Toenail fungus is rare in children but the incidence increases as you age, with an estimated 48% of people in the United States having at least one toe affected by the time they are 70 years of age.
Wearing tight-fitting shoes and layers of nail polish increases the risk of developing toenail fungus. It can also be spread person-to-person in public areas, such as locker rooms and showers. Having a chronic condition that affects your circulation, such as diabetes, or HIV also increases your risk.
Symptoms of Toenail FungusThe affected nail will become discolored (yellow or brown) and will become very thick and overgrown. You may notice foul-smelling debris under the nail. The nail may crumble and eventually completely fall off, or it may become so thick that it is very painful to wear shoes.
Diagnosis of Toenail FungusIf a fungal infection becomes uncomfortable enough to seek medical treatment, your doctor will examine the toenail and may take small samples. The nail can be examined for fungi or some other infection under a microscope in the lab.
Treatment of Toenail FungusToenail fungus often becomes a chronic condition, and if it is not painful, many people do not get treatment. However, people with chronic illness like diabetes should see a doctor if they notice changes in their nails as it may be an indication of more serious problems. If the nail becomes very thick and makes wearing shoes and walking painful, you should see a doctor.
The nail can be trimmed and filed down carefully, either at home or by a foot specialist (podiatrist). If the infection is mild and very localized, your doctor may prescribe a medicated nail polish containing either Loceryl (amorolfine) or Loprox (ciclopirox).
If the infection persists or continues to spread, your doctor may prescribe an oral, systemic anti-fungal medication such as Sporanox (itraconazole) or Lamisil (terbinafine). The length of treatment will be about 12 weeks. Both of these drugs have some very serious side effects and may not be appropriate for some people.
For extremely persistent infections, permanent surgical removal of the nail may be necessary.
Prevention of Toenail FungusYou can help to prevent toenail fungus by:
- Wearing comfortable, well-fitting shoes and clean hosiery every day, and allowing your shoes to dry thoroughly between wearings
- Wearing shower shoes, sandals or flip-flops in community showers or locker rooms
- Washing your feet daily, drying them thoroughly, and using a good-quality foot powder
- Keeping your toenails trimmed
- Avoid applying layers of nail polish