Toenail Fungus


Fungal Toenails

Toenail Fungus is an Infection

The Good News? It is rarely invasive and most fungus infections of the toenails do not cause pain.

The Bad News? If the nails are excessively thick they may cause pain from footwear or may become painfully ingrown into the skin.

More Bad News? Toenail fungus looks awful. Most patients do not want their toenails looking bad. It conveys an image of disease that most people do not want others to see. 

Why me? Toenail fungus is most common in adults who work in warm or wet conditions, where the feet are enclosed in shoes or boots for hours on end. Living and working in Arizona is perfect for fungus. Fungus thrive in moist, dark, warm environments such as the inside of a sweaty shoe or sock. 

Nail infections often begin with injured nails. If you've ever lost a toenail because of an injury or bruised the toenails from running or hiking, your infection may have started there. 

     PAS Stain: Gold Standard Diagnostic          Testing

Why is it so hard to treat? Toenail fungus infections usually originate under the toenail, where it is difficult for most topical medicines and home remedies to reach.

Toenail Fungus can be caused by many different organisms.  

Dermatophytes are the most common organisms. They typically cause infections from underneath the toenail. Nails are usually brown or yellow in color and crumbly with much debris under the nail.

Molds can infect either the top surface of the nail or under the nail. Colors vary from yellow to black and also result in a thick nail. 

Yeasts usually infect the top of the nail but can infect under the nail as well. Yeast infections often cause white debris on the surface of the nail or under the nail. It can also cause redness, irritation and pain to the skin around the nail.

How Does Dr. Clement Approach Toenail Fungus? We start with getting the right diagnosis. The species of fungus affecting your toenails is only susceptible to certain medicines. We determine the fungus species using PAS histopathology and sometimes fungus cultures. 

How is Toenail Fungus treated? In most cases, a combination of treatments is most effective. Combinations may include pills such as Lamisil or Sporanox, topical medicines such as Jublia, tolnaftate or nystatin, and cutting away the infected portion of toenail.

We Tailor Treatment to Your Toenail. Whether treatment with pills, topicals, cutting away the nail, or a combination of the above, we do it all. Studies show combination treatments to be the most effective.

What about Recurrence? Remember, the infection is an infection. Just like you get a cold every so often, it is possible for treated toenails to be reinfected. 

You can prevent re-infection by good foot hygiene including daily washing with soap and water, changing socks frequently, bleaching socks, and alternating shoes.  Our Fungus Prevention page also lists more ways of preventing fungus.

See our Self-Treatment page for tips on how to increase your odds of success with home remedies and topical medicines. Or, call for an appointment to have your nails examined and tested for fungus.