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Toenail fungus, or onychomycosis, is a common fungal infection that usually affects the toenail but can spread to the fingernails too. In most cases, 90% of the toenail becomes infected and turns thick, rough, and distorted with off-colored staining. (1)(2)
This infection accounts for nearly half of all nail disease cases. It is more common among older adults, affecting 20% of those above the age of 60 years, 50% of those above 70 years, and 10% of the global population overall.
This article will discuss everything you need to know about treating this infection.
Mode of Transmission
Toenail fungus is highly contagious and can easily spread through:
- Direct contact: Touching the infected toenail or skin
- Indirect contact: Touching surfaces that have been contaminated with the fungus that falls with the dead nail or skin cells that shed from the infected area
Indirect transmission is more common than direct transmission for this fungal infection.
Home Remedies for Toenail Fungus
Here are some things you can do to thwart toenail fungus:
1. Use colorless nail polish
Nail polish containing antifungal agents such as amorolfine or ciclopirox olamine can help get rid of toenail fungus. Many people have reported successful results after using colorless nail polish as a topical remedy for this infection. (3)
Amorolfine nail lacquer is usually applied once a week, and ciclopirox is applied daily to the affected nails.
How to use:
- Trim and file the infected nail as much as you comfortably can.
- Wipe off the old layer of polish with an alcohol-based remover.
- Apply the new layer.
Amorolfine-containing nail polishes should only be applied once or twice a week, as this compound is not water soluble and prolonged application can be bad for the nail.
Ciclopirox is water soluble and therefore can be applied every other day throughout the first month. You can bring this down to twice a week in the second month and then once a week in the month after that.
2. Apply Vicks VapoRub
Vicks VapoRub contains several potent compounds including thymol, menthol, camphor, and oil of Eucalyptus, all of which exhibit antifungal activity.
Thus, Vicks VapoRub works as a strong antifungal agent for clearing toenail fungus with gradual results but little to no side effects. (4)
How to use:
- Clean the infected area and let it dry.
- Apply Vicks VapoRub to the affected area with a clean finger.
- Wash your hands with soap thereafter.
3. Try a mentholated topical ointment such as camphor/menthol
How to use:
Apply the ointment to the infected area once every day until you see improvement. It can take several weeks for the results to show, so be patient and consistent.
4. Treat with essential oils
Essential oils are a safe and effective topical remedy for onychomycosis. The infection-causing fungus has little to no resistance against it. (7)
One study demonstrated the effectiveness of a combination of essential oils along with vitamin E in treating onychomycosis. This antifungal mix helps control the fungal growth, repair the infected nail, improve the patient’s adherence to treatment, and lower the risk of recurrence to facilitate complete recovery. (8)
How to use:
- Mix a few drops of tea tree oil in 1 teaspoon of olive oil or coconut oil.
- Using a clean cotton swab, dab this mixture over the infected toenail, 2–3 times daily.
5. Consider snakeroot extract
Snakeroot extract (Ageratina pichinchensis) was found almost as effective as ciclopirox in terms of their antifungal activity. (9)(10) Plus, the aerial parts of this plant have been used in Mexican traditional medicine for treating skin mycosis, which is a fungal infection. (9)
How to use:
Apply this extract to the infected area 2–3 times per week until you see results.
6. Use garlic
Research has shown that garlic extract has antifungal activity that can help curb the fungal growth responsible for onychomycosis. However, this should not be used as a standalone cure for toenail fungus, but rather as an adjunct to your prescribed antifungal medication. (11)
Still, more broad-based human trials are needed to verify and solidify this claim.
How to use:
- Chop garlic cloves into halves.
- Apply their exposed side to the infected nail for 20–30 minutes, once a day, for up to a week.
Note: Garlic is a pungent ingredient that can be a little harsh on the skin, especially sensitive skin. So, be careful when using it for the first time. Conduct a patch test on a small area of normal skin to rule out any irritation or adverse reactions.
Cause of Toenail Fungus
Onychomycosis can be caused by the overgrowth of certain fungi, such as dermatophytes and yeast, in your toenail. (12) The fungal spores may be airborne or live naturally on the skin and find their way to your foot or toenail.
The fungi thrive in warm and humid conditions. So, if your feet remain damp or sweaty, these microbes will multiply rapidly and give rise to an infection.
Any crack or tear in the skin or nail can provide the fungi entry into the deeper tissue. They sustain themselves by feeding on the nail tissue, and they slowly penetrate the skin under the enamel.
As the fungal debris collects under the nail enamel, it starts to thicken and rise above the nail bed. This damaged and discolored part of the nail will not heal and reattach to the nail bed again but will eventually grow out. (12)
Symptoms of Toenail Fungus
Common symptoms of toenail fungus include the following:
- The infected toenail gradually becomes thick and turns yellow, brown, or white.
- Since the infection weakens the nail, it may develop cracks.
- There is generally no pain, but the infection becomes progressively severe.
- In some cases, toenail fungus may be accompanied by athlete’s foot, which is also a fungal skin infection that affects the foot, especially the area between the toes.
How to Protect Your Toenails
Here are a few tips to protect your feet from infection:
- Keep your feet clean and dry: Wash your feet every day with soap, and make sure to dry them (especially the area between the toes) before wearing socks or shoes. If your shoes or socks become damp, change out of them as soon as possible. If your feet sweat a lot, put some antiperspirant powder on the insides of your socks or shoes. Also, wear socks that wick away moisture from the skin such as acrylic.
- Use antifungal powder: Sprinkle some antifungal powder on the insides of your footwear every day to keep infection away.
- Choose the right footwear: Wear shoes made with a breathable fabric that allows airflow inside to keep your feet ventilated. Poor ventilation inside shoes leads to excess foot sweating, creating the perfect warm and humid climate for infection-causing fungus to grow. If you do develop a foot or toenail infection, it’s best to wear slippers and sandals as much as you can.
- Protect your feet: The damp floors of public washrooms, community swimming pools, and gym locker rooms are hotbeds of fungal infections. You can easily contract athlete’s foot or toenail fungus by walking barefoot on such contaminated grounds. So, it is important to always wear sandals or flip-flops in such places.
Risk Factors of Toenail Fungus
Some factors can make you more susceptible to this infection or can exacerbate the condition. These include:
- Contracting athlete’s foot or a history of this infection
- Old age
- Previous nail trauma due to injury or surgery
- Wearing occlusive footwear
- Partaking in sporting activities such as running or swimming
- History of fungal infection anywhere on the body (5)
- Preexisting conditions such as diabetes, psoriasis, blood circulation problems, and other immunocompromising ailments
Complications Associated With Toenail Fungus
If left untreated, the infection can spread from the toenail to surrounding skin, other nails, the foot, and even other parts of the body.
Delayed treatment can also trigger or exacerbate other skin conditions such as atopic dermatitis and hives. (5)
Most-Asked Questions About Toenail Fungus
What is the best treatment for toenail fungus?
The most commonly prescribed treatment for toenail fungus is an oral antifungal medication called terbinafine. Multiple recent studies claim it to be more effective than other available interventions.
What about using hydrogen peroxide at home?
Hydrogen peroxide is credited with strong antifungal and antiseptic properties that can help eliminate toenail fungus, but it is very harsh at its original consistency.
Directly applying it to your skin or nail can cause extreme dryness, stinging, and irritation. So, it is recommended that you mix it with water to dilute its potency before topical use. It’s highly recommended to consult your doctor before trying this potentially useful but somewhat risky remedy.
Toenail fungus can spread easily and tends to get worse if not cared for properly. Even milder cases can take a long time to heal, and you run the risk of infecting other people or other areas of your body. So, exercise proper foot hygiene and follow the recommended treatment.
You can use the above-listed home remedies in conjunction with your doctor-prescribed meds for faster and better recovery. But bear in mind that this is a stubborn infection that will heal in its own sweet time.
If your symptoms fail to improve or become more severe, consult your podiatrist immediately. Also, remember that this infection has a tendency to come back after healing, so you must continue practicing proper foot care to avoid recurrent episodes.