Fungal Toenails

Fungus can grow under a toenail and change its appearance. An exam helps determine the cause of nail changes.

Why it happens
Fungus favors warm, moist places and can spread from athlete's foot into a nail. Thick or discolored nails can also have other causes. 

What you may notice
Yellow or brown color, thickening or a misshapen nail. A fungal skin infection may also be present.

Why it can come back
Fungus can remain in damp footwear and can pass between people through shared personal items. A new infection can develop even after successful treatment. Ongoing athlete’s foot also provides a source of fungus that may reach the nails.

Treatment and what to expect
Treatment may include thinning the nail, prescription nail medicine or antifungal pills. A nail sample may confirm fungus. Pills require a review of your medicines and health; blood tests may be needed. Nails grow slowly, so a clearer nail can take many months. Use medicine for the prescribed length of time, even if the nail starts looking better. Tell the clinician if you are pregnant, breastfeeding or taking other medicines before treatment is selected. Laser treatments can be effective as well.

When to call
Call if the nail becomes painful or the surrounding skin develops redness, swelling or drainage. Do not dig under the nail or pull it off.

Your next steps
● Have the nail checked before choosing treatment.
● Ask for help with nail care if the nail is difficult to trim.
● Tell your clinician about peeling or itchy skin, diabetes, numbness or poor circulation. Follow the nail and skin treatment plan you are given. 

Preventing another infection
Change socks every day and whenever they become sweaty. Use breathable shoes and give each pair about 24 hours to dry before wearing again.

 Do not share nail tools, shoes or unwashed towels. Clean and disinfect nail tools after use; ask the office how to do this safely.

Wear shower sandals on shared wet floors. Ask about cleaning or replacing previously worn shoes during treatment.

Keeping your progress on track
Report new itching, peeling or cracking and get athlete’s foot treated. Household members with signs of a fungal infection should seek care too. Watch for new nail lifting, splitting or discoloration. Bring your treatment products to follow-up so the clinician can check what you are using and how often.