The Center for Podiatric Care and Sports Medicine

How to Recognize and Treat Toenail Infections

Posted by on Wednesday, October 17th, 2012


There’s no way to sugarcoat this–toenail infections are yucky and ugly. Nevertheless, plenty of people get them, so let’s talk today about these nasty little infections and what you can do about them.

How do I know I have a toenail infection? Oh, you’ll know it–your toenail will start to grow thicker and will change color. Sometimes there may be a discharge of pus. The nail may eventually fall off or crumble away. By then you can be pretty sure you have a toenail infection.

Well, what kind of colors? Can you be more specific? Absolutely! There are four main types of toenail infections. Here’s how to recognize them:

  • Distal subungual onychomycosis The nail turns yellow or green in the area between the top of the toenail and the toe, on the outer and inner edges of the nail. If left without treatment, the nail will harden and may fall off. This is the most common type of toenail fungal infection.
  • Proximal subungual onychomycosis Look for white or yellow discoloration near the cuticle. If left untreated, the affected areas will crumble away, and the infection will spread to the rest of the nail.
  • White superficial onychomycosis A white substance will grow over the nail. If untreated, the nail will crumble away (infected nails LOVE to crumble!).
  • Candida onychomycosis You’ll see the nail turn yellow or green, and will lose that translucent appearance that lets you see the pink nail bed underneath. As the infection progresses, the nail will get thicker and may fall off.

Okay, well, yuck, yuck, yuck, and super yuck. How do you get nail infections (as in preferably you, not me)? The fungi that cause nail infections are highly contagious and they love warm, moist environment. They hide in toenails, socks, and shoes. So if someone at your local pool or in your gym’s locker room has a toenail infection, everyone is at risk. You can also get them if your feet sweat heavily, as the fungi will be happy to grow in your damp shoes and socks if you keep them on. The one that’s a little different is the Candida infection, which affects people who have their feet or hands (these all attack fingernails too) submerged in water for long periods of time (for example, if you’re trying to get way too much out of your feng shui aquarium).

So how can I avoid them? Everything you’ve ever been told about always wearing flip flops or some kind of shoe in the locker room or at the pool is true. Never walk barefoot in these places. Shower shoes will save your toenails (and your feet–the fungus that causes athlete’s foot also thrives in these environments). Stay away from wet shoes and socks; if you do find yourself caught wearing them for a little bit (like if you are out running and the skies open for a downpour, as happened to me this morning), get them off as soon as you can and wash your feet thoroughly and dry them completely, especially between the toes. Throw the socks in the wash–don’t forget about them in the bottom of your gym bag. Let your shoes dry completely before you put them on; if you’re suspicious of them, dust them with anti-fungal powder before you put them on again.

And what if you (preferably not) have a toenail infection? There are over the counter topical ointments or creams you can find in a drugstore to treat toenail infections. There are also some home remedies you can try if you catch them early.

  • Put a mix of teatree oil and olive oil on the nail for about fifteen minutes, then scrub it off.
  • Soak your feet in a mix of apple cider vinegar and water.
  • Soak your feet in Listerine (yes, Listerine–it’s an antiseptic for your mouth, so why not your toenails?).

If that doesn’t do the trick, then you need to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) to really get rid of it, probably with laser treatments. Lasers have proven to be one of the most successful ways to really eliminate stubborn fungal infections.

It’s certainly fun to say you’re being treated with lasers, but you don’t want to let a toenail infection reach that point. Keep your feet dry and take time to take a look at your toenails so you can catch that infection before it gets bad!


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.