Curing nail fungus is hard, but it is possible to have pretty toes again. With the arrival of spring, it’s time to put away the leather boots and bring out the slinky sandals and flip-flops. Are your feet ready to bask in the sun for all to see? Or are you cringing at the thought of stripping off those wool socks you’ve been hiding behind? After all, there’s nothing cute about toenails that are thick and yellowing from nail fungus.
If you’ve got a nasty case of nail fungus, you’re not alone. The condition affects millions worldwide and, while it’s just a cosmetic issue for most people, it can have serious health implications for those with diabetes and compromised immune systems.
“Fungus is everywhere,” says Dr. Howard Roesen with Affiliated Podiatrists in Newport News. “It likes areas that are dark and warm, and your feet are in shoes a lot, so that sets you up for getting a fungus in the nails.”
The elderly, people with diabetes and circulation problems, and athletes are the most prone to nail fungus, but the condition doesn’t discriminate.
“It’s just around, looking for an opportunity to get into the nail,” explains Dr. Patrick Agnew with Coastal Podiatry Group in Virginia Beach. “You don’t have to go to a locker room or nail parlor to catch it. You can find these organisms on your bedroom floor.”
Distal subungual onychomycosis is the most common form of nail fungus, where the organism infects the space between the tip of the nail and toe. The nail plate slowly detaches from the skin, and the nail usually turns a grimy yellow, brown or green. Foul-smelling debris, or “toe cheese” as some people call it, collects under the nail. At this stage, nail fungus is still just a cosmetic issue. You can usually paint a coat of pretty rose polish over it, and forget about it.
But as the fungus grows, it causes the nail plate to become thick and hard. Sometimes the nail completely detaches from the bed, and the condition can become painful.
“In many cases, like in a patient with diabetes, it may be a bigger problem than the patient realizes,” Agnew says. “If their nail gets thick and they get a sore under the nail [that becomes infected], they can lose their leg, and this happens a lot.”
The American Diabetes Association recommends annual foot exams for all diabetics since they are prone to developing foot infections that can lead to amputations.
There are three common treatments for curing nail fungus: topical, oral and laser.
“There are many over-the-counter [topical] products, none of which I am aware of have strong scientific evidence that they work, and none of which can claim they can cure it,” Agnew says.
Oral medications Lamisil and Sporanox have better success rates with curing nail fungus, but in rare cases can cause liver damage and have unwanted side effects.
The newest treatment involves using a laser on the infected nails.
“That’s really the latest and greatest, and it’s good because there are really no side effects for doing it,” Roesen says.
None of these treatments will cure your nail fungus in time for sandal season, but by next spring, you should be able to go au naturel again.
“All medicines take a year to work,” Agnew says. “The nail that has been impregnated with the medicine [or been treated with the laser] has to slowly replace the diseased nail.”
Did You Get More Than A Pedicure?
Nail fungus can be passed from customer-to-customer if salons fail to properly clean their manicure/pedicure tools.
- Visit dpor.virginia.gov to confirm the salon you plan to visit is licensed.
- All equipment, like nail clippers, must be sanitized between customers.
- Disposable items, like nail files, must be thrown away after one use.
- Pedicure basins must be drained and disinfected between customers.
Originally posted April 5, 2013. Updated April 2, 2019