completion of therapy.If during treatment the skin on the legs begins to peel and redden, this is a manifestation of an allergy that occurs in response to the use of the drug.Therefore, it is important to stop treatment in time.

Other means

Oils: tea tree and lavender.As for lavender oil, it 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 have 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

Treatment of the disease with a laser beam is a physiotherapeutic treatment method.It can only be used in combination with antifungal drugs to achieve an effect.Laser therapy alone will not completely eliminate nail fungus.This procedure is aimed at improving the nutrition of the nails and increasing blood circulation.As a result, the antifungal drug penetrates the damaged plaque better.However, the laser itself cannot kill the fungus.

This method has no contraindications and reduces the risk of recurrence of the disease.Laser therapy is a safe and painless way to fight fungal nail infections.

Toenail fungus prevention

If a person's immune system is functioning properly, toenail fungus will not harm him or her even after infection, as the immune system will neutralize it on its own.If a fungal infection spreads along the nail plate, it is necessary to select the best methods to combat it.

This is a rather laborious process, so the following preventive measures can help prevent infection:

You should avoid walking barefoot on the beach;
Closed rubber slippers are optimal shoes for saunas and baths;
Socks for daily wear should be made of cotton fabric;
It is forbidden to wear other people's shoes;
You should keep your feet dry.