Toe Nail Fungus


A fungal infection of the nail may affect part of the nail, the entire nail, or several nails.

Visible Signs

Visible fungal nail infection signs include:

  • Scaling under the nail (subungual hyperkeratosis)
  • White or yellow streak on the nail (lateral onychomycosis)
  • Crumbling corner or tip of the nail (distal onychomycosis)
  • Flaking white areas on the nail’s surface (may include pits in the nail)
  • Yellow spots at the bottom of the nail (proximal onychomycosis )
  • Loss of the nail

Common fungal nail infection signs include:

  • A distorted nail
  • An odor coming from the infected nail
  • A brittle or thickened nail
Tests to diagnose: 

Nail Examination: He or she may scrape some debris from under nail and send it to a lab to identify the type of fungus causing the infection.


Treatments may vary, depending on the nature and severity of the infection. Your podiatrist can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.

Newer oral antifungals, approved by the Food and Drug Administration, may be the most effective treatment. They offer a shorter treatment regimen of approximately three months and improved effectiveness. Your podiatrist may also prescribe a topical treatment, which can be an effective treatment modality for fungal nails.

In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail that has not responded to any other treatment permits the fungal infection to be cured and prevents the return of a deformed nail.

Trying to solve the infection without the qualified help of a podiatrist can lead to more problems. With new technical advances in combination with simple preventive measures, the treatment of this lightly regarded health problem can often be successful.

Antifungal tablets

Taking antifungal medication in the form of tablets means that the treatment reaches your nail through your bloodstream.

Terbinafine and itraconazole are the two medicines most commonly prescribed for fungal nail infections and they can be very effective.

However, you may have to take the tablets for several months to ensure that the infection has completely cleared up. If you stop taking the medication too early, the infection may return.