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 about 50 species of fungi that can cause the development of pathological nail conditions, but they are all united in these three large groups.Moreover, up to 90% of cases of nail plate disease are caused by 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 very often, about 10% of the time.The remaining small percentage of morbidity is due to infection of the nail with fungal mycotic organisms.In medical terminology, nail fungus is similar to onychomycosis.

According to statistics, the spread of the disease is quite wide.Athlete's foot affects up to 20% of the world's population.The spread of the disease among the population is influenced by many factors: climatic conditions in which the population lives, social conditions of a particular person, his age, gender and profession.In addition, dermatologists note a constant increase in the number of cases in both adults and children.The likelihood of developing toenail fungus increases with age (the disease is more common in people over 65).

Symptoms of toenail fungus

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

Symptoms vary depending on the shape of the fungus:

Symptoms of normotrophic nail fungus.The color of the damaged plate changes, but the thickness and gloss remain the same.First, stripes and spots appear on the nail - their shape and size change, 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, remains normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in the inability of the plate to grow on the nail bed.As a result, the patient can easily remove it - accidentally or intentionally.
Symptoms of hypertrophic nail fungus.In addition to the color of the color, this form of the disease is characterized by a thickening of the plate with a size of 2 mm or more.This growth occurs due to an increase in skin scales under the nail.The shine is lost, the affected plates become dull and begin to break.As a result, the nail is strongly deformed.The further the stage of the disease, the greater the degree of deformation.Onychomycosis - taking the shape of a bird's claw by the nail 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 accompanying this form of nail fungus leads to the fact that a person begins to experience pain when walking.The color of the nail becomes dark yellow or gray.
Symptoms of atrophic nail fungus.First of all, patients notice a change in the color of the plate;It becomes brownish-gray.The normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the plate is destroyed.The final stage of the atrophic form of the fungus is the exposure of the nail bed and its complete necrosis.(Read also: 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 gradually, starting from the outer end 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.These two types of mycotic lesions have in common that they are often diagnosed in symbiosis and cause the same changes in parts of the nail plate.The affected part of the plate loses its normal color and becomes dull.Transverse grooves pass along it, which have a yellowish color.When toenail fungus occurs due to infection with mold and mycotic organisms, the nail plates can turn bluish-green to black.The nail itself begins to break, becomes rough on the sides.Over time, the affected parts die, which leads to deformation of the shape of the plate.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 the bed with skin flakes on top.If lateral onchomycosis is added to the clinical picture of distal nail fungus, then the ridges surrounding the nail are swollen, reddened and thickened.The man is in pain.When the pathology is aggravated by a bacterial infection, pus can come out from under the nail if you press lightly on it.
Symptoms of proximal nail fungus.This rare lesion of the nail plate primarily affects the side of the skin fold.The main cause of proximal nail fungus is removal of the eponychium (cuticle).The nail plate begins to whiten in the area next to the growth zone.The fungus deposits its spores and mycelium in the nail tunnels located in this area.The fungus multiplies, surrounds the entire nail and completely destroys it.
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 break, break and is completely destroyed.
Symptoms of white superficial nail fungus.Opal white spots appear in the area of the back pad, which completely cover the entire nail during the reproduction of the fungus.The spots tend to coalesce and may visually resemble scattered fine powder.

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

breaking a nail;
changing the color of the plate;
nail phalanx dissection;
painful sensations that occur during the progression of the pathological process;
Itching of the skin may occur in the area around the nail.

Causes of toenail fungus

Toenail fungus always occurs as a result of infection with mycotic organisms.Most often they are dermatomycetes.Increased keratophilicity is a distinctive feature of fungi included in this group.They have a wide range of proteolytic enzymes that help them penetrate the skin and nails.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:

From below the distal (free, lateral) edge of the nail.In this case, the pathological process is localized under the plate - in the bed, and not in the nail itself.As the fungus grows, subungual hyperkeratosis develops.This leads to the deterioration of the connections between the bed and the plate, followed by their separation.The fungus entered the nail from the bed and slowly destroys it.
Through the dorsal part of the nail, fungi rarely reach its depth.This method of distribution is available only for dermatomycetes with pronounced keratolytic abilities.In this case, the process of destroying the nail itself will be much faster.
The rarest route of spread is through the proximal ridge.From the last part of the matrix, the fungus penetrates under the nail plate and into the bed, or settles in the matrix, from there it destroys the collagen structures of the nail phalanx.If the nail damage is caused by fungi of the genus Candida, then the proximal ridge will be involved first in the pathological process with its swelling and thickening.However, 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 detergents containing synthetic components, constant contact with water, use of degreasing agents, etc.
Wearing things made of synthetic materials, wearing uncomfortable narrow shoes.As a result, a favorable moist and warm environment is created in which fungi multiply rapidly.
Sympathetic type of autonomic regulation, during 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 foot aeration significantly worsens.
Nail growth rate.
Non-compliance with personal hygiene rules.
Immune system dysfunction.Moreover, nail fungus is not the only disease that has a reduction in protective powers.Other organs are also susceptible to mycotic damage.
Varicose veins.
Climatic characteristics of the area where people live.More often, fungal infections affect people who live in areas with a temperate or cold climate.The fact is that there you often have to wear warm clothes, thick and tight shoes, which creates favorable conditions for the functioning of the fungus.Populations of subtropical countries are also at risk, since the development of the fungus is facilitated by high humidity and general ambient temperature.
Age-related changes in the human body.More often, toenail fungus is diagnosed in the elderly and the elderly.However, dermatologists and mycologists note an increasing trend of frequency in adolescents and children.Thus, statistics indicate that every 10 years of life increases the risk of infection by 2.5 times.While the probability of a mycotic infection in childhood is 3%, this figure increases to 50% in the elderly.Experts attribute such indicators to the fact that with age, the rate of growth of the plate slows down, nutrition of the bed worsens, and angiopathy develops.
gender.It was found that men get sick almost three times more often than women.However, it is men who seek qualified help less often.
Profession expenses.Fungus on the legs is more often found in miners who serve nuclear power plant workers and metallurgical plant workers.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 about fungal infections of sauna, bath and laundry workers are becoming more frequent.Masseurs, orthopedists, employees of rest houses and other representatives of service personnel are frequent guests of mycologists.
Associated pathologies.In this regard, the greatest danger is diabetes mellitus, foot deformities, overweight, gastrointestinal diseases, metabolic disorders, thyroid gland pathologies, any peripheral angiopathy, for example, with lymphostasis or venous insufficiency.HIV infection increases the risk of nail fungus by 5 times.(Also read: HIV causes, symptoms, diagnosis and prevention)
Taking antibacterial drugs, corticosteroids and cytostatic drugs.

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

visiting saunas and baths, swimming pools and public showers - any public place where people walk barefoot for some time;
the use of common (even in the family) household items, such as cloths, slippers, pumice stone, rugs;
Conducting cosmetic procedures, in particular pedicure, in beauty salons where hygiene standards are not observed.

It should be noted that the greatest danger in this regard is wooden floors, chairs and other items made of this natural material.The fact is that the wood has a porous structure and it is almost impossible to wash the mushroom mycelium from it.

Why is athlete's foot 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:

Prevalence of mycosis of the skin and its appendages in the presence of immunodeficiency conditions.
Development of diabetic foot against the background of diabetes mellitus.
Development of erysipelas of the lower limbs.
Development of elephants.
Development of lymphostasis.
Development of invasive mycosis in patients undergoing immunosuppressive or cytostatic therapy.
Disturbance of the growth of the nail and its turning into the surrounding tissues, which is accompanied by severe pain and an inflammatory reaction.
development of eczema.
Addition of bacterial infection and development of inflammation.
Loss of the nail plate, exposure of the nail bed.
The development of aspergillosis (ie, infection with mold fungi), the therapeutic treatment of which is difficult.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Fungus on the feet never affects the nail at the same time.

The disease often progresses slowly and goes through several stages of development:

The early or initial stage is marginal damage.In this case, any pathological changes are practically invisible.The manifestation of the process is manifested in the appearance of narrow gray stripes located in the area of the free edge of the nail.
The stage of normotrophic damage to the nail plate.When the 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 under the nail.
Stage of hypertrophic damage.First, onyshoxysis is formed - a subcutaneous injury, the nail thickens and hypertrophy increases.The plate changes color and, depending on the type of pathogen, breaks, peels, thins, stops growing or is deformed.As a result, the nail is completely lost.

The initial stage of toenail fungus

Most often, the infection is preceded by an injury to the skin of the leg.An itching sensation appears in the interdigital folds, cracks, blisters and maceration may appear.When the fungus penetrates deep into the nail, it begins to affect one or another of its edges.It largely depends on the type of pathogen and the route of infection, which was 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 invisible to the naked eye.Detection of the disease is possible in laboratory conditions.

Prolonged toenail fungus

Advanced toenail fungus is characterized by complete damage to the nail phalanx.With prolonged absence of therapy, the probability of not only the complete destruction of the nail, but also the damage to the skin, as well as the spread of the disease to the nails of the hands, increases.

The main indicator of the advanced stage of the disease is breaking, separation and deformation of the nail.Thinning of the nail body and changing its color occurs gradually over many years.A rapid transition to the total stage of the disease is possible only against the background of existing systemic diseases, which are most often manifested in old age.The final stage is the destruction of the nail plate or its severe deformation, as well as the development of serious complications that can be caused by the fungus on the feet.

How to get rid of toenail fungus

The modern pharmaceutical industry offers a wide range of effective medications to people diagnosed with toenail fungus.There are both local and general remedies.

It is the abundance of available antimycotic drugs that makes it difficult to choose an independent drug.After all, the fungus can affect not only toenails, but also mucous membranes, any organs and tissues.Therefore, it is very important to undergo a comprehensive diagnosis and receive medical recommendations regarding the treatment of nail fungus.

Therapeutic tactics are based on four points:

registration of the affected area;
the time that has passed 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 accumulate in the thickness of the nail plate, staying 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 completely remove the problem.It is important to have an integrated approach to therapy, combining local treatment with oral medications.Here the question arises, how to choose a medicine and get rid of toenail fungus?Below we will discuss all modern types of medicines.

Antifungal nail polish

When the toenail fungus has not reached an advanced stage, only local therapy can be used.For this purpose, specialized patches 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 look more attractive, you can apply nail polish over the treatment polish.

To achieve the maximum effect of treatment with nail fungus stain, you must follow certain rules:

You should not complete the treatment on your own until you receive laboratory data indicating the absence of fungus in the nail;
Applying varnish should be regular and without skipping;
Treatment can last up to a year and is a necessary measure to eliminate the mycotic organism.

Toenails have a greater ability to accumulate drugs than fingernails.You should not combine patches, because their therapeutic effect will be lower.

There are also some contraindications for therapy using antifungal patches:

lactation period;
fruiting;
individual intolerance to the components of the drug;
childhood.

Sometimes reddening of the skin around the nail is possible.

Rules for using antimycotic patches:

Using a nail file, you need to remove as much of the affected nail as possible;
clean the surface of the nail using a solution containing water and alcohol, or use a soap and soda bath on the nail steam;
use the tool;
Once a week it should be removed using a common solvent.

Means for removing nails affected by fungus

Before applying the nail remover, you need to steam your feet in water containing 1 teaspoon of liquid soap and baking soda per 1000 ml.Then the feet are dried, the skin around the damaged nail should be fixed using adhesive plaster.Apply the product to the affected area with a thick layer, but without packing.The upper part of the nail is also fixed with adhesive plaster.

After 4 days, the plaster is removed, the feet are steamed, and the nail affected by the fungus is simply cut with manicure tools.

Antifungal tablets

Systemic antibacterial agents are needed in cases where the 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 fungus, but some of them are incompatible with hormonal contraceptives, some cannot be taken in childhood, and some are prohibited for use in case of liver problems.

Local treatment with cream, spray, ointments

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

However, complete recovery can only be verified by conducting tests that patients undergo 14 and 30 days after the end of therapy.If the skin on the legs begins to peel and redden during the treatment, this is a manifestation of an allergy that occurs in response to the use of the drug.Therefore, it is important to stop the treatment in time.

other means

Oils: tea tree and lavender.As for lavender oil, it can eliminate irritation, while tea tree oil helps fight bacteria.However, it is important that the oil is natural;Only in this case they can get 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 antimycotic treatment.

laser treatment

Treatment of diseases with a laser beam is a method of physiotherapeutic treatment.It can only be used in conjunction with antifungal agents to achieve the effect.Laser therapy alone cannot completely eliminate nail fungus.This procedure aims to improve nail nutrition and increase blood circulation.As a result, the antimycotic drug penetrates better into the damaged plate.However, the laser itself cannot kill the fungus.

This method has no contraindications and reduces the risk of recurrence of the disease.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 toenail fungus will not harm him even after infection, since the immune system neutralizes it on its own.If the fungal infection has spread to the nail plate, then it is necessary to choose the best methods to fight against it.

This is a rather time-consuming process, so the following preventive measures will help you avoid infection:

avoiding walking barefoot on the beach;
Closed rubber slippers are optimal footwear for saunas and baths;
Socks for everyday wear should be made of cotton fabric;
it is forbidden to wear other people's shoes;
Your feet should be dry.