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 types of fungi that can lead to the development of a pathological condition of the nails, but they are all united in these three large groups.In addition, in up to 90% of cases, the cause of nail plate disease is fungi belonging to the group of dermatomycetes, 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 occurs due to infection of the nail by fungal mycotic organisms.Nail fungus in medical terminology sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite wide.Toenail fungus affects up to 20% of the world's population.The spread 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, gender and profession.In addition, dermatologists note a steady increase in the number of cases among both adults and children.The likelihood of developing toenail fungus increases with age (the disease is more common in the elderly over 65).

Symptoms of toenail fungus

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

Symptoms vary depending on the form of the fungus:

Symptoms of normotrophic nail fungus.The color of the affected plate 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 lateral parts of the nail.The color of such spots is ocher-yellow or white;if the disease is not treated, the spots increase in size, gradually covering the entire area of the plate.The nail completely changes color, remaining normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in the inability of the plate to grow to the nail bed.As a result, the patient can 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 measuring more than 2 mm or more.This increase is due to the increased growth of skin scales under the nail.There is a loss of luster, the affected plates become dull and begin to crumble.As a result, the nail is severely deformed.The more advanced the stage of the disease, the greater the degree of deformity.Onychomycosis - the acquisition of a shape of the nail 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 that accompany 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 of all, patients notice a change in the color of the plaque;turns brownish-gray.The normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the plaque is destroyed.The last 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 finds layers of loose consistency consisting of skin scales.Atrophy of the plate occurs in stages, starting from the outer edge towards 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 plaque loses its normal color and becomes dull.It has transverse furrows that have a yellowish color.When toenail fungus occurs due to infection with molds and mycotic organisms, the nail plates may turn blue-green to black in color.The nail itself begins to crumble, becomes rough on the sides.Over time, the affected parts die, which leads to a deformation of the shape of the plaque.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 with skin scales on the tip.If the clinical picture of distal nail fungus is supplemented by lateral onychomycosis, then the ridges around the nail swell, redden and become thicker.A person suffers from pain.When the pathology is aggravated by a bacterial infection, pus can come out from under the nail if you press it lightly.
Symptoms of fungus of the proximal nails.This rare lesion of the nail plate primarily affects the area lateral to 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 adjacent to 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, then total onychomycosis occurs.The nail loses its color, begins to crumble, break and completely destroy.
Symptoms of white superficial nail fungus.In the area of the back cushion, opal-white spots appear, which, with the reproduction of the fungus, completely cover the entire nail.The spots tend to coalesce and can visually resemble scattered fine dust.

Despite existing differences in clinical manifestations in different forms of fungal infection, several common symptoms can be identified, including:

Falling nails;
Changing the color of the plate;
Dissection of the nail phalanx;
Painful sensations that occur as the pathological process progresses;
Itchy skin may appear in the area around the nail.

Causes of toenail fungus

Nail fungus always occurs as a result of infection by mycotic organisms.Most often they are dermatomycetes.Increased keratophilicity is a distinctive feature of the fungi included in this group.They are helped to penetrate the skin and nails by the wide range of proteolytic enzymes they possess.First, dermatomycetes infect the skin of the feet and then spread to the nail plates.

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

Under the distal (free, lateral) edge of the nail.In this case, the pathological process will be localized under the plate - in the bed, and not in the nail itself.With the proliferation of the fungus, subungual hyperkeratosis develops.This leads to a deterioration of the connections between the bed and the plate, followed by their separation.From the bed, the fungus penetrates the nail and slowly destroys it.
Through the dorsal part of the nail, the fungus penetrates into its depths much less often.This method of propagation is available only to dermatomycetes with pronounced keratolytic abilities.In this case, the process of nail destruction itself will continue much faster.
The rarest route of spread is through the proximal edge.From the end of the matrix, the fungus penetrates under the nail plate and into the bed or settles in the matrix, from where it destroys the collagen structures of the nail phalanx.If the nail lesion is caused by fungi of the genus Candida, then the proximal edge with its swelling and thickening will first be included in the pathological process.But 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 preparations containing synthetic components, constant contact with water, application of degreasers, etc.
Wearing things made of synthetic materials, wearing uncomfortable tight shoes.As a result, a favorable moist and warm environment is created in which fungi multiply rapidly.
Sympathetic type of autonomic regulation in which a person suffers from increased sweating.This factor is related 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 aeration of the foot deteriorates significantly.
Nail growth rate.
Non-compliance with the rules of personal hygiene.
Disorders in the functioning of the immune system.In addition, nail fungus is not the only disease with a decrease in defenses.Other organs are also susceptible to mycotic damage.
Varicose veins.
Climatic features of the area where a person lives.More often, fungal infections affect people living in areas with a temperate or cold climate.The fact is that there you often have to wear warm clothes, thick and tight shoes, thereby creating favorable conditions for the functioning of the fungus.Residents of subtropical countries are also at risk, as the development of the fungus is facilitated by high humidity and temperature of the environment in general.
Age-related changes in the human body.More often, toenail fungus is diagnosed in older people.However, dermatologists and mycologists note a growing trend of morbidity among adolescents and children.Thus, statistics show that every 10 years of life increases the risk of infection by 2.5 times.While in childhood the probability of a fungal infection is 3%, in older people this figure rises to 50%.Experts attribute such indicators to the fact that with advancing age, the growth rate of the plate slows down, nutrition of the bed deteriorates, and angiopathy develops.
genderIt has been found that men are affected almost three times more often than women.However, men are less likely to seek qualified help.
Expenses for the profession.Athlete's foot is more common in miners serving workers in nuclear power plants and workers in metallurgical plants.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 those working in saunas, baths and laundries are becoming more frequent.Frequent visitors of mycologists are massage therapists, orthopedists, employees of rest homes and other representatives of the service staff.
Associated pathologies.The greatest danger in this regard is diabetes mellitus, foot deformities, excess body weight, gastrointestinal diseases, metabolic disorders, thyroid gland pathologies, any peripheral angiopathy, for example with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus 5 times.(also read: HIV Causes, Symptoms, Diagnosis and Prevention)
Taking antibacterial drugs, corticosteroids and cytostatics.

As for the direct ways of infection, this most often happens in the following cases:

Visiting saunas and baths, swimming pools and public showers - all public places where people walk barefoot for some time;
The use of ordinary (even intra-family) household items, such as towels, slippers, pumice stone, carpets;
Carrying out cosmetic procedures, in particular pedicures, in beauty salons where hygiene standards are not observed.

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

Why is foot fungus 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 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 a 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 immunosuppressive or cytostatic therapy.
Impaired growth of the nail and its rotation in the surrounding tissues, which is accompanied by severe pain and an inflammatory reaction.
Development of eczema.
The addition of bacterial infection and the development of inflammation.
Loss of the nail plate, exposure of the nail bed.
The development of aspergillosis (ie, a mold infection) that is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophyte onychomycosis.

Stages of toenail fungus

Toenail fungus never affects the entire nail at once.

The disease often progresses slowly, passing through several stages of development:

The early or initial stage is a marginal lesion.In this case, all 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 thickening has not yet occurred and there is no subungual hyperkeratosis, but traces made by the fungus are visible.They look like stripes and sectors of damaged plates.The fragility of the phalanx increases and its color changes.Sometimes serous contents can come out from under the nail.
Stage of hypertrophic lesion.First, onychoksis is formed - a subungual lesion, the nail thickens and hypertrophy increases.The plaque changes color and, depending on the type of pathogen, breaks up, exfoliates, thins, stops growing or is deformed.As a result, the nail is completely lost.

Initial stage of toenail fungus

Most often, the infection is preceded by damage to the skin of the feet.There is a feeling of itching in the interdigital folds, cracks, blisters and maceration may appear.Penetrating deeper into the nail, the fungus begins to affect one or another of its edges.This largely depends on the type of pathogen and the route of infection, which were described above.

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

Advanced toenail fungus

Fungus on the feet in an advanced stage is characterized by total damage to the nail phalanx.With prolonged absence of therapy, the probability of not only complete destruction of the nail, but also of damage to the skin, as well as the spread of the disease to the nails of the hands, increases.

The main indicators of an advanced stage of the disease are crumbling, separation and deformation of the nail.The thinning of the nail body and the change in its color occurs gradually over many years.The rapid transition to the full stage of the disease is possible only against the background of existing systemic diseases, which most often occur in old age.The last stage is the destruction of the nail plate or its severe deformation, as well as the development of serious complications that can cause foot fungus.

How to get rid of toenail fungus

The modern pharmaceutical industry offers people who are diagnosed with toenail fungus a wide selection of effective drugs to deal with the problem.There are funds for both local and general action.

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

Therapeutic tactics are based on four points:

Calculation of the affected area;
The time elapsed since the onset of the disease;
The nature of the pathological changes provoked 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, remaining there for a long time.This allows you to significantly reduce the duration of therapy to 8-16 weeks.This time will be enough to get rid of the problem completely.An integrated approach to therapy, a combination of topical treatment with oral medications, is important.Here the question arises, how to choose a remedy and get rid of toenail fungus?Below we will consider all modern types of drugs.

Antifungal nail polish

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

In addition, to achieve a therapeutic effect, you can use patches that have a peeling effect.To make your nails more attractive, you can apply nail polish over the treatment polish.

In order to achieve the maximum effect of nail fungus treatment with varnish, you must follow certain rules:

You should not complete the treatment yourself until you have laboratory data showing the absence of nail fungus;
The application of varnish must be regular and without gaps;
Treatment can last a year and is a necessary measure to eliminate the mycotic organism.

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

There are also certain contraindications for therapy with antifungal varnishes:

Breastfeeding period;
Birth of the fetus;
Individual intolerance to the components of the drug;
Childhood.

Sometimes reddening of the skin areas that are located around the nail is possible.

Rules for using antifungal varnishes:

Using a nail file, you should remove as much of the affected nail as possible;
Degrease the surface of the nail using a water-alcohol solution or use a soap and soda bath to steam the nail;
Administer the medicine;
Once a week it should be removed with a common solvent.

Means for removing nails affected by fungus

Before applying the nail remover, you should steam your feet in water containing a teaspoon of liquid soap and soda per 1000 ml.After that, the feet are dried, the skin around the affected nail should be fixed with a plaster.The product is applied to the sore spot in a thick layer, but without rubbing.The upper part of the nail is also fixed with a plaster.

After 4 days, the patch is removed, the feet are steamed, and the nail affected by the fungus is simply scraped off with 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 get rid of the fungus, but some of them are incompatible with hormonal contraceptives, some cannot be taken in childhood, and some are prohibited for use if you have liver problems.

Local treatment with cream, spray, ointment

If the therapy is chosen correctly and the symptoms of a fungal infection are completely eliminated and the scheme is completed, then the affected nail tissue will eventually be replaced by a healthy one.

However, full recovery can only be confirmed by performing tests that patients undergo 14 and 30 days after completing therapy.If during the treatment the skin of the legs begins to peel and turn red, this is a manifestation of an allergy that occurs in response to the use of the drug.That is why it is important to stop the 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 they can have the desired effect.

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

Laser treatment

Treatment of the disease with a laser beam is a method of physiotherapy treatment.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 nail nutrition and increasing blood circulation.As a result, the antifungal drug penetrates better into the damaged plaque.However, the laser itself cannot kill the fungus.

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

Prevention of toenail fungus

If a person's immune system is functioning properly, then the toenail fungus will not harm him even after infection, because the immune system will neutralize it on its own.If the fungal infection spreads along the nail plate, then it is necessary to choose the best methods of combating 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;
Wearing other people's shoes is prohibited;
You need to keep your feet dry.