Early-Stage Toenail Fungus Symptoms and Treatment
Medically reviewed by Adam H. Kaplan, DPM
If your toenail has recently become thickened and discolored, you may be dealing with a fungal infection known as onychomycosis. You are not alone—this has been found to affect about 14% of people. You may first notice the edge of the nail looking thicker and more brittle before it spreads to the rest of the nail.
This article will highlight the first signs of toenail fungus and discuss its causes, how to determine if you have it, early treatment options, and what happens if you leave it untreated.
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What Are the Early Symptoms of Toenail Fungus?
The early stage of onychomycosis may start as a simple, painless spot on the tip of the nail. That area of the nail may turn a color such as white, brown, or yellow. With time, this may begin to affect more of the nail. Also, residue may build up under the nail.
The nail may also begin to pull away from the bed, and the top may become powdery. Over time, the nail may become discolored and thickened and may start to split and break down. Eventually, this may spread to the other nails.
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What Causes Toenail Fungus?
Toenail fungal infections are caused by various species of fungi, which flourish in heat and humidity. Fungi can also cause other infections, such as ringworm and athlete's foot. If your toenail has a crack or injury, you may be particularly susceptible.
Some of the ways you may acquire toenail fungus include the following:
Coming into skin-to-skin contact with someone who has the fungal infection on their skin
Using a nail clipper or towel previously used by someone with the infection
Walking barefoot in a warm, moist place such as an indoor pool or locker room
Wearing sweaty socks and sneakers where fungus may thrive
However, not everybody who comes into contact with a fungal organism will develop toenail fungus. Some things that will make you more vulnerable include:
Your state of health: If you are contending with a condition such as cancer, especially if you are undergoing chemotherapy, you may be at an increased risk. You may also face an increased risk if you have diabetes or psoriasis (an autoimmune skin disease).
Your age: It is unusual for children to have a toenail fungus infection. The older you get, the more common this infection becomes.
Previous fungal infections: If you've had previous nail infections or fungal infections like athlete's foot, you may be more prone to developing nail fungus.
Nail cracks or injuries: Injuries or cracks in your nails can give the fungus a potential entry site. Runners and athletes whose toes repetitively hit the tips of the shoe can have micro-injuries to the nail that allow fungi to enter.
How Do I Know I Have Toenail Fungus
If your toenail is undergoing some changes, you may not be sure whether the changes are due to an injury or a fungal infection just by looking at it.
If you recently stubbed your toe or dropped something heavy on it, you may be contending with a bruise. If there is a black area underneath the nail, that is likely what it is. But if the nail appears gray, yellow, or even greenish, then the likelihood is that this is a fungal infection.
You may also want to check to see if the nail is still fully attached to the bed. If it has begun to separate, it may be a case of toenail fungus.
To determine whether it's toenail fungus, a healthcare provider will take samples of the nail, the debris underneath it, and the nearby skin. These samples will be mixed with a special dye/stain and then undergo close examination with a microscope to determine what organisms may be infecting the area.
A fungal skin infection (like athlete's foot) found in the surrounding area will often appear as nail fungus.
How Is Early Toenail Fungus Treated?
To treat early toenail fungus, a healthcare provider will first trim away as much of the fungus-infected nail as possible, including clearing away any debris in the area.
They will then prescribe medicine for you to apply to the affected nail every day or every week. The idea is to keep any remaining fungus from spreading so the healthy toenail has a chance to grow out over the next year or year and a half.
Possible topical medicines (applied to the nail) you may be prescribed include the following:
Amorolfine
Penlac Nail Lacquer (ciclopirox)
Jublia (efinaconazole)
Kerydin (tavaborole)
If you are prescribed one of these medicines, particularly one you must use less frequently, you may want to develop a system for reminding yourself to apply it so that it can effectively keep the fungus in check as the nail grows.
What Happens if Early Stage Toenail Fungus Is Untreated?
It may be easy to dismiss toenail fungus, especially in the beginning. In the early stages, it doesn't cause pain and may be confined to just one part of one nail. But it's important not to forgo treatment. If left untreated, it will likely spread, affecting more of the initial nail in question and also beginning to impact other nails and the surrounding skin.
As toenail fungus gets worse, it can become more unsightly and painful. In some cases, it may even become painful to wear shoes.
The condition also becomes more difficult to treat. Early on, topical treatment is the mainstay, but it may not be sufficient to eliminate the infection. Instead, you may need to take an antifungal pill such as Diflucan (fluconazole), Grifulvin V (griseofulvin), Sporanox (itraconazole), or Lamisil (terbinafine), either alone or in combination with topical treatment.
If the toenail fungus is severe enough, it may become necessary to remove the nail altogether, either by applying a chemical to the area or by surgically removing it. The nail can grow back, but the fungus may return as well. Your healthcare provider can also treat the area so that the nail will not return.
Can You Prevent Toenail Fungus?
Steps you can take to help avoid developing toenail fungus include the following:
Keep your nails well-groomed, clip them regularly, and keep the area clean.
Don't continually keep your feet in sweaty socks and shoes. Instead, keep them dry when possible.
Wear flip-flops or other shoes in public areas like locker rooms or pool areas.
Don't borrow a nail clipper from anyone.
If you get a professional manicure, ask about the sterilization procedures for the equipment.
Summary
Detecting toenail fungus can be a little tricky in its early stages. It may resemble a simple nail injury, which will resolve on its own. But if it's toenail fungus, it may only get worse, expanding from a spot on just the tip to thicken and discolor more of the nail and detach it from the bed.
This may be treated early using topical fungal medication. But if this progresses, then more aggressive oral treatment may be necessary. If left untreated, this may spread to other nails and even affect the surrounding skin.
Read the original article on Verywell Health.
