What is toenail fungus?
Onychomycosis or Tinea unguium is a fungal infection of the nails. Most toenail fungal infections occur due to a crack or cut in the toe. Toenail fungus can cause discoloration, thickening, and separation from the nailbed, discomfort, pain, and if left untreated, the nail may be lost altogether. Tinea unguium affects toenails more commonly than fingernails because of their slower growth, reduced blood supply, and frequent exposure to dark, moist environments.
General information
What causes toenail fungus?
Fungal transmission can occur through contact with infected people, animals, soils, or fomites. Most tinea infections are caused by person-to-person contact with individuals infected with anthropophilic (human) dermatophytes. A dermatophyte is a type of mold that causes Tinea unguium. The term tinea refers exclusively to a dermatophyte or fungi that infects keratinous tissue. A dermatophyte requires keratin (which is a protein) to grow. Dermatophytes cause about 90% of toenail fungal infections. Other types of fungi can affect the toenails as well.
What can I do to prevent toenail fungus?
- Wear protective footwear (flip flops, rubber or wooden sandals) when using public locker rooms, community pools or communal showers
- Wear shoes that fit correctly (Shoes should not fit too tight or loose around the toes)
- Wash your feet daily with warm soap and water (Dry feet completely after bathing or showering)
- Trim toenails straight across and do not round the edges
- Keep your nail trimmer clean
How do I treat toenail fungus?
Toenail fungus is most effectively treated with an oral antifungal medication called terbinafine. Itraconazole is more effective than terbinafine if the toenail fungal infection is caused by a yeast called Candida. If terbinafine or itraconazole cannot be used, fluconazole is another option for treatment. Topical antifungals include ciclopirox lacquer, efinaconazole, and tavaborole. Topical antifungals may be useful in patients with mild-to-moderate infection not involving the nail matrix or candidates who are unable to tolerate oral therapy. Ask the pharmacist today for more information.
Frequently Asked Questions
Who does toenail fungus affect?
Toenail fungus can affect anyone but occurs most often in adults over the age of 60.
Disease states that can increase your risk for toenail fungus include the following:
- Athlete’s foot (tinea pedis)
- Hyperhidrosis (disorder causing excessive sweating)
- Nail injury
- Psoriasis
- Obesity
- Type 2 Diabetes
- Poor blood circulation
- Immune system disorders
What does toenail fungus look like?
- The color of the toenail may appear white, brown, or yellow
- Certain areas of the toenail may have a chalky or patchy appearance
- The toenail will become thick, rough, dry, brittle, misshapen, and or odorous
- The toenail may separate from the nailbed
Is toenail fungus contagious?
Many types of toenail fungal infections are contagious including Tinea unguium. An infected person can easily spread the fungus to someone by direct contact. A noninfected person can get toenail fungus by touching a contaminated surface.
L’Neisha Leslie
Midtown Express Pharmacy
Pharm.D. Candidate 2023
Resources
- Goldstein AO, Bhatia N. Onychomycosis: Management. UpToDate. UpToDate, Inc.; 2022. Updated July 12, 2022. Accessed August 21. 2022. https://www.uptodate.com
- Smith MG. Fungal skin infection. In: Krinsky DL, ed. Handbook of Nonprescription Drugs: An Interactive Approach to Self-Care. 20th ed. American Pharmacists Association; 2020:chap 42. Accessed August 22, 2022. https://doiorg.bunchproxy.idm.oclc.org/10.21019/9781582123172.ch42
- De Sa DC, Botto Lamas AP, Tosti A. Oral therapy for onychomycosis: an evidence-based review. AM J Clin Dermatol. 2014;15(1):17-36. doi:10.1007/s40257-013-0056-2
