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What Are the Different Types of Toenail Fungus?

cartoon boy with green fungus growing out of toenails

Fungal nail infections are quite common. According to the CDC and the American Podiatric Medical Association, they occur in approximately 14% of the population. Fungal infections affect fingernails and toenails both. However, toenail fungal infections are more common due to the damp environment created by wearing shoes and socks. 

Please continue reading to learn more about the different types of fungal toenail infections. We will discuss how this skin condition is treated and also talk about what you can do to prevent toenail fungus.

Who is at risk of fungal nail infections?

Anyone can get a toenail fungus infection. However, older people and those with a nail injury, foot deformity, diabetes, venous insufficiency, a weakened immune system, or poor overall health are at higher risk. Risk factors for nail fungus also include fungal skin infections of the foot called athlete’s foot (tinea pedis or ringworm of the foot). In rare cases, a bacterial infection can occur on top of a fungal infection of the nails and cause serious problems.

What does nail fungus look like?

Some people find toenail fungus painful. However, most people seek treatment because they are bothered by the appearance of their toenails. Common symptoms of a fungal nail infection include a thickened, cracked, rough, or crumbly nail surface. Toenail fungus can also cause discolored nails and lead to nail separation. The infection can start in one nail and spread to other nails.

What is the most common nail fungus infection?

Toenail fungal infections can be caused by different types of fungi found in the environment. The fungus enters the nail through small cracks in the nail bed or breaks in the surrounding skin. Here are the most common types of fungal infections of the toenails. 

Subungual Onychomycosis

This type of toenail fungus is called tinea unguium. It is the most common nail fungus and is caused by fungi called dermatophytes, which also cause athlete’s foot. The infection starts under the nail (distal subungual onychomycosis), near the base of the nail (proximal subungual onychomycosis), or along the side of the nail (lateral subungual onychomycosis). 

White Superficial Onychomycosis

This type of fungal nail infection is caused by fungal species called Acremonium or Fusarium. The infection is present only in the top layer of the nail and is relatively easier to treat. 

Candida Onychomycosis

This type of fungal infection is caused by a yeast called Candida. Candida infections are less common in the nails, although they are quite common in other parts of the body, such as the throat, vagina, and gastrointestinal tract. 

How do I know what type of toenail fungus I have?

Most cases of toenail fungus are not serious. However, it is important to have your toenail fungus diagnosed by a healthcare provider. A doctor can tell you what type of nail fungus you have by examining your toenails. They may need to send a sample of your nail clipping or a scraping from your nail bed to the laboratory to find out the type of toenail fungus. Some other skin conditions can be confused with nail fungus, such as a bacterial nail infection, or a non-infectious condition like psoriasis. Knowing what is causing the symptoms can help your doctor prescribe the best treatment for your nail infection. 

Does tea tree oil for toenail fungus work?

Tea tree oil and eucalyptus oil are natural substances that are believed to have antibacterial properties. They are often used to treat conditions ranging from acne to insect bites, lice, athlete’s foot, and nail fungus. However, there is no evidence that tea tree oil is a good topical treatment for toenail fungus. In other words, you should not rely on tea tree oil to cure your toenail fungus. 

There is some evidence that the application of tea tree oil twice a day for a month may relieve symptoms of athlete’s foot. In general, this is a safe product to use for acne and superficial skin infections. But keep in mind that there are no standardized methods of extracting tea tree oil, so results can vary.

How do doctors treat nail fungus?

Fungal nail infections do not usually go away on their own. They can be difficult to cure and may take several months to a year to clear. Treatment options consist of topical medications, oral medications, and laser treatments. The treatment tends to be most successful when started early. 

The best medical treatment for nail fungus is a prescription oral medication (antifungal pill) such as griseofulvin, terbinafine, or an azole antifungal (itraconazole, fluconazole, and others). Oral antifungals (medications taken by mouth) work better than topical treatment or laser treatment. However, if you find it more convenient, you can ask your healthcare provider about a medicated antifungal nail polish called ciclopirox (Penlac).

In severe cases of toenail fungal infections, it may be necessary to remove the nail completely. 

Treating onychomycosis (fungal nail infections) is important. Failure to do so can lead to the spread of the fungal infection to the other toenails or other nail problems. The infection can also spread to the skin of the feet and other parts of the body. For this reason, it is important to be properly treated for all fungal infections at the same time so that the infections do not spread from one part of the body to another.

Some fungal nail infections can come back after treatment, especially in people with diabetes or a weakened immune system. You should talk to your healthcare provider if this occurs. 

How to know if toenail fungus is dying? 

You can tell that toenail fungus is dying, and your fungal nail infection is clearing if your toenail grows with a clear color near the base and has decreased thickness. These are signs of healthy new growth and indications that the treatment for nail fungus is working.

How long does it take to cure fungal nail infections?

Nail fungus can be difficult to get rid of. It can take weeks, months, or even longer for toenail fungus treatment to work. This is because toenails grow very slowly, at a rate of approximately 2 mm per month. The nail bed needs to grow out completely before you can consider toenail fungus cured. 

How to prevent a fungal infection of the nails?

Here are some tips on preventing fungal nail infections:

  • Keep your hands and feet clean and dry. Wash them with soap and water, and don’t forget to clean between the toes.
  • Wear shoes that fit well and dry socks.
  • Make sure you keep your fingernails and toenails short.
  • Wear shower shoes and avoid walking barefoot in public areas like locker rooms and public showers.
  • Never share nail clippers with others.
  • Make sure your nail salon is clean and that they disinfect tools between customers. 

 

References:

  1. https://www.cdc.gov/fungal/nail-infections.html
  2. https://www.mayoclinic.org/drugs-supplements-tea-tree-oil/art-20364246