Summer may be months away. But if your feet are looking (or smelling) a little different due to toenail fungus, you should get to work on that pronto. It can take several months to get rid of the fungus. But starting now may help you be sandal-ready, particularly if you catch the infection in an early stage and can prevent it from changing the nail's texture and becoming more noticeable. Even if the condition has advanced, consider that treatment now may also help control odor.
What the fungus?
Fungal nail infections are common and occur when fungi get underneath the surface of the nail. Toenail fungus infections usually come from athlete’s foot that has spread to the nail, says Dina Strachan, M.D., a board-certified dermatologist and director at Aglow Dermatology in New York City. People can get athlete’s foot and nail fungus from walking barefoot in damp public places like swimming pools, locker rooms and showers. It’s also possible to pick up a fungal infection at the nail salon if the pedicure tub and instruments aren’t sanitized, Strachan says.
As we get older, fungal nail infections tend to be more common. That’s because your toenails also get older and become brittle and dry, leading to small cracks. Those cracks provide an entryway for fungi.
“As we get older, fungal nail infections tend to be more common. That’s because your toenails also get older and become brittle and dry, leading to small cracks. Those cracks provide an entryway for fungi.”
Not sure if you have nail fungus? Some clues: One or more of your toenails may have a whitish to yellow-brown color. If the infection has progressed, the nail may be thick, brittle, crumbly or the shape may be off.
The good news is toenail fungal infections are usually painless and harmless. It’s mostly a cosmetic issue. So, you don’t have to treat it if it’s not bothering you. One caveat: See a doctor if you have a suppressed immune system due to diabetes, other conditions or medication. In those cases, nail fungus can lead to serious infections.
If you want the fungus gone, there are several treatment options.
Self-care and DIY treatments
First, keep your feet clean and dry. Let them breathe as much as possible. “If it’s appropriate, wear open shoes because fungi like warm, dark, damp environments,” says Strachan.
Chances are, if you ask a family member or friend, they’ll have a home remedy for nail fungus. Many people swear by Vicks VapoRub. Others say tea tree oil, applied once or twice daily, can nip it in the bud. And some folks claim soaking the feet in mouthwash for 30-45 minutes daily will help get rid of toenail fungus.
The belief is different ingredients in these products work to kill off the fungus and prevent more from growing. So as your new nail grows out, it will be healthy and fungus-free.
There may be something to some of these DIY remedies. A very small study showed that applying a pea-sized amount of Vicks VapoRub to the nail once a day helped treat (or at the very least, improved) toenail fungus. And another small study suggests that tea tree oil might help with nail fungus. Still, more clinical evidence is needed to determine if any of these (or other) home remedies truly treat toenail fungus.
Just know that you’ll have to be patient and consistent. It can take anywhere from several months to a year before you see results. Even after your toenails start to look better, keep up your regimen. Once the fungus is clear and your new nail grows out, you may want to do the treatment periodically as a preventative measure because fungus can come back.
Sometimes, you can take care of a mild case of toenail fungus with OTC antifungal creams, ointments or nail polishes. However, topicals aren’t as effective as prescription oral antifungals.
That said, if you try an OTC treatment, remove your toenail polish, file off any white markings on the surface of your nail and then apply the product. It may help the medication better penetrate the nail.
If your toenails don’t improve with the OTC antifungal, or their appearance worsens, see a dermatologist or podiatrist.
At the doc’s office
On the prescription side, there are topical antifungal creams and solutions (similar to nail polish). You apply the medication to the affected toenails daily. It can take months to see the results. While using these treatments, skip nail polish. Although some topicals claim to penetrate nail polish, they will likely penetrate better without it, says Strachan.
Oral antifungal pills are the most effective treatment for toenail fungus. They offer a shorter treatment period, about three months. Plus, you may be able to wear regular nail polish since the treatment is systemic. The downside to oral antifungals is they can affect the liver and can interact with other medications. So not everyone can take them.
Sometimes doctors recommend both an oral and topical antifungal at the same time. Another option, though less effective, is laser therapy.
If the fungal infection is severe, keeps recurring or you’re unable to take oral antifungals, your doctor may remove the infected nail to treat the nail bed directly.
Regardless of the treatment method, be patient. Antifungals kill the fungus, but you must wait for the old nail to grow out, Strachan says. So, it can take several months to a year before your nail looks “normal” again.
Unfortunately, toenail fungus might come back even after treatment. These things will, hopefully, allow you to rock your favorite sandals fungus-free:
- Wash your feet regularly and dry them thoroughly.
- Trim your toenails straight across. Disinfect the clippers after each use.
- Wear shoes that fit properly and are made of breathable material.
- Wear shower shoes at public pools, locker rooms and showers.
- Choose nail salons that sanitize instruments after each use (or bring your own). Make sure a disposable barrier is used in the pedicure tub.
- Treat athlete’s foot before the infection spreads to your toenails.