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How to deal with toenail fungus

toenail fungus

Oncychomycosis is a fungal infection of the toenail. Infected nails can appear as:

  • Thickened
  • Brittle or crumbly
  • Distorted in shape
  • A dark color, caused by debris building up under the nail
  • Yellow or white discoloration, most often common in big toenail.

The most common risk factor is aging, though there are other contributing risk factors.

Factors that can increase your risk of developing nail fungus include:

  • Being male, especially if you have a family history of nail fungal infections
  • Working in a humid or moist environment 
  • Wearing socks and shoes that hinder ventilation and don't absorb perspiration
  • Living with someone who has nail fungus
  • Walking barefoot in damp communal areas, such as swimming pools, gyms and shower rooms
  • Having athlete's foot
  • Having diabetes, circulation problems, a weakened immune system or, in children


The fungus can be prevented in many cases. Prevention measures include going to a reputable nail salon and taking your own nail polish. The fungus can be contracted easily in shared bathrooms such as locker rooms or hotel rooms so carrying shower flip flops can help prevent contraction.

Most females tend to notice the infection in the winter. When toenails are painted all summer long patients are less able to detect changes in the nail. 


The fungus can be treated through prescription oral or topical medication such as medicated nail polish or medicated antifungal nail cream. Toenails are sometimes removed because the nails become so thick that they are very painful to touch and wear a closed shoe.

Some of the oral medications affect liver function, so if patients are on certain medications they aren’t a treatment option. There are two newer topical medications for the infection and they seems to work better if toenails have thickness of 3 to 4 mm or less. 

About Miki Matsuda DPM

Miki Matsuda, DPM, is a podiatrist with Ascension Medical Group in Wichita, Kansas.