Toenail Infection

Toenail infections are infections that are often caused by nail fungus—medically known as onychomycosis—but may also be the result of a virus or bacteria.

Toenail infections are infections that are often caused by nail fungus—medically known as onychomycosis—but may also be the result of a virus or bacteria. Nail fungus typically appears as a yellow or white spot at the tip of the toenail, and can cause the nail to discolor, thicken or become brittle the deeper the infection goes. The infection typically occurs when there is a crack in the nail or in the skin around it (paronychia of the toenail), such as from an ingrown toenail.

In most cases, the infection is mild and doesn’t cause a problem (other than an aesthetic one). Additional symptoms that point to a fungal infection include:

  • An unpleasant smell originating from one or more toes
  • Pain or sensitivity
  • The nail is warped or abnormal in shape
  • The toenail is black in appearance, likely due to a buildup underneath the nail
  • White or yellowish brown discoloration

What causes a fungal toenail infection?

A fungal toenail infection can appear on anybody, but it tends to affect males more than females and older patients more than younger ones. The most common type of fungus that results in infection is called dermatophyte, which is responsible for infections like ringworm (Tinea unguium).

Risk factors that increase the risk of a fungal infection include:

  • A history of athlete’s foot
  • Diabetes or other conditions that result in poor circulation to the extremities
  • Having a skin condition that can cause the skin to split, such as psoriasis
  • Having a weakened immune system
  • Sweating heavily or excessively
  • Walking barefoot in common areas that are damp, such as shower rooms, pools or gyms

How is a toenail infection diagnosed and treated?

A doctor or specialist will thoroughly examine the patient’s foot and toes. Then, nail clippings or debris scrapings from under the nail may be sent to a lab for analysis to determine which fungus (or other microbe) is causing the infection.

Treatment can be difficult for a fungal infection and depends on the severity as well as the fungus. Medications that can be taken orally (oral antifungal drugs) or directly applied to the nail, such as a medicated polish or cream.

In some cases, temporary removal of the nail may be necessary so the antifungal medication can be applied directly to the nail bed where the infection lies. If the infection causes severe pain and doesn’t respond to treatments, permanent removal of the nail may be recommended.

How can toenail infections be prevented?

To keep fungal toenail infections from occurring or reoccurring, make the following actions a habit:

  • Avoid artificial nails and nail polish
  • Choose a nail salon with sterilized tools
  • Choose shoes that breathe, such as those made of cotton
  • Trim nails across, smooth edges out and file down thickened nail (be sure to disinfect clippers after each use)
  • Wash and moisturize hands and feet regularly, especially after handling an infected nail
  • Wear footwear in damp communal places
  • Wear socks that absorb sweat or change them throughout the day

EUP: The Toenail Infection Specialists

Essex Union Podiatry (EUP) is a complete foot and ankle practice, serving the podiatric needs of Essex and Union counties. Our specialty-trained physicians utilize the latest techniques and tools to diagnose, treat and provide preventive care for all foot and ankle conditions. With an emphasis on patient education, our practice offers quality care by creating an informative and personalized treatment plan tailored to meet individual needs. 

For more information or to schedule an appointment with one of our podiatrists, contact us today.

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Jason P. Galante, DPM,

Jason Galante, DPM, AASPS

Nancy A. Kaplan, DPM, MBA, AACHE, FACFAS


Sarah E. Haller, DPM, AACFAS