White fungus under toenail


What is the best home remedy for toenail fungus?

Toenail fungus is a common infection of the toenails. It is contagious, so it can often start in one toenail and spread to several others.

Medical treatment usually involves the use of prescription-strength antifungal medications. Though effective, some people experience unpleasant side effects, ranging from upset stomach to other skin issues.

As a result, some people may choose home remedies to treat toenail fungus. The following are some of the more popular home methods that people have tried to treat toenail fungus.

Baking soda

Share on PinterestThere are a number of popular home remedies that may help treat toenail fungus.

Baking soda soaks up moisture that may cause toenail fungus. In one small study, researchers studied the effect of baking soda on common fungi that cause infections, such as toenail fungus.

The researchers found that baking soda prevented fungal growth in 79 percent of the specimens tested. In another 17 percent, baking soda reduced fungal growth, though it did not eradicate it.

How to use it

A person can try putting baking soda inside their socks and shoes to soak up moisture.

People can also apply a paste of baking soda and water directly to the affected nail and let it sit for at least 10 minutes before rinsing. Repeat this several times a day until the fungus clears.

Mentholated topical ointment

Mentholated topical ointments could help treat toenail fungus.

Doctors often recommend these types of ointments to help treat cough and cold symptoms. The same active ingredients in mentholated ointments — menthol, eucalyptus oil, and camphor — have other properties that may be effective in treating toenail fungus.

One small study examined the use of one of these ointments to treat toenail fungus. All 18 participants reported being satisfied or very satisfied with the results of using the rub on their toenail fungus. However, mentholated topical ointment cured just five participants at the end of the 48-week-long study.

More research is needed to prove further that a mentholated ointment is an effective option for treating toenail fungus.

Apply mentholated ointment directly to the affected nail. Do this about once a day for several weeks or until the nail shows noticeable improvements.


Vinegar is a common household product found in cooking and some home cleaning solutions. Though no clinical evidence exists to date, there is anecdotal evidence to suggest that vinegar is an effective tool to help treat toenail fungus.

Anyone interested in trying vinegar can apply vinegar directly to the affected nails by soaking the toes in a bowl of warm water mixed with vinegar. People should use a 2–1 mix of water to vinegar.


As with vinegar, there is no direct scientific evidence to support using mouthwash to treat toenail fungus. However, some studies suggest that many types of mouthwash have antifungal properties.

One study reports that seven commercial types of mouthwash showed some antifungal activity in laboratory samples.

Try soaking the toenails in a small bowl of mouthwash.


Typically used for seasoning food, garlic may help treat toenail fungus as well. Though limited, there is some evidence to support this claim.

One study found that a garlic extract showed strong antifungal properties against fungi that cause fungal infections in laboratory samples. Another study also reported promising results for garlic oil against certain strains of fungus, again in lab-based samples.

Many people use chopped cloves of garlic to help treat their toenail fungus. To use garlic, chop up a clove and apply it to the affected nails and leave it on for about 30 minutes.

Be careful when using garlic to treat toenail fungus, as raw garlic can sometimes cause a chemical burn on the skin.

Snakeroot extract

Snakeroot is not well-known in the United States but is a traditional treatment for fungal infections in Mexico. Snakeroot, also known as Ageratina, is a part of the sunflower family and is known for its antifungal properties.

One laboratory review observed that specific compounds within snakeroot showed antifungal properties against strains of fungus that can cause athlete’s foot.

Another recent but small study found no significant differences in the results for treating vaginal yeast infections with snakeroot extract compared with a common antifungal medication.

Those interested in snakeroot extract can buy it at specialty stores or online. People can apply the extract to affected toenails two to three times a week. Treatment typically lasts for about 3 months.

Essential oil blends

Share on PinterestIt may help to apply essential oils with antifungal properties to the affected nails.

Blends of certain essential oils may have an antifungal effect when applied to fungus.

These blends included:

  • lavender oil
  • petitgrain oil
  • clary sage oil
  • ylang ylang oil
  • jasmine oil

One study suggests that blends of these oils have an antifungal and antimicrobial effect in laboratory samples. However, the efficacy depends on the mix of the oils and the amount of the chemicals linalool and linalyl acetate that the oils contain.

How to use them

A person interested in trying a blend of essential oils can buy the oils online or from a health food store. Mix the oil with a carrier oil before applying the mixture to the affected nails.

Ozonized oils

Ozonized oils are oils infused with ozone gas. Examples of oils that are available in ozonized form include sunflower oil and olive oil.

According to one study, ozonized oils show positive effects similar to a traditional medication called terbinafine cream in treating one type of fungus. In this study, the researchers used rabbits to test the effectiveness of the treatment.

Another study carried out on 400 people tested how ozonized oils affected fungal infections. In this 2011 study, researchers used ozonized sunflower oil to treat toenail fungus.

Their results indicated that ozonized oils cured up to 90.5 percent of the total infections with only a 2.8 percent relapse rate after 1 year. The researchers concluded the ozonized sunflower oil works more effectively than ketoconazole cream, which is an antifungal medication.

To use ozonized oils, apply the oil to affected nails twice a day for 3 months.

Olive leaf extract

Some researchers have identified olive leaf extract as a potential home remedy for toenail fungus. People have used olive leaf extract for centuries, though not many people in the U.S. use it, today.

According to one review, olive leaf extract is a safe way to help treat toenail fungus.

However, olive leaf extract may cause potential side effects. These include flu-like symptoms, such as:

  • fatigue
  • head and muscle aches
  • vomiting and diarrhea

A person should start slowly to help avoid the side effects. If taking capsules, a person can typically take between one and three capsules two times a day with a meal once they are used to them.

Dietary changes

Share on PinterestIncluding iron-rich foods in the diet can help prevent brittle nails.

A person can change their diet to improve their overall health. Though no clinical evidence suggests a dietary change can cure toenail fungus, certain diets may help improve a person’s overall health and well-being.

Diets should include plenty of nutrients. In particular, a person can eat foods rich in vitamins, minerals, and other materials that help aid nail growth and development.

Some foods to include in a nail-healthful diet:

  • any food rich in calcium and vitamin D
  • fatty acids found in oily fish, such as salmon
  • yogurts that contain probiotics
  • food rich in lean protein to help nail growth
  • foods rich in iron to help prevent brittle nails, such as spinach

When to see a doctor

Toenail fungus is not a significant problem for most people.

Those most at risk for complications are people with diabetes and those with weakened immune systems. People in either of these groups should seek medical treatment for their toenail fungus and avoid home remedies altogether.

Any person who does not see improvements or has complications as a result of home remedies should talk to their doctor and stop using the home remedy as soon as possible. Always speak to a doctor before trying any treatment for toenail fungus.


Home remedies for toenail fungus may be a safe alternative to traditional medications. In most cases, the remedies are considered safe and simple to apply.

When purchasing alternative remedies and supplements, it is essential to buy from a trusted retailer. These treatment options are not regulated by the U.S. Food and Drug Administration (FDA) in the same way as medications, and so people should take more care when buying them.

A person should speak to their doctor if they have any doubts about treatment, if their infection is not clearing, or they have underlying conditions, such as diabetes.

It’s popularly known as athlete’s foot. But the single term actually encompasses two conditions: foot fungus and mycotic nails – sometimes called fungal toenail infections – and they are very common. That is probably because exposing yourself to the fungus that causes them is easy to do.

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This is especially true if you walk barefoot through communal areas such as locker rooms, public showers, swimming pools or steam baths.

For most people, the cracking or peeling skin or the crumbly, yellow toenails that the fungus causes are an itchy, painful irritation and a cosmetic embarrassment in public. But for some people, it’s a serious condition.

“For patients who are diabetics and those who are immune-compromised, it’s important to address those issues,” says dermatologist Pamela Ng, MD. “The fungal infections can cause breakdown of the skin and lead to conditions like cellulitis or foot ulcers.”

See a dermatologist to pinpoint the problem

If you think you have a foot or toenail fungus, first and foremost, see your dermatologist. There are several tests that your dermatologist can perform to identify the problem.

These infections won’t just go away on their own, Dr. Ng says. So, for safety’s sake, you need to confirm exactly what the cause is.

“It’s important to be aware that there are other diseases which can cause nail changes.” she says. “For example, we do see things like squamous cell skin cancers in the nail beds and even melanomas, which have a brownish or blackish discoloration.”

Doctors weigh best treatments

Right now, the best treatment for fungal nail infections is a pill that your dermatologist can prescribe. You must take it every day for two to three months.

The pill is not for everyone, since oral antifungals can interact with other medications and can affect the liver.

There was a topical solution that people used to paint on their nails, but it wasn’t very effective, Dr. Ng says and she does not prescribe it very often any more.

Fortunately, a prescription topical cream, efinaconizole, has a success rate that is comparable to the oral medication.

Unfortunately, even if your nail is cleared after a treating it, fungal infections in the nails have a tendency to recur, especially in predisposed individuals.

Over-the-counter cream may help

If your foot fungus infection is only on the skin of your feet, then Dr. Ng recommends an over-the-counter antifungal cream.

“I like the creams better than the sprays or powders because the creams will completely coat the foot and treat the entire skin surface,” she says. “Make sure that you get in between the toes, because that’s really where we see the most problems in those warm, moist areas.”

Various lasers are also being used for nail fungus. However, further studies are needed to establish the efficacy of lasers in the treatment of nail fungus, Dr. Ng says. Laser therapy for nail fungus is usually not covered by insurance.

The danger of waiting to treat the fungus

The greatest danger of not treating the foot or toenail fungus is that it can spread to other parts of the body, such as the hands and groin.

If for some reason you can’t treat your toenails, at least use an antifungal topical cream on the surrounding skin, Dr. Ng says. That will help keep it from spreading and keep the skin intact.

The best ways to avoid the fungus? Wear shoes or flip-flops in communal areas. Avoid sharing shoes and make sure you protect your feet at home if a family member has the infection.


1. Dab on Vicks VapoRub

Vicks VapoRub contains known antifungal ingredients such as camphor and eucalyptus oil, Graedon says.

In a small study published in the Journal of the American Board of Family Medicine, 83 percent of people who used a cotton swab to apply a small amount of Vicks to an affected nail at least once a day reported improvement, while almost 20 percent got rid of the infection entirely.

How to use it: Follow the study participants’ lead and use a cotton swab to apply a small amount of Vicks to the affected nail once a day. For best results, apply the solution when you have time to let it dry before putting on socks or shoes.

2. Soak in Listerine and white vinegar

The combination of Listerine’s antifungal ingredients (such as thymol and menthol) and vinegar’s acidity makes an inhospitable environment for fungi. “This treatment is effective for green nails which may have what’s called ‘atypical organisms,’” says Dr. Goldenberg. If you have true toenail fungus, it’s less likely to work, though.

How to use it: Combine the two in equal portions and soak your toes in the solution, ideally for 45 to 60 minutes daily.


3. Apply tea tree oil

Tea tree oil has been used for many years to combat skin conditions, especially fungal infections, says Graedon. Research has shown that the oil might stop and kill fungal infections by breaking down the outer layer of fungal cells and interfering with the way they work. Again, this may not work in all cases.

How to use it: Dab a few drops of tea tree oil on the affected toenails twice a day.


4. Opt for cornmeal

Just a heads up: This is largely anecdotal. “We’ve heard from a few readers that this has gotten rid of fungus,” Graedon says. Due to its antifungal properties, cornmeal has long been used as a way to banish black-spot fungal disease from roses, according to one 2014 review of research.

How to use it: Pour cornmeal into a shallow pan, mix it with water hot enough to dissolve it into a paste, let it cool, and then soak your feet in it for an hour a week.


5. Drop on some oregano oil

Oregano oil contains thymol, a natural compound with antifungal properties. One 2015 study published in BMC Complementary & Alternative Medicine found that thymol reduced the presence of fungus by nearly 90 percent.

How to use it: Put a few drops of oil on your affected nails twice daily.


6. Try topical medications

There are several prescription drugs approved by the Food and Drug Administration (FDA) to treat nail fungus:

  • Amorolfine
  • Ciclopirox
  • Efinaconazole
  • Tavaborole

In addition, some OTC treatments that contain antifungal agents like tolnaftate and clotrimazole (most commonly used to treat athlete’s foot, ringworm, and other fungal skin infections) can also be worth a try for temporary improvement—but aren’t a permanent fix.

“They are effective in treating athlete’s foot and may help infected nails to some degree, but they are unlikely to clear fungal nail infections because those formulations do not effectively penetrate into the nail itself,” explains Dr. Zeichner. One such topical solution that does sink into the nail? A brush-on treatment called Jublia, an FDA-approved option you can ask your dermatologist about.

How to use it: Each has specific instructions, but you generally apply the medication directly to your nail. The treatment helps keep new fungus out while your nail grows, Dr. Goldenberg says.

7. Ask about antifungal pills

If topical treatment isn’t doing the trick, your doctor may prescribe one of the following antifungal pills:

  • Fluconazole
  • Griseofulvin
  • Itraconazole
  • Terbinafine

How to use it: Antifungal pills work faster than medicine applied to the nails, the AAD says, but you should still expect a few months of consistent use, per your doctor’s instructions.

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What causes white toenails and how do I fix them?

The treatment consisted of alternating vinegar and hydrogen peroxide soaks. What was interesting about this case study was the fact that the press & release technique was used, in order to increase the absorption of the natural remedies at the level of the affected toenail. The technique requires that one pressed on the toenails, then release it. The procedure has to be repeated several times, during the actual soak. The authors draw attention to the fact that the two remedies have to be alternated and not used at the same time (this leads to the formation of peracetic acid, which can irritate the skin and the toenails significantly).

A study regarding onychomycosis, presented in the Journal of Fungi, talks about the different types of fungal infections and the characteristic changes the toenails go through. For example, in the situation that the patient suffers from distal and lateral subungual onychomycosis, the toenail plate will turn yellow-white, becoming thickened at the same time.

If the patient suffers from white superficial onychomycosis, the fungi will be present on the dorsal nail plate. The fungal colonies can be identified in the area where the toenail has turned white and opaque. In many situations, these friable patches can be scraped away without any effort. In case of proximal subungual onychomycosis, the ventral part of the nail plate is affected; the toenail will turn white, in the area which is close to the lunula, being accompanied by acute periungual inflammation. Last, but not least, in case of endonyx onychomycosis, which is one of the rarest forms of toenail fungal infection, the entire nail plate is affected, becoming white and split.

Final word

As you have seen, there are a number of conditions that can cause the toenails to become white. It is important to first diagnose the underlying condition and then seek out suitable treatment. Natural remedies, as well as medical treatments, have to be recommended and supervised by a medical professional.

The efficacy of vinegar and hydrogen peroxide in treating toenail fungus: a case study. 2008. Retrieved from: http://www.michaelandjudystouffer.com/judy/articles/toenailfungus.htm
Onychomycosis: a review. Journal of Fungi, 2015, 1, 30-43. Retrieved from: http://www.mdpi.com/journal/jof

  • White Chalky Toenails from Nail Polish

    White chalky toenails from nail polish are called keratin granulations. This is not toenail fungus! Learn how to fix your toenails and fingernails!

    Wearing nail polish can cause toenail fungus. BUT it is usually something called keratin granulations. This is a mostly harmless white chalky substance that is dehydrated toenail protein.

    Table of Contents

    Overview of White Chalky Toenails from Nail Polish:

    • White chalky toenails from nail polish are called keratin granulations.
    • These occur when you dehydrate the top of your nail with nail polish remove like acetone.
    • They are not actually chalky until you remove the toenail polish.
    • This is not fungus but can be very easily compared to this due to extensive dryness. There is a comparable toenail fungus called superficial white onychomycosis.

    At this point this is very advanced damage that prevents blood flow into the toenail. This is when bacteria and toenail fungus can grow on the nail!

    Treatment Overview (read the rest for a detailed explanation):

    • Any moisturizing lotion will work great for dehydrated toenails: So don’t just buy the ones that I am recommending!
    • These options are great for both repairing and killing any fungus if you think that may also be going on.
    • If it sounds like you have just keratin granulations: use something around the house and start doing it TODAY!
    • So the KEY is…. Just moisturize and debride the dead toenail crust with a nail file then moisturize them.

    Best Toenail Repair Products: Top Choice For Direct Toenail Application. Top Choice For Cream For Toenails & Webspaces. Great Option For Foot Soak. Price: $19.90 $15.49 $15.97 Overview: All natural option that is toxic to fungus. This is similar to tea tree oil in that respect but can be more effective. You still need to exfoliate dead skin and trim thick toenails. All natural cream option. This is a good option compared to some of the quick dry gels. This can be used on the skin surrounding your toenails. Safe, cost effective and relaxing all at the same time! This needs to be used in a 20 minute foot soak. Works well for exfoliating loose skin/toenail as well as softening. Pros: All natural, relatively cost effective. 1,000s of reviews with excellent results. Very clean and quick drying, easy to apply. Relatively cost effective. All natural tea tree oil that is proven toxic to fungus. Can be used on surrounding skin as well. Very safe, little risk, low cost and very effective if used correctly. The key is to use it as an aid to soften and exfoliate loose/dry dead skin and toenail. Cons: Small amount and a little more expensive than some other options. Once more has 0% chance of working if your goal is to heal a dead, detached toenail or dry skin. Are you noticing this is a trend? This is really the key! Still more expensive than other options. Can get messy all over different areas of your foot. Key is still debride and cleaning your dry dead toenails and skin. TRIM them! It once more has 0% chance working if you are trying to save loose and dead crusty skin. Fungus will always grow on this if no blood flow. It can not regenerate dead skin, only exfoliate it. Amazon Reviewer Comments (Make sure to do your own review research through the link): “I have been used a lots products didn’t work. This product is really really work well. I have been using 3weeks, so far works good. The healthy nail is growing now.” “I’ve had athletes foot, with toenail fungus for the past 10+ years. I’ve used just about everything off the shelf to address this problem. This product did the trick!” “In love with this product! While at work all I can think about is coming home to soak my feet. My feet feel absolutely amazing!” Affiliate Link (Buying through these links helps support the site): Thank you! Best Toenail Repair Products: Top Choice For Direct Toenail Application. Price: $19.90 Overview: All natural option that is toxic to fungus. This is similar to tea tree oil in that respect but can be more effective. You still need to exfoliate dead skin and trim thick toenails. Pros: All natural, relatively cost effective. 1,000s of reviews with excellent results. Very clean and quick drying, easy to apply. Cons: Small amount and a little more expensive than some other options. Once more has 0% chance of working if your goal is to heal a dead, detached toenail or dry skin. Are you noticing this is a trend? This is really the key! Amazon Reviewer Comments (Make sure to do your own review research through the link): “I have been used a lots products didn’t work. This product is really really work well. I have been using 3weeks, so far works good. The healthy nail is growing now.” Affiliate Link (Buying through these links helps support the site): Thank you! Best Toenail Repair Products: Top Choice For Cream For Toenails & Webspaces. Price: $15.49 Overview: All natural cream option. This is a good option compared to some of the quick dry gels. This can be used on the skin surrounding your toenails. Pros: Relatively cost effective. All natural tea tree oil that is proven toxic to fungus. Can be used on surrounding skin as well. Cons: Still more expensive than other options. Can get messy all over different areas of your foot. Key is still debride and cleaning your dry dead toenails and skin. TRIM them! Amazon Reviewer Comments (Make sure to do your own review research through the link): “I’ve had athletes foot, with toenail fungus for the past 10+ years. I’ve used just about everything off the shelf to address this problem. This product did the trick!” Affiliate Link (Buying through these links helps support the site): Thank you! Best Toenail Repair Products: Great Option For Foot Soak. Price: $15.97 Overview: Safe, cost effective and relaxing all at the same time! This needs to be used in a 20 minute foot soak. Works well for exfoliating loose skin/toenail as well as softening. Pros: Very safe, little risk, low cost and very effective if used correctly. The key is to use it as an aid to soften and exfoliate loose/dry dead skin and toenail. Cons: It once more has 0% chance working if you are trying to save loose and dead crusty skin. Fungus will always grow on this if no blood flow. It can not regenerate dead skin, only exfoliate it. Amazon Reviewer Comments (Make sure to do your own review research through the link): “In love with this product! While at work all I can think about is coming home to soak my feet. My feet feel absolutely amazing!” Affiliate Link (Buying through these links helps support the site): Thank you!

    White Chalky Toenails from Nail Polish: Usually not fungus!

    White spots and white marks from toenail polish are due to the toenail getting dehydrated. This can cause the toenail to dry out and curl. This is not all that dangerous, but it can look like fungus. Just make sure to moisturize and clean it up, it will go away!

    White chalky toenails from nail polish are called Keratin Granulations are white smudge marks on your nails that usually occur after you take off your nail polish, but are luckily very treatable!

    • Nail polish polish contains compounds like acetone.
    • These compounds can dehydrate the nails underneath them leading to a protein called “keratin” to dehydrate.
    • These keratin molecules can clump together creating white smudges.
    • These are called “keratin granulations”

    Are Keratin Granulations Dangerous?

    The toenail polish was just taken off the toenails here. There is extensive white buildup with a black streak. This is a thicker dehydrated toenail with dry blood underneath it.

    No they are not dangerous!

    • This condition is not very dangerous, it is basically just a fancy way of saying that you have dry nails.
    • The only downsides to not doing anything about it is that your nails are more brittle and more likely to chip in the future.
    • Think of this as being a completely cosmetic problem only.

    Symptoms Of Keratin Granulations:

    Keratin granulations can manifest themselves in the following ways:

    • White nails.
    • Dry and brittle nails.
    • Nail polish was just recently removed.
    • No pain or irritation.
    • Nails were previously healthy.

    Keratin Granulations Home Treatment:

    • Keratin Granulations are very easily taken care of through moisturizing your nails with cuticle wax, oils and simply avoiding nail polish for a little while.
    • It is not necessary to buy anything expensive or online; it is fine simply using a product like Vaseline or any other petroleum oil in most circumstances.
    • Protect your fingernails and toenails from toenail polish remover, this can permanently damage the toenails until new and healthy toenail polish grows out.
    • It can take well over a year to grow a new healthy toenail for your lesser toes and big toenails.
    • So get yourself some petroleum jelly at your corner store and just apply it to your nails at night when you won’t be using your hands. In 2 weeks you should be in great shape!

    Treatment Steps:

    You can already see that there is a white chalky like substance developing underneath the toenail. This can be trimmed and it will look much better underneath.

    Step #1) Stop using toenail polish if you can help it.

    • Washing off toenail polish with acetone remover will generally cause these white smudges to happen.
    • This is not toenail fungus, but the dehydrated toenail granulations from the acetone remover.
    • If you stop needing to use acetone remover, then its pretty much guaranteed that you won’t have any future keratin granulations.
    • But if you do need to keep using the remover, don’t worry there is always stuff you can do to prevent anything worse from happening.
    • You can still take care of your ganulations at home.

    As the toenail polish is trimmed away, you can see the white chalky toenail substance already. This is a very thick buildup of keratin granulations.

    Step #2) Use a currette or nail file to clean off the superficial keratin granulation.

    • There are deeper good layers of toenail still alive underneath the superficial dead layers.
    • Its like exfoliating your dead skin, just clean off the outer dead layers.
    • A nail file and a currette can work great in this regard.
    • Your toenail has many layers and simply smoothing out the top layers will make your toenail look healthy again.
    • Underneath this is good healthy toenail that can then be moisturized.

    If you use a toenail file or a currette, this will be able to clean the white chalk like substance off the toenails and fingernails. The key is then to moisturize the nails and get them looking better!

    Step #3) Moisturize your toenails:

    • I would recommend using something strong like a cream or petroleum jelly at night.
    • These work much better than water based lotions.
    • This strengthens your nail and makes it look healthy.
    • This works great when combined with exfoliation.

    Home Treatment Pros vs. Cons:

    White Chalky Toenails From Toenail Polish Treatment Review: A+


    • This is a cheap treatment option.
    • Petroleum jelly and moisturizing creams are readily available.
    • The cure is almost instant.


    • The downside of the treatment is that it is not permanent.
    • As long as you keep using acetone remover, you will keep getting keratin granulations.

    Recommended White Chalky Toenail Treatment Option:

    This is a very damaged toenail with extensive callus buildup underneath the toenail and dry dead toenail. The best thing to do is trim it up and start an antifungal agent with moisturizing later on. Don’t wait this long, this is a very elderly patient who kept painting their toenails and ignoring the problem!

    Just remember as long as your moisturize you will do great, this is just one recommended option.

    Good luck!

    Other causes of white spots on my nails & toenails:

    • Another name for white spots on your toenails is called the Leukonychia.
    • Leukonychia is a condition where there are white lines work that form on your fingernails or toenails.
    • 95+ percent of time this is very common and harmless. But there’s always a chance that it can be something dangerous.
    • This is nothing to worry about, and Leukonychia, it is likely not a fungus.

    The most common cause of white spots on your toenails:

    • The most common cause of leukonychia is a minor injury to the nail bed.
    • This is especially common if you bump or jam your toenail or fingernail.
    • It is also possible for manicures and pedicures to cause a injury of white spots to the toenails due to gel or acrylic.
    • This is likely due to the dehydration on top of your toenails. This is also known as keratin granulations. As noted above.

    Although this does look like superficial white onychomycosis (white toenail fungus), it is actually called keratin granulations! This is not toenail fungus but curled up protein that causes white marks and white spots on the toenail.

    Causes of white spots on the toenails:

    • The 95% most common cause is an nail injury which is superficial.
    • Dehydration of the toenail.
    • Fungal infection.
    • Allergic reaction.
    • Mineral deficiency.

    This is a toenails with very advanced traumatic damage. This is a patient with very poor feeling in their toes and the big toenail is peeling back almost every day. Don’t just cover this up with toenail polish, make sure you trim it and keep it healthy!

    White marks on toenails:

    • White marks on the toenails are most commonly due to injury.
    • This is nothing to worry about, the damage should go away relatively quickly!

    These are white chalky toenails from toenail polish after we removed the polish and smooth down the top layer. These can be very healthy underneath the top layers!

    White superficial onychomycosis toenail fungus:

    • White superficial onychomycosis is the most common type of toenail fungus that can live on top of your toenails.
    • This type of toenail fungus can be high risk for further growth into your toenails.
    • If you do suspect fungus that is not related to removing toenail polish, make sure you treat this disease!

    As the toenail polish is removed in this picture, you can see there is dry and dehydrated toenail under the toenail polish. This is not fungus by thick callus with dehydrated toenail.

    White patches or spots under the toenails:

    • White patches or spots under the toenails can be due to injury.
    • The way to know that this is due to an injury is because the white spot will extend with the toenail or the fingernail as it grows.
    • Most people don’t remember when injury actually happened, because Apple long time ago.
    • Your toe nail only grows 1 mm per month. So this could happen a very long time ago.

    Toenails turning white by themselves:

    These toenails are very thick and have a white chalky film on them after removing toenail polish.

    • If your toenails are turning white all by themselves, consider superficial white onychomycosis. This can worsen to complete toenail fungus.
    • Look at some of the toenail fungus treatments we recommend at the beginning of this guide!

    Over-the-counter and Natural Remedies for Onychomycosis: Do They Really Work?

    Onychomycosis is a fungal infection of the nail unit by dermatophytes, yeasts, and nondermatophyte molds. It is characterized by a white or yellow discoloration of the nail plate; hyperkeratosis of the nail bed; distal detachment of the nail plate from its bed (onycholysis); and nail plate dystrophy, including thickening, crumbling, and ridging. Onychomycosis is an important problem, representing 30% of all superficial fungal infections and an estimated 50% of all nail diseases.1 Reported prevalence rates of onychomycosis in the United States and worldwide are varied, but the mean prevalence based on population-based studies in Europe and North America is estimated to be 4.3%.2 It is more common in older individuals, with an incidence rate of 20% in those older than 60 years and 50% in those older than 70 years.3 Onychomycosis is more common in patients with diabetes and 1.9 to 2.8 times higher than the general population.4 Dermatophytes are responsible for the majority of cases of onychomycosis, particularly Trichophyton rubrum and Trichophyton mentagrophytes.5

    Onychomycosis is divided into different subtypes based on clinical presentation, which in turn are characterized by varying infecting organisms and prognoses. The subtypes of onychomycosis are distal and lateral subungual (DLSO), proximal subungual, superficial, endonyx, mixed pattern, total dystrophic, and secondary. Distal and lateral subungual onychomycosis are by far the most common presentation and begins when the infecting organism invades the hyponychium and distal or lateral nail bed. Trichophyton rubrum is the most common organism and T mentagrophytes is second, but Candida parapsilosis and Candida albicans also are possibilities. Proximal subungual onychomycosis is far less frequent than DLSO and is usually caused by T rubrum. The fungus invades the proximal nail folds and penetrates the newly growing nail plate.6 This pattern is more common in immunosuppressed patients and should prompt testing for human immunodeficiency virus.7 Total dystrophic onychomycosis is the end stage of fungal nail plate invasion, may follow DLSO or proximal subungual onychomycosis, and is difficult to treat.6

    Onychomycosis causes pain, paresthesia, and difficulty with ambulation.8 In patients with peripheral neuropathy and vascular problems, including diabetes, onychomycosis can increase the risk for foot ulcers, with amputation in severe cases.9 Patients also may present with aesthetic concerns that may impact their quality of life.10

    Given the effect on quality of life along with medical risks associated with onychomycosis, a safe and successful treatment modality with a low risk of recurrence is desirable. Unfortunately, treatment of nail fungus is quite challenging for a number of reasons. First, the thickness of the nail and/or the fungal mass may be a barrier to the delivery of topical and systemic drugs at the source of the infection. In addition, the nail plate does not have intrinsic immunity. Also, recurrence after treatment is common due to residual hyphae or spores that were not previously eliminated.11 Finally, many topical medications require long treatment courses, which may limit patient compliance, especially in patients who want to use nail polish for cosmesis or camouflage.

    Currently Approved Therapies for Onychomycosis

    Several definitions are needed to better interpret the results of onychomycosis clinical trials. Complete cure is defined as a negative potassium hydroxide preparation and negative fungal culture with a completely normal appearance of the nail. Mycological cure is defined as potassium hydroxide microscopy and fungal culture negative. Clinical cure is stated as 0% nail plate involvement but at times is reported as less than 5% and less than 10% involvement.

    Terbinafine and itraconazole are the only US Food and Drug Administration (FDA)–approved systemic therapies, and ciclopirox, efinaconazole, and tavaborole are the only FDA-approved topicals. Advantages of systemic agents generally are higher cure rates and shorter treatment courses, thus better compliance. Disadvantages include greater incidence of systemic side effects and drug-drug interactions as well as the need for laboratory monitoring. Pros of topical therapies are low potential for adverse effects, no drug-drug interactions, and no monitoring of blood work. Cons include lower efficacy, long treatment courses, and poor patient compliance.

    Terbinafine, an allylamine, taken orally once daily (250 mg) for 12 weeks for toenails and 6 weeks for fingernails currently is the preferred systemic treatment of onychomycosis, with complete cure rates of 38% and 59% and mycological cure rates of 70% and 79% for toenails and fingernails, respectively.12 Itraconazole, an azole, is dosed orally at 200 mg daily for 3 months for toenails, with a complete cure rate of 14% and mycological cure rate of 54%.13 For fingernail onychomycosis only, itraconazole is dosed at 200 mg twice daily for 1 week, followed by a treatment-free period of 3 weeks, and then another 1-week course at thesame dose. The complete cure rate is 47% and the mycological cure is 61% for this pulse regimen.13

    Ciclopirox is a hydroxypyridone and the 8% nail lacquer formulation was approved in 1999, making it the first topical medication to gain FDA approval for the treatment of toenail onychomycosis. Based on 2 clinical trials, complete cure rates for toenails are 5.5% and 8.5% and mycological cure rates are 29% and 36% at 48 weeks with removal of residual lacquer and debridement.14Efinaconazole is an azole and the 10% solution was FDA approved for the treatment of toenail onychomycosis in 2014.15 In 2 clinical trials, complete cure rates were 17.8% and 15.2% and mycological cure rates were 55.2% and 53.4% with once daily toenail application for 48 weeks.16 Tavaborole is a benzoxaborole and the 5% solution also was approved for the treatment of toenail onychomycosis in 2014.17 Two clinical trials reported complete cure rates of 6.5% and 9.1% and mycological cure rates of 31.1% and 35.9% with once daily toenail application for 48 weeks.18

    Given the poor efficacy, systemic side effects, potential for drug-drug interactions, long-term treatment courses, and cost associated with current systemic and/or topical treatments, there has been a renewed interest in natural remedies and over-the-counter (OTC) therapies for onychomycosis. This review summarizes the in vitro and in vivo data, mechanisms of action, and clinical efficacy of various natural and OTC agents for the treatment of onychomycosis. Specifically, we summarize the data on tea tree oil (TTO), a popular topical cough suppressant (TCS), natural coniferous resin (NCR) lacquer, Ageratina pichinchensis (AP) extract, and ozonized sunflower oil.

    Nail Fungus

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    What is nail fungus?

    Fungal infections of the nails (onychomycosis) can be a persistent and sometimes embarrassing problem, and occasionally can become painful. These infections develop when fungi, known as dermatophytes, burrow under nails causing them to become crusty, thick, discolored, and distorted.

    What are the symptoms of nail fungus?

    The first signs and symptoms of fingernail or toenail fungus is a white or yellow spot appearing underneath the tip of the nail, which then thickens and distorts the nail as the infection progresses. As fungi grow under and into the nail, crusting, discoloration, and darkening begin. Moreover, infected nails often separate from the nail bed, which can cause pain in the tips of fingers and toes, as well as a slightly foul-smelling odor.

    What are the causes?

    You can pick up a fungal infection such as toenail fungus while walking barefoot at a swimming pool, in a gym locker room or shower, or even when having a pedicure under less-than-sanitary conditions. The fungus thrives in warm, dark, moist environments, like showers or sweaty shoes. Susceptibility may be heightened among those who have diabetes, an immune deficiency condition, a history of athlete’s foot, or who are prone to excessive perspiration. Foot and toenail fungus usually will travel through an opening in the skin or separation in the nail bed, and if continually exposed to warm and moist environments, will grow in abundance. Infection with nail fungus seems to occur more in toes than fingers because toenails usually are confined to the dark, warm, and moist environments where fungus thrives, as opposed to fingers, which are out in light and open air. Diminished blood circulation to the toes as compared with the fingers can also make it harder for the body’s immune system to detect and eliminate the infection.

    What are the conventional treatments?

    There are antifungal creams available over the counter as a fingernail/toenail fungus treatment, but their efficacy is questionable. The oral anti-fungal medications are much more effective as home remedies for toenail fungus, but not without bothersome side effects ranging from skin rashes to liver damage. These fingernail treatments and toenail fungus treatments and medications must be used with caution, especially since toenail fungus treatment is usually long-term. Fluconazole (Diflucan), itraconazole (Sporanox) and terbinafine (Lamisil) are a few commonly prescribed oral antifungal medications. They must be taken anywhere from 6 to 12 weeks as these infections are not quick to clear up.

    There is a “nail lacquer” called ciclopirox (Penlac) that can be painted on the nail, applying it daily for a week. You then wipe the layers off with alcohol and start the process all over again. This tedious process is done for up to a year and only has a 10 percent efficacy rate. Another topical prescription is efinaconazole (Jublia) requiring daily treatment for 48 weeks. Any topical application tends to work better when used in conjunction with oral medications. Serious infections may warrant removal of the nail.

    Doctors also advise keeping nails trimmed short and allowing time for the feet to dry after showers, baths or swimming, using absorbent socks, and discarding old shoes that may contain fungal spores.

    What therapies does Dr. Weil recommend fo nail fungus?

    Dr. Weil has always recommended using tea tree oil as a step toward a toenail fungus cure. This natural disinfectant sold at health food stores, as a home remedy for toenail fungus and fingernail fungus. Here, too, you won’t get speedy results. Paint the oil on affected nails twice a day for at least two months. The nail has to grow out for the toenail fungus to be eradicated, so you may not see results for a year. An alternative remedy is grapefruit seed extract used the same way as tea tree oil – twice a day for at least two months. Eating one to two cloves of raw garlic a day may also be helpful over time as garlic has significant antifungal properties.

    The oral antifungal drugs that serve as fingernail and toenail fungus treatments of fingernail and toenail fungus seem to be effective but are expensive and not as safe. While cases of toxicity are rare, Dr. Weil sees no reason to take even a small risk for a problem that is usually cosmetic. In painful cases, podiatrists may temporarily remove infected nails so that a topical antifungal medication can be applied directly to the nail bed. In stubborn cases, an infected nail can be permanently removed.

    Anecdotal evidence suggests that Vicks VapoRub may help get rid of nail fungus in some cases, and one small 2011 study found that 56 percent of people who applied this product to their nails had partial improvement of their fungus, while 17 percent saw no improvement. Vicks VapoRub might work because it contains camphor, which has antifungal properties. If you want to try it, rub a small dab of the ointment into affected nails twice a day with a cotton swab.

    Toenail Fungus Prevention

    Vinegar has been used traditionally to ward off nail fungus. Evidence of efficacy is sketchy at best, but you could try soaking your feet in one part vinegar to two parts warm water for 15 to 20 minutes daily.

    Whatever treatment you choose, take these precautions to prevent recurrences:

    • Keep your feet as clean and dry as possible
    • Wear waterproof sandals at swimming pools or other wet public areas
    • Change your socks or hose daily
    • Clip toenails straight across and keep them shorter than the tips of your toes
    • Avoid tight hosiery, which promotes moisture retention, and wear synthetic fabric socks that wick moisture away from feet better than cotton or wool

    Be especially careful of any nail problem if you have a weakened immune system or diabetes, and have foot concerns already. What might start out as a cosmetic problem can quickly turn into a more serious issue leading to complicated fungal infections mixed with bacteria, skin breakdown, worsening pain, neuropathy, and in the case of advanced diabetes, permanent nail removal or even amputation of the toe.

    A final consideration:

    Chronic fungal nail infections may be a sign of a chronic gut or other systemic yeast infection. Refer to Dr. Weil’s recommendations for yeast infections and speak to your doctor about evaluation and systemic treatment possibilities.









    Reviewed by Benjamin S. Gonzalez, M.D., May, 2016.

    How to Prevent and Treat Toenail and Foot Fungus

    Fungi love dark, damp places, so your feet are especially vulnerable to fungal infection, says Rebecca Sundling, doctor of podiatric medicine, a spokeswoman for the American Podiatric Medical Association, and a podiatrist at Northwood Foot and Ankle Center in Holland, Michigan. Both toenail fungus and foot fungus are very common, and both can be caused by the same organism. However, they aren’t the same condition, and they are treated differently, she explains. Read on to learn how to identify toenail and foot fungus, and how to prevent and treat both.

    Toenail Fungus: Causes and Risk Factors

    Toenail fungus is a fungal infection in the toenail. It happens when a fungus — anything from mold to yeast to other types of fungus — gets in the nail bed from a cut or break in the nail or repetitive trauma to the nail, and penetrates the nail itself, says Dr. Sundling. The nail then continues to grow with the fungus. Once a nail plate is infected with fungus, it will never not be infected, and you must wait to see how it grows out and whether the new nail growing behind it is healthy. The new nail rarely grows in healthy without treatment, says Sundling.

    Toenail fungus is very common — 14 percent of people have it in North America, according to an article published in the journal PLoS Pathogens — and it’s more common the older you get, adds Sundling. Wearing shoes that are too small can damage the nail and make it more vulnerable to fungus, as can having a fungal infection on the skin of the foot (known as foot fungus or athlete’s foot) and not treating it, which could expose the nail to fungus. You may be more at risk to toenail fungus if you have diabetes, or a weaker immune system.

    Signs and Symptoms of Toenail Fungus

    When you have a toenail fungus, the nail tends to be thickened, discolored — yellow, brown, or dark white — and crumbly (it’s a little bit more brittle and breaks easily), says Sundling. It’s not always painful, but it may get painful as the nail gets thick and is pushed down into the skin, she adds.

    Your Options for Treating Toenail Fungus

    If you think you may have toenail fungus, you should see a podiatrist or dermatologist, who will send a specimen or a piece of your nail to a lab. Different types of fungus are treated slightly differently, so it’s important to know which type you have, says Sundling.

    Also, sometimes the root of the problem is not a fungus at all, but rather another condition, or some kind of trauma to the nail bed — for instance, if you dropped something on your toe. There is no treatment for toenail trauma, but removing the nail may be an option if the nail is painful.

    If you do have a toenail fungus, your doctor will likely recommend one or more of the following treatment options:

    • Trimming the Toenail Trimming the toenail is usually combined with medication, but having a podiatrist periodically trim the nail down is helpful and allows the medication to work better, says Sundling. (Most of the time, the nail gets so thick that you can’t trim it yourself, she adds.)
    • Prescription Topical Medications These are used the same way you would use nail polish. One such medication, efinaconazole, has about a 50 percent success rate, says Sundling, and you must use it every day for 48 weeks. Another similar medication, ciclopirox, has a 20 percent success rate, and you must use it for 11 to 12 months, she adds. One caveat: If you like painting your toenails with regular nail polish, you won’t be able to do so for the whole time you’re using these medicines.
    • Oral Medications Terbinafine is an oral medication that you take every day for three months, and it’s up to 70 percent effective, says Sundling. But it can have severe liver side effects, so if you’ve ever had liver disease, risk factors for liver disease, or are taking other medication that is processed through liver, like cholesterol medication, you can’t take it, she warns. Itraconazole is another oral medication for toenail fungus. It’s 50 percent effective, and you take it for three months, says Sundling.
    • Nail Removal Sometimes completely removing the toenail is seen as a treatment option for toenail fungus, says Sundling. There are two ways to do it: Permanently, so it never grows back (and then you won’t have a toenail anymore), or you can let it grow back in. Sometimes it grows back in as a healthy nail, and sometimes it grows back with the fungus.
    • Home Remedies There are people who swear by applying Vicks VapoRub, oregano oil, or tea tree oil to the toenail daily, says Sunding. However, these home remedies have never been proven by research to be successful at removing a fungal infection, she adds.
    • Lasers There are laser treatments for toenail fungus, but they can be very expensive and insurance doesn’t cover them, says Sundling. More research is needed to know whether lasers can provide safe and effective treatment for most people, according to the American Academy of Dermatology, but the FDA has approved several laser devices for the treatment of toenail fungus.
    • Ignoring It You don’t have to treat toenail fungus, as it’s mostly a cosmetic issue, says Sundling (though in some cases it can be painful). Some people put toenail polish on the affected nail and forget about it, she notes.

    Foot Fungus: Causes and Risk Factors

    A foot fungus is a fungal infection of the skin, better known as athlete’s foot, says Sundling. The fungus enters through cracks in the skin. It’s known as athlete’s foot because athletes or anyone who is more active and sweats a lot is more at risk. Kids are also more at risk, because they don’t tend to wear different shoes, and changing your shoes is one way to avoid foot fungus.

    Foot fungus is very common. It does not mean that someone is dirty or didn’t bathe, and if you have a compromised immune system, you may be more susceptible, says Sundling.

    Signs and Symptoms of Foot Fungus

    Itchy skin is an early sign of foot fungus, or scaly, peeling skin, or tiny blisters on the skin that will pop at times, says Sundling. The skin tends to break out in the shape of a moccasin, or the area of the foot that a moccasin would cover. You don’t see foot fungus on the top of the foot very often. It’s common to get a fungal infection between the toes as well, she adds.

    How to Prevent Both Foot and Toenail Fungus

    While toenail fungus and foot fungus aren’t the same condition, the following tips can help you prevent both, says Sundling:

    • Practice good hygiene, such as keeping your feet clean.
    • Alternate your shoes during the week. Your feet sweat all day long. Alternating your shoes allows them to dry out, so the fungus can’t survive.
    • Wear moisture-wicking socks that help dry out shoes and kill fungus. You can find these at running stores and athletic stores. If your socks are exceptionally sweaty, changing them more than once per day can help.
    • Wear shoes in public places like locker rooms, pools, and gyms to limit exposure to fungus.
    • Stay healthy to maintain a good immune system to fight off fungal infection.
    • Wear shoes that fit well — most people wear shoes that are too tight and they don’t realize it.
    • Use over-the-counter sprays or powders that help dry out shoes and kill fungus.
    • Keep your skin dry, and don’t forget to dry between the toes after bathing, exercising, or sweating. A lot of people don’t dry between the toes, so the skin stays wet, which can lead to infection.

    Your Options for Treating Foot Fungus

    To treat foot fungus, you have the following over-the-counter and prescription options:

    • Use an over-the-counter or prescription antifungal cream. For most people the fungus should go away easily, and you might be able to self-treat, says Sundling. “I tell patients to buy the over-the-counter cream because it’s cheaper and it works just as well,” she says. If you have a very severe case, you can get antifungal creams with steroids mixed in — these are prescription only, she adds. See a podiatrist if you have a foot fungus that’s not going away, as it can spread to other parts of your body.
    • Take oral medication. You can also take terbinafine (the same medication used for toenail fungus) for two weeks (as opposed to the three months it takes to treat a toenail infection with this medication). Doctors don’t often prescribe oral medication for a fungal infection of the skin unless it’s a really severe case, explains Sundling.

    Toenail vs. Foot Fungus: A Summary

    While foot fungus is fairly easy to treat, toenail fungus is incredibly difficult to eliminate, and in some cases it never goes away, says Sundling, noting that even the best oral medication is only up to 70 percent effective. However, if you’re patient and undergo the right course of treatment, you can have positive results. Moreover, keeping your feet dry and alternating your shoes will help you avoid getting a toenail or foot fungus to begin with.

    Additional reporting by Jennifer D’Angelo Friedman.

    How to manage a detached toenail

    There are several common causes of a nail falling off. These include fungal infections, injuries, and psoriasis.

    There are some less common causes, such as medication side effects and other illnesses, which do not affect many people.

    Possible causes of a nail falling off include:

    Fungal infection

    Fungus can grow on many areas of the body, including between the nail and the nail bed. When this occurs, a person runs the risk of the toenail falling off.

    However, there are some signs a person can look out for before a nail a detaches. The signs of fungal infection include:

    • white or yellowish discoloration of the nail
    • a foul smell
    • thicker toenails
    • unusual toenail shape
    • brittle or easily broken nails

    Fungal infections can develop for many reasons and are more likely to occur when the skin or nail is broken. Key causes and risk factors include:

    • aging
    • cracked nails
    • athlete’s foot
    • diabetes

    Treating fungal infections is often tricky. It may require topical creams, oral antifungal medications, or sometimes a combination of the two.

    In extreme cases, a person may require surgery to remove the nail and stop it from growing back.

    Preventing toenail fungus may be easier than treating the infection. A person can prevent toenail fungus by:

    • keeping the feet dry
    • keeping the nails trimmed
    • changing socks frequently
    • disinfecting nail clippers after use
    • wearing shoes in damp community areas, such as gym locker rooms


    Share on PinterestBallet dancers may damage toenails from wearing ballet pointe shoes.

    Injuries are a common cause of a toenail falling off. Even minor injuries can have this impact. Typical injuries may include:

    • a bike or car accident
    • dropping a heavy object on the toe
    • contact sports
    • ballet or other demanding forms of dance
    • stubbing the toe on a hard surface

    When injured, the toenail will often appear black or purple as blood collects under the nail, which is called subungual hematoma. The blood puts pressure on the nail, which may fall off after several weeks.

    When the hematoma covers more than a small portion of the nail, or there is intense pain or throbbing, a person should seek medical attention. A doctor may be able to relieve the pressure by creating a small hole with a needle, which allows the blood to drain.

    In many cases, a person can treat the injury at home. Common treatment methods include:

    • elevating the foot
    • soaking the area in cool water
    • applying fresh bandages frequently
    • taking anti-inflammatories, such as ibuprofen
    • cleaning the area with antibiotic ointments
    • clipping away jagged edges of the nail

    Depending on which toe is affected, and how much of the nail is damaged, it can take up to 18 months for a toenail to grow back completely.

    It is important to wear well-fitting shoes and socks and keep the nail well-trimmed to prevent further injury.


    Psoriasis is a common autoimmune disorder that causes scaly, red patches to appear on a person’s skin. This condition causes the body to overproduce skin cells that buildup in patches.

    Psoriasis typically appears on the skin, but up to 55 percent of people with this condition also experience it on their finger or toenails.

    A person who does not have psoriasis on their skin is unlikely to develop nail psoriasis. Only 5 percent of people without psoriasis on their skin will get nail psoriasis.

    When psoriasis appears under the nail, it is often mild and causes minimal issues. However, the buildup of skin cells can act in the same way as blood forming under an injured nail — eventually, the pressure can cause the nail to fall off.

    Symptoms of psoriasis under the toenail include:

    • yellow or brown coloration
    • thick nails
    • abnormal nail shape
    • chalky buildup under the nail
    • pitting of the nail

    Many of the symptoms of psoriasis and fungal infections are similar. A person with psoriasis should speak to his or her doctor to rule out a fungal infection.

    A person can start to treat psoriasis by soaking the nail in warm water. A doctor will likely prescribe additional medicated creams to help alleviate the symptoms. Phototherapy (light therapy) may also be an option.

    • Your nails becoming brittle or changing color, especially your big toe nail which is most likely to become infected — these are common symptoms of tinea unguium
    • A whitish-yellowish or brownish discoloration developing of the front or sides of the nails
    • Nails becoming soft, breaking easily or becoming thicker and changing shape
    • Pain around the nails
    • The nail detaching from the skin or nail bed
    • White patches forming on the surface of the nail, either in large blotches or small dots that are spread out (called “white superficial onychomycosis”)

    Persistent fungal signs can show up slowly but last for years. Getting rid of toenail fungus can take some patience and requires time to fully heal. It can take several months until treatment is successful, but doing things the right way and getting rid of the underlying cause of nail fungus is the only thing that will keep the infection from coming back again.

    There are actually four types of onychomycosis or toenail fungus:

    1. Distal subungual onychomycosis — the most common type, representing 58–85 percent of all cases. It’s characterized by an easily crumbled nail, thick with discoloration and subungual hyperkeratosis (scaling under the nail).
    2. Proximal subungual onychomycosis — common in immunosuppressed patients, the nail plate becomes white near the cuticle.
    3. White superficial onychomycosis — the nail becomes white and may turn crumbly.
    4. Candidal onychomycosis — the nail plate actually separates from the nail bed. (3)

    Causes of Toenail Fungus

    Well, essentially it’s an imbalance of bad bacteria to good bacteria in your body. Just like with other health conditions that stem from gut-related problems, when you don’t have enough good bacteria living within your gut, you wind up developing high levels of yeast and fungus (bad bacteria) in your body that can show up on your skin.

    Besides poor gut health, other risk factors that can tip the scale in terms of an infection forming include:

    • Having athlete’s foot
    • Coming into contact with fungi, for example in nail salons, contaminated swimming pools, gyms and saunas
    • Damaged nail beds
    • Wearing dirty or tight shoes
    • Skin conditions, such as psoriasis
    • Circulation problems in the legs, from existing conditions like diabetes or artery disease
    • A weakened immune system
    • Genetic predisposition

    In particular, fungal nail infections can be caused by three different types of fungus, either by themselves or in combination:

    1. Dermatophytes — fungus that grows on the skin, hair and nails but don’t penetrate tissues of the body. Athlete’s foot or Trichophyton rubrum is the most common dermatophyte and can actually infect the toenails. Infection can also begin by touching objects that have dermatophytes on them, such as nail clippers, nail files, socks, shoes, shower floors, etc. Dermatophytes are the cause of most fungal toenail infections.
    2. Yeasts — a type of fungus that grows on the skin and nails. While already pre-existing on the human body, illness, antibiotic or birth control pill use and immune system issues may spur an overgrowth of yeast and spawn a yeast infection.
    3. Molds — referred to as nondermatophytes, it’s a type of fungus that often grows in soil and may grow on the skin and nails. It’s not usually transferred between people. (4)

    The genus of fungi that causes tinea unguium or toenail fungus is called trichophyton, and it can also lead to ringworm, jock itch, and even infections of the beard, skin and scalp.

    Conventional Treatment

    For problems of the toenail, most people turn to dermatologists or podiatrists for general foot health as well, especially in cases where the nail infection goes beyond the nails. Some people also use topical treatments or medications to get rid of their toenail fungus, but often these don’t work long term or solve the underlying issue. (5)

    Some drugs designed to kill nail fungus that you might have tried in the past include itraconazole or terbinafine. These might be taken for anywhere from three to six months to treat fungal nail infections, but many people will still find that the fungus comes back. (6)

    Medications in tablet form are much more effective at fighting nail fungus than topical treatments are, but they aren’t guaranteed to work and also have more side effects, long treatment durations and possible interactions. (7) Another downside is that they are like putting a Band-Aid on the problem — they’re not addressing why the fungus developed in the first place.

    Natural Toenail Fungus Treatment

    Step 1: Eliminating the Source of Yeast and Fungus

    The first step in treating toenail fungus is using one of the most effective and natural ways to fight candida. In other words, you’ll likely need to make some changes in your diet and adopt a candida diet. The most crucial tactic for treating candida overgrowth is to eliminate what feeds the yeast and candida virus living in your digestive tract in the first place: sugars and conventional grain products.

    Candida albicans is a common yeast that grows inside the human body. In healthy people, other bacteria and immune cells keep this yeast under control so it doesn’t cause any problems, but in some people candida can become overgrown and cause infections in various areas. One of the ways candida shows up is through the skin where it can cause noticeable reactions or infections. Other ways are on the mouth, vagina and anus.

    What triggers candida in the first place? This overgrowth of yeast can develop from a number of factors, including antibiotic use, poor digestion, low immune system function, a high sugar and grain diet, stress or hormonal changes. All these create an acidic environment that encourages yeast growth and the presence of candida. Many people opt for over-the-counter anti-fungal creams or even medications, but they only treat the symptoms, not the environment that allows candida to flourish.

    Once it takes hold, the bacteria and yeast thrive off of sugar molecules entering the digestive tract through the foods you eat. That’s exactly why you need to eliminate the underlying cause, which is likely stemming from your diet (and possibly also your lifestyle to some degree). This will help ultimately restore your body’s pH balance, improve your immune function and boost the presence of good bacteria in your gut.

    It will be hard to effectively overcome any type of yeast infection or toenail fungus without kicking your sugar addiction and going almost sugar-free, as well as grain-free.

    Step 2: Replenishing Healthy Bacteria

    After cutting off the life-supply to the yeast causing the problem, the next step in terms of changing your diet is to start consuming loads of food that support the growth of good bacteria.

    Superfoods that will help replenish your levels of healthy bacteria include various fermented foods, things like cultured vegetables including sauerkraut and kimchi. I strongly recommend that you start having a daily serving of fermented vegetables along with other probiotic foods like fermented dairy or kombucha.

    For example, yogurt and kefir benefits include enhancing immune function and restoring gut health by building up your body’s defense mechanisms. Additionally, you should also take a quality probiotic supplement to help speed up the healing process.

    Step 3. Consume More Fiber, Protein and Quality Fats

    Next, start consuming more of a high-fiber diet. Due to its structure and our inability to absorb it, fiber passes through our digestive system unabsorbed by digestive enzymes and acids within the stomach, taking with it toxins, waste, fat and cholesterol particles that can accumulate within the gut.

    Because you’re removing the majority of sugars and grains from your diet, in addition to fiber, I also recommend increasing the amount of protein-rich foods you’re eating. Make sure to buy grass-fed meat; organic, cage-free eggs or poultry; raw, unpasteurized dairy; and wild-caught fish — this is key for obtaining enough protein while also reducing toxins in your diet.

    On top of quality fiber and protein foods, your gut also needs plenty of healthy fats, especially coconut oil. Coconut oil contains caprylic acid and lauric acid, which are antibacterial and antimicrobrial fatty acids that help your body kill off candida.

    If you can consume a diet that’s high in good fats and proteins along with some quality fiber — and really reduce the sugar and starches — then you’ll be on the path to eliminating candida in your body, and therefore signs of toenail fungus. Here are some more details on which types of foods to limit or remove from your diet in order to combat yeast and fungal overgrowth …

    Foods to Eat Plenty Of:

    • Colorful vegetables — these nutrient-packed whole foods provide essential vitamins and minerals to help with healing the gut and boosting the immune system.
    • Cultured dairy or fermented foods (ideally organic and raw) — these are beneficial for replacing good bacteria in the gut since they provide probiotics. Probiotics help control yeast and also have numerous immune-enhancing effects. For other sources of probiotics, in addition to yogurt or kefir try cultured foods like kimchi, kombucha or sauerkraut.
    • Vegetable juices/green drinks — Green vegetables will help improve your immune response and flush waste, toxins and bacteria from your gut. Avoid adding fruit and sugar to your green drinks and focus on fresh veggies instead. You can use a small amount of organic stevia extract to help sweeten your veggie juices since it contains no sugar.
    • Coconut oil, ground flax and chia seeds — Flax and chia seeds are anti-fungal and provide healthy, healing sources of fats. Coconut oil does the same, plus it contains lauric acid which is a powerful antimicrobial and antibacterial fatty acid.
    • Garlic, turmeric and cinnamon — all effective for fighting bacterial infections, virus and poor gut health
    • Unsweetened cranberry juice — Cranberry juice creates an environment that is unpleasant for yeast. Make sure to look for a 100 percent pure cranberry juice that has no added sugar.
    • High quality proteins from grass-fed, pasture-raised, cage-free and wild-caught chicken, beef, eggs and fish.

    Foods to Remove or Greatly Limit:

    • Sugar — all types as much as possible, including cane sugar, coconut sugar, Manuka honey, maple syrup. Sugar feeds yeast, so you should avoid it at all costs if you can.
    • Grains — grains wind up breaking down into sugar molecules which as you know, feed candida, yeast and bad bacteria. Even whole grains (like oats, rice, quinoa) are capable of worsening the problem, but you should especially limit refined grains like the kind used in baked goods, breads, cereals, muffins and packaged foods.
    • Fruit or fruit juice — even though fruit is generally healthy, it is high in sugar and can make candida worse. Fruit juice also lacks fiber and therefore causes blood sugar spikes that can lead to cravings, low energy, inflammation and poor immune function.
    • Alcohol — produces more yeast and should be avoided. Many alcoholic drinks are also high in sugar.
    • Food intolerances — Some yeast infections are due to food allergies. Try to avoid foods that cause negative reactions of any kind and pay attention to symptoms you experience when eating things like dairy, eggs, certain nuts, wheat-containing foods and grains. If you think you have a food allergy or sensitivity, try an elimination diet to figure out what foods are causing intolerance and work on removing those foods.

    If this seems like an overwhelming task, keep in mind that many people have successfully done it, plus it doesn’t necessarily need to be forever.

    Following this protocol for several months might be able to help solve the problem for good, and then you can slowly reintroduce sources of sugar like fruit, or whole grains, while monitoring your progress. However, keep in mind that some candida or yeast sufferers have lived with their condition for years, so combating the issue might take more than just a few weeks or months.

    Eating in accordance with an anti-candida diet for six months or more might be needed for some people, and for a percentage eliminating all refined carbs, sugary foods and alcohol permanently might be necessary in order to prevent the overgrowth of fungus from returning.

    Step 4. Utilizing Supplements and Essential Oils

    The final step to removing fungal and yeast infections is taking supplements, such as the probiotic supplement that I mentioned above. A quality probiotic supplement will help you get rid of the yeast and candida in your system that’s truly causing your toenail fungus. I personally recommend a probiotic supplement that has at the very least 10+ strains of probiotics with at least 15 billion CFUs.

    Additionally, I would take olive leaf extract. Olive leaf benefits include its powerful antimicrobial action that can help eliminate yeast within your system. There are other supplements, meanwhile, that contain enzymes like cellulose and hemicellulose, which can kill fungus within your system, so look into trying those enzymes as well.

    Last, but not least, the secret to natural and effective toenail fungus treatment — and getting rid of it for good — is using essential oils. I personally recommend two powerful essential oils below if you want to get rid of toenail fungus. I consider this to be one of the most crucial steps! Even if you do this one thing to solve your problem, with or without changing your diet (although you should change your diet too!), you may be able to get rid of toenail fungus.

    The first oil you want to use is oil of oregano. Not only can oil of oregano kill fungus, it can kill mold and other causes of candida within your system too.

    Try using oil of oregano along with another essential oil called melaleuca, which is also known as tea tree oil. The uses of tea tree oil will astound you, including its ability to act as a natural antifungal agent. Use these two oils topically on your toenail fungus daily. I recommend three drops of oil of oregano and two drops of melaleuca applied directly on the toenail, four times a day, ideally.

    The key to effectively fighting toenail fungus with essential oils is consistency. You need to be religious with using essential oils to see lasting results. You can’t do this once a day, then miss a day here and there and say you’re not seeing changes. If you use these two oils four times a day for two months, in 90+ percent of cases, it will clear up your toenail fungus for good!

    Trust me, my mom had this condition for 10 years as I mentioned above. She went through chemotherapy. She had loads and loads of candida and yeast in her system. She followed this essential oils routine, and after two months, it amazingly completely cleared up her toenail fungus.

    Interview Transcript

    Interviewer: Nail fungus treatment options, that’s next on The Scope.

    Announcer: Health tips, medical news, research, and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

    Interviewer: They’re ugly, and, for some, nail fungus can be painful and also very tough to get rid of. Dermatologist, Dr. Christopher Hull, what’s the first thing you do when a patient comes in with nail fungus?

    Dr. Hull: Well, first, I like to make sure that it actually is nail fungus, because there are other nail conditions that can look very similar to and mimic nail fungus. So first that usually involves assessment of the nails. Sometimes we’ll do some confirmatory testing with clippings and cultures and scrapings. And then, once we’re comfortable that it’s a fungal infection and not another condition of the nail that looks like nail fungus, then we talk about how it’s affecting them and what they’re hoping to achieve as far as treatment.

    Interviewer: Got it. So if it’s something else, the treatment options would be different. That’s why you really want to find out, what . . . it is fungus, right?

    Dr. Hull: Right. And treating nail fungus is notoriously very challenging, often with failures along the way. And so it’s important to be sure that before you start going down the path of treatment, that you’ve actually got a correct diagnosis.

    Interviewer: And it can take a long time to treat. So you wouldn’t want to go down this path of treatment and then . . . yeah.

    Dr. Hull: Right. And some of the treatments require monitoring and have some risks associated with them.

    Interviewer: Got it. So you find out it’s a nail fungus. At that point, what are the treatment options?

    Dr. Hull: There are a number of treatments. There are many things that are discussed. You know, they have over the counter. You go to the internet and Google “nail fungus treatment,” you’ll come up with 10,000 hits, I bet.

    Interviewer: Yeah, pills, polishes, creams?

    Dr. Hull: Right.

    Interviewer: Yeah, all sorts of things. What do you tend to like to use?

    Dr. Hull: Most of those have not been investigated with really good clinical trials. But I think there’s things that people have used and have found to be helpful. One common thing that comes up are products that contain menthol. So Vicks VapoRub is a common nail remedy for nail fungus. It probably won’t help. But it won’t hurt anything either.

    Most of my conversation is usually discussing medical therapy, so things that are available by prescription only. And those come in two main forms, which are topical antifungal medications, and then oral antifungal medications. There are other surgical or procedural options, so you can remove nails as well. And then there’s starting to be more interest in technologies like lasers for nail fungus.

    Interviewer: So you would said at one point that you have a conversation with the patient, what is it you’re trying to accomplish. I understand for some people it can be very painful. So it might be to alleviate the thickness of the nail and the pain.

    Dr. Hull: Right. And it gets difficult to clip, trim, and groom nails when they get very thick. It can be associated with pain because of ingrown nails. And in some cases, it can also predispose people to infection, so cellulitis and so forth. So there are medically important reasons to treat them. Some people just don’t like the appearance of the nails.

    Interviewer: Yeah. Because doesn’t look good in your flip-flops, does it?

    Dr. Hull: Right. Wearing sandals in the summer time with thick, yellow nails is something that a lot of people would like to not have to do.

    Interviewer: So if it isn’t necessarily painful, do you recommend treatment? Do you really leave that up to the patient at the point?

    Dr. Hull: Yeah. My personal philosophy is to leave it up to the patient. So I give them the different options, talk about the length of treatments, the monitoring, the likelihood of success, and then have a conversation with them about whether they want to move forward with those treatments. And a lot of people like not to do anything and many people are very motivated to treat their nails.

    Interviewer: Sure. What about the oral drugs? I understand that some people are concerned about the side effects those can cause. So are the oral drugs, generally, better than the topical or . . .

    Dr. Hull: Yeah. The oral medications are more effective than topical treatments.

    Interviewer: Sure.

    Dr. Hull: The good news though is that the safety of most of these oral medications is very good. And the treatments are also much less expensive. So there’s quite a bit of cost benefit from using the oral medications.

    Interviewer: What are some of the concerns with the oral medication side effects?

    Dr. Hull: The primary concern is liver toxicity, because these medications are metabolized by the liver. Looking at cost effectiveness of oral versus a topical medication, I’m really sort of arguing for the oral medication because it’s so much less expensive. But then, also, looking at a lot of the safety information about the medication and the risk of serious liver adverse event is very low in that medication. That said, I still will recommend appropriate monitoring. And that’s laboratory testing, usually a baseline and then midway through the treatment.

    Interviewer: Are they antibiotic based?

    Dr. Hull: They’re antifungal, so they’re specific towards fungus. So they have no effect on bacterial like an antibiotic would.

    Interviewer: So people that are afraid of antibiotics for whatever stomach reasons they might have.

    Dr. Hull: Yeah. It won’t have any effect on the flora of the gut. And actually, interesting, they don’t . . . this particular one, terbinafine, doesn’t have an effect on the natural yeast that we see in the intestine called candida. So it shouldn’t have any effect on that. Some people can get rashes, and there’s, you know, other less common side effects. But for the most part, I find them to be well tolerated.

    Interviewer: Some of the home remedies that I saw, you mentioned Vicks VapoRub, snake root extract, tea tree oil . . .

    Dr. Hull: I haven’t come across snake root extract yet. But it sounds like it might eat away a nail pretty well.

    Interviewer: Sure.

    Dr. Hull: Yeah. There’s a lot of those things out there. A lot of people use vinegar, tea tree oil. The hard part with any of these topical medicines is they don’t penetrate the nail unit very well. So getting them, actually, to the fungus in the nail unit is very difficult. And that’s why a lot of the prescription topical medicines have such limited effects.

    Interviewer: What about do-it-yourself at home trying to thin that nail out like, you know, by coating it with . . . what do people coat it with?

    Dr. Hull: Well, I think doing debridement at home is, actually, helpful. So a lot of times, I’ll have people file their nails down, clip the nails back, because that helps to kind of trim away some of the infected nail as well.

    Interviewer: Would your recommendation, generally, be for somebody to use the oral pills if possible just because it’s such a shorter treatment time?

    Dr. Hull: Well, I think it just depends on the person. There are some people who have other risk factors, who have a history of liver disease or something where I wouldn’t be comfortable putting them on that medication. So I use both medications, and sometimes I use them in combination. So I’ll have them do a first course with an oral antifungal and then follow up with a topical. And that may help prevent reinfection, too, down the road.

    Interviewer: Which is pretty common from what I understood.

    Dr. Hull: Yeah. So it’s common. You can get the nail clear, and then people are just exposed to the fungus in their environment, in their shoes and so forth, and they can get reinfected easily.

    Interviewer: So it sounds like that if somebody does have nail fungus, for the most part, does it bother you because it’s ugly? If there’s pain involved, then for sure, you would recommend some treatment. For some people, there could be other medical reasons to treat it.

    Dr. Hull: Right, yeah. Somebody with, you know, for example, diabetes who’s at risk of ulcerations on the feet, cellulitis infections, they are people that may be . . . they may be more proactive about treating to help reduce their risk of infections.

    Interviewer: But for the most part, it sounds like if you don’t really have many symptoms, it’s just kind of a personal choice?

    Dr. Hull: That’s true.

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