Nail fungus

23 October 2025

Toenail fungus is an infectious disease caused by mycotic organisms such as dermatomycetes, molds and yeast-like fungi of the genus Candida.In fact, there are up to 50 types of fungi that can lead to the development of a pathological condition of the nail, but all of them are combined in these three large groups.In addition, up to 90% of cases, the cause of nail plate disease are fungi belonging to the group of dermatomycetes, of which there are up to 20 different species.Fungi such as yeasts of the genus Candida cause nail diseases not so often, in about 10% of cases.The remaining small percentage of morbidity occurs due to infection of the nail by fungal organisms.Nail fungus in medical terminology sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite wide.Toenail fungus affects up to 20% of the world's population.The spread of the disease among the population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of a certain person, his age, gender and profession.In addition, dermatologists notice a constant increase in the number of cases in both adults and children.The likelihood of developing toenail fungus increases with age (the disease is more common in the elderly over 65).

Symptoms of nail fungus

The symptoms of nail fungus will depend on the type of pathogen causing the infection, as well as the degree of damage to the nail plate.The age of the patient can affect the speed of recovery.It is known that in childhood the phalanges of the nails are affected much less often than in the elderly.

Symptoms vary depending on the shape of the fungus:

Symptoms of normotrophic nail fungus.The color of the affected plaque changes, but the thickness and gloss remain the same.First, lines and spots appear on the nail - their shape and size change, the location is the lateral parts of the nail.The color of such spots is ocher-yellow or white;if the disease is not treated, the spots increase in size, gradually covering the entire plaque area.The nail completely changes color, remaining normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in the impossibility of plaque to grow on the nail bed.As a result, the patient can easily remove it - accidentally or on purpose.
Symptoms of hypertrophic nail fungus.In addition to discoloration, this form of the disease is characterized by plaque thickening in dimensions that exceed 2 mm or more.This growth occurs due to increased growth of skin scales under the nail.There is a loss of luster, the affected plates become dull and begin to crumble.As a result, the nail is severely deformed.The more advanced the stage of the disease, the greater the degree of deformity.Onychomycosis - taking a shape from the nail similar to a bird's claw, is a common symptom of the hypertrophic type of the disease.The lateral parts of the nail are the most damaged.The complex of symptoms accompanying this form of nail fungus leads to the fact that a person begins to experience pain while walking.The color of the nails becomes dark yellow or gray.
Symptoms of atrophic nail fungus.First of all, patients notice a change in the color of the plaque;turns gray to brown.The normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the plaque is destroyed.The last stage of the atrophic form of the fungus is the exposure of the nail bed and its complete necrosis.(read also: Causes and symptoms of necrosis, outcome and prevention) On the surface of the bed, the patient reveals layers of loose consistency, consisting of skin scales.Atrophy of the plate occurs in stages, starting from the outer end towards the area of growth and folding of the nail.The growth area remains intact longer than other parts of the nail.
Symptoms of lateral and distal nail fungus.The commonality of these two types of fungal lesions is that they are often diagnosed in symbiosis and cause the same changes in parts of the nail plate.The affected part of the plaque loses its normal color and becomes dull.Transverse grooves pass along it, which have a yellow color.When toenail fungus occurs due to infection with mold and fungal organisms, the nail plates may turn blue-green to black.The nail itself begins to crumble, becoming rough on the sides.Over time, the affected parts die, causing the plaque to deform.The nail bed remains partially exposed.The final stage of the disease is characterized by the complete destruction of the nail and the opening of a bed of skin flakes on top.If the clinical picture of distal nail fungus is complemented by lateral onychomycosis, then the ridges surrounding the nail swell, redden and become thicker.A man suffers from pain.When the pathology is aggravated by a bacterial infection, pus can come out from under the nail if you press lightly on it.
Symptoms of proximal nail fungus.This rare lesion of the nail plate mainly affects the area on the side of the skin fold.The main cause of proximal nail fungus is the removal of the eponic (cuticle).The nail plate begins to whiten in the area located near the growth zone.The fungus locates its spores and mycelium precisely in the tunnels of the nail located in this area.As the fungus multiplies, it surrounds the entire nail and completely destroys it.
Symptoms of total nail fungus.If the lateral, distal or proximal form of the disease is not treated, then total onychomycosis appears.The nail loses its color, begins to crumble, break and completely destroy.
Symptoms of superficial white nail fungus.Opal white spots appear in the area of the back pad, which, as the fungus multiplies, completely cover the entire nail.The spots tend to coalesce and may visually resemble fine scattered dust.

Despite existing differences in clinical manifestations in different forms of fungal infection, some common symptoms can be identified, including:

Crushing of nails;
Changing the color of the plate;
Dissection of the nail phalanx;
Painful sensations that occur as the pathological process progresses;
Itchy skin may appear in the area around the nail.

Causes of toenail fungus

Nail fungus always appears as a result of infection by fungal organisms.Most often they are dermatomycetes.Increased keratophilicity is a distinctive feature of the fungi included in this group.They are helped to penetrate the skin and nails by the wide range of proteolytic enzymes they possess.First, dermatomycetes infect the skin of the feet, and then spread to the nail plates.

There are three possible ways in which they penetrate deep into the nail:

From below the distal (free, lateral) edge of the nail.In this case, the pathological process will be localized under the plate - in the bed, and not in the nail itself.As the fungus grows, subungual hyperkeratosis develops.This leads to a deterioration of the bonds between the bed and the plate, followed by their separation.From the bed, the fungus penetrates the nail and slowly destroys it.
Through the dorsal part of the nail, the fungus penetrates into its depths much less often.This method of delivery is available only for dermatomycetes with pronounced keratolytic abilities.In this case, the process of nail destruction will continue much faster.
The rarest route of spread is through the proximal ridge.From the last part of the matrix, the fungus penetrates under the nail plate and into the bed, or settles in the matrix, destroying the collagen structures of the nail phalanx.If the nail lesion is caused by fungi of the genus Candida, then the proximal ridge with its swelling and thickening will first be involved in the pathological process.However, more often such an inflammatory process affects the nails.

In order for the fungus to penetrate the nail area, it must first be damaged and destroyed.

This happens under the influence of the following provocative factors:

Mechanical injuries.
Exposure to chemical factors, such as: regular contact with detergents containing synthetic ingredients, continuous contact with water, application of degreasers, etc.
Wearing things made of synthetic materials, wearing uncomfortable narrow shoes.As a result, a favorable moist and warm environment is created in which fungi multiply quickly.
A sympathetic type of autonomic regulation, in which a person suffers from increased sweating.This factor is related to the individual characteristics of the body.
Flat feet or narrow spaces between the toes, as an anatomical feature of foot development.Such deformations lead to the fact that the ventilation of the foot deteriorates significantly.
Nail growth rate.
Non-compliance with the rules of personal hygiene.
Disorders in the functioning of the immune system.Moreover, nail fungus is not the only disease with a decrease in defense forces.Other organs are also susceptible to fungal damage.
Varicose veins.
Climatic characteristics of the area in which a person lives.Most often, fungal infections affect people who live in areas with mild or cold climates.The fact is that there you often have to wear warm clothes, thick and tight shoes, thus creating favorable conditions for the operation of fungi.Residents of subtropical countries are also at risk, as the development of fungi is facilitated by high humidity and ambient temperature in general.
Age-related changes in the human body.Most often, toenail fungus is diagnosed in the elderly and the elderly.However, dermatologists and mycologists note an increasing trend of incidence in adolescents and children.Thus, statistics show that every 10 years of life increases the risk of infection by 2.5 times.While in childhood the probability of fungal infection is 3%, in the elderly this figure increases to 50%.Experts attribute such indicators to the fact that as we age, the rate of plaque growth slows down, bed nutrition worsens, and angiopathy develops.
Gender.It has been found that men get sick almost three times more often than women.However, it is men who rarely seek qualified help.
Costs of the profession.Fungus on the feet is most often found in miners who serve workers of nuclear power plants and in workers of metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas pollution, the higher the risk of infection.In this regard, visits to specialists for fungal infections by workers in saunas, baths and laundries are becoming more frequent.Frequent visitors of mycologists are massage therapists, orthopedists, employees of rest homes and other representatives of service personnel.
Associated pathologies.The greatest risk in this regard is diabetes mellitus, leg deformities, excess body weight, gastrointestinal diseases, metabolic disorders, thyroid pathologies, any peripheral angiopathy, for example, with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus by 5 times.(also read: HIV causes, symptoms, diagnosis and prevention)
Taking antibacterial, corticosteroid and cytostatic drugs.

As for direct routes of infection, this most often occurs in the following cases:

Visiting saunas and baths, swimming pools and public showers - any public place where people walk barefoot for some time;
Using common household items (even within the family), such as washcloths, slippers, pumice stones, carpets;
Performing cosmetic procedures, especially pedicures, in beauty salons where hygiene standards are not respected.

It is worth knowing that the greatest risk in this regard are wooden floors, benches and other items made of this natural material.The fact is that the wood has a porous structure and it is almost impossible to wash the mycelium of the fungus from there.

Why are toenail fungus dangerous?

It is wrong to perceive toenail fungus as a purely aesthetic problem.This is a serious disease that requires qualified treatment.After all, onychomycosis is one of the most common chronic diseases.Untreated toenail fungus is dangerous due to the following complications:

Prevalence of mycosis of the skin and its appendages in the occurrence of immunodeficiency conditions.
Development of diabetic foot against the background of diabetes mellitus.
Development of erysipelas of the lower extremities.
Development of elephantism.
Development of lymphostasis.
Development of invasive mycosis in patients undergoing immunosuppressive or cytostatic therapy.
Damaged growth of the nail and its rotation in the surrounding tissues, which is accompanied by severe pain and an inflammatory reaction.
Development of eczema.
The addition of a bacterial infection and the development of inflammation.
Loss of nail plate, exposure of the nail bed.
The development of aspergillosis (ie, fungal infection), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Fungus on the feet never affects the nails immediately.

The disease often progresses slowly, passing through several stages of development:

The early or initial stage is a marginal lesion.In this case, any pathological changes are practically invisible.The manifestation of the process is expressed in the appearance of narrow gray lines located in the area of the free edge of the nail.
The stage of the normotrophic lesion of the nail plate.When thickening has not yet occurred and there is no subungual hyperkeratosis, but traces made by the fungus are visible.They look like lines and sectors of damaged tiles.The fragility of the phalanx increases and its color changes.Sometimes serous contents can come out from under the nail.
Stage of hypertrophic lesion.First, onychauxis is formed - a subungual lesion, the nail thickens and hypertrophy increases.The plaque changes color and, depending on the type of pathogen, crumbles, melts, becomes thinner, stops growing or is deformed.As a result, the nail is completely lost.

Initial stage of nail fungus

Most often, the infection is preceded by damage to the skin of the feet.There is an itching sensation in the interdigital folds, cracks, blisters and maceration may appear.As it penetrates deeper into the nail, the fungus begins to touch one or another of its edges.It mainly depends on the type of pathogen and the route of infection, which were described above.

As a rule, the initial stage is not available for self-diagnosis, since there are no obvious clinical signs.Lines and spots on the nails are practically not visible to the naked eye.Detection of the disease is possible in laboratory conditions.

Advanced nail fungus

Advanced athlete's foot is characterized by total damage to the nail phalanx.With a prolonged lack of therapy, the likelihood of not only the complete destruction of the nails, but also damage to the skin, as well as the spread of the disease to the nails of the hands, increases.

The main indicators of the advanced stage of the disease are crumbling, splitting and deformation of the nails.Thinning of the nail body and changing its color occurs gradually over many years.A rapid transition to the total stage of the disease is possible only against the background of existing systemic diseases, which most often occur in old age.The final stage is the destruction of the nail plate or its severe deformation, as well as the development of serious complications that can cause foot fungus.

How to get rid of toenail fungus

The modern pharmaceutical industry offers people who have been diagnosed with toenail fungus a wide selection of effective drugs to cope with the problem.There are means of local and general action.

It is the abundance of antifungal drugs available that makes it difficult to independently choose a drug.After all, fungi can affect not only the toenails, but also the mucous membrane, any organ and tissue.Therefore, it is so important to undergo a comprehensive diagnosis and receive medical recommendations regarding the treatment of nail fungus.

Therapeutic tactics are based on four points:

Accounting for the affected area;
The time that has passed since the onset of the disease;
The nature of the pathological changes provoked by the disease;
The presence of accompanying pathology.

Modern drugs not only destroy fungal organisms and stop their development, but also tend to accumulate in the thickness of the nail plate, staying there for a long time.This allows you to significantly reduce the duration of therapy, up to 8 - 16 weeks.This time will be enough to completely get rid of the problem.What is important is an integrated approach to therapy, a combination of local treatment with oral medications.This begs the question, how to choose a remedy and get rid of toenail fungus?Below we will consider all modern types of drugs.

Antifungal nail polish

When toenail fungus has not reached an advanced stage, only topical therapy can be used.For this purpose, specialized varnishes or solutions containing antimycotic ingredients can be used.

In addition, to achieve a therapeutic effect, you can use patches that have a peeling effect.To make your nails look more attractive, you can apply nail polish over medicated nail polish.

To achieve the maximum effect from the treatment of nail fungus with varnish, you must adhere to some rules:

You should not complete the treatment yourself until you receive laboratory data showing the absence of fungus in the nails;
The application of varnish must be regular and without skipping;
The treatment can last a year and this is a necessary measure to get rid of the fungal organism.

Toenails have the ability to accumulate medicine to a greater extent than fingernails.You should not combine varnishes, as their therapeutic effect will be lower.

There are also some contraindications for therapy with antifungal varnishes:

Lactation period;
Carrying a fetus;
Individual intolerance to the components of the drug;
Childhood.

Sometimes reddening of skin areas around the nail is possible.

Rules for the use of antimycotic varnishes:

Using a nail file, you need to remove as much as possible from the affected nail;
Degrease the surface of the nail using a solution based on water and alcohol, or use a soap and soda bath to steam the nail;
Apply the medicine;
Once a week it should be removed using a regular solvent.

Remedies for removing nails affected by fungus

Before applying the nail remover, you should steam your feet in water, where there is a teaspoon of liquid soap and soda per 1000 ml.Then the feet are dried, the skin around the affected nail must be fixed using an adhesive plaster.The product is applied to the affected area in a thick layer, but without rubbing.The upper part of the nail is also fixed with an adhesive plaster.

After 4 days, the patch is removed, the feet are steamed and the nail affected by the fungus is simply removed using manicure tools.

Antifungal tablets

Systemic antibacterial agents are required in cases where toenail fungus has reached an advanced stage.Only a doctor can choose the optimal treatment regimen.There are many tablets that can get rid of fungus, but some of them are incompatible with hormonal contraceptives, some cannot be taken in childhood, and some are prohibited for use if you have liver problems.

Local treatment with cream, spray, ointment

If the therapy is chosen correctly and the symptoms of the fungal infection are completely eliminated and the scheme is completed, then the affected nail tissue will eventually be replaced with a healthy one.

However, complete recovery can only be verified by performing tests that patients undergo 14 and 30 days after the end of therapy.If during the treatment the skin on the leg begins to peel and redden, this is a manifestation of an allergy that appears in response to the use of the drug.Therefore, it is important to stop the treatment in time.

Other means

Oils: tea tree and lavender.As for lavender oil, it can eliminate irritation and tea tree oil helps fight bacteria.However, it is important that the oil is natural;only in this case can they have the desired effect.

Apple cider vinegar, mouthwash, lemon juice.After mixing these three products, you should soak your feet in the resulting solution for about a quarter of an hour.This is an excellent addition to the main antifungal treatment.

Laser treatment

Treatment of the disease with laser beams is a method of physiotherapeutic treatment.It can only be used in combination with antifungal drugs to achieve an effect.Laser therapy alone will not completely eliminate nail fungus.This procedure aims to improve nail nutrition and increase blood circulation.As a result, the antifungal drug penetrates better into the damaged plaque.However, the laser itself cannot kill the fungus.

This method has no contraindications and reduces the risk of disease recurrence.Laser therapy is a safe and painless way to fight fungal nail infections.

Prevention of toenail fungus

If a person's immune system is working properly, then toenail fungus will not harm him even after infection, as the immune system will neutralize it on its own.If a fungal infection spreads along the nail plate, then it is necessary to choose the best methods to fight it.

This is a rather labor-intensive process, so the following preventive measures can help prevent infection:

You should avoid walking barefoot on the beach;
Closed rubber slippers are the optimal footwear for saunas and baths;
Socks for everyday wear should be made of cotton fabric;
It is forbidden to wear someone else's shoes;
You must keep your feet dry.