Toenail fungus affects at least 20 percent of the population, and three-fourths of those affected are over age 60. Initially, toenails turn yellow and grow thicker, and skin around the nail may itch. As the condition progresses, toenails become brittle, edges become jagged and the nail itself may become deformed or may detach from the nail bed. This make trimming the nails difficult, and if the nails are too thick, wearing shoes may be uncomfortable. Left untreated, toenail fungus could lead to serious infections.
Types and Causes
Onychomycosis is the medical name for toenail fungus, and multiple fungi species are often the cause. Because fungus thrives in warm, moist areas, such as showers, feet are vulnerable to infection. Age, malnutrition and some medical conditions, such as diabetes, are also causes of toenail fungus. There are four types of toenail fungus.
- DSO (distal subungual onychomycosis) The most common form of toenail fungus, DSO infects the nail itself and the skin under the nail. Skin and nail fragments collect under the nail, which may split, crumble and separate from the skin. DSO can continue throughout a person’s lifetime and be difficult to treat.
- WSO (white superficial onychomycosis) The second most common form of toenail fungus, WSO affects the nail’s top layer. White spots develop on the nail’s surface, which is eventually covered in an eroding, chalky powder.
- Candida Onychomycosis An uncommon form of toenail fungus, candida onychomycosis is a yeast infection that affects the nail and skin around the nail. Invading weak nail areas, the condition causes toenails to become oddly shaped and turn green, white or brownish. Nails may be red, swollen, warm, tender and painful.
- PSO (proximal subungual onychomycosis) Affecting the nail base near the skin fold, PSO causes thickened skin which separates from the toenail. Infection may impact skin on top of feet. PSO is common among those with HIV.
Problems and Complications
Since toenail fungus is not usually painful, many people merely think of it as an unsightly inconvenience, but it could be much more. Severe cases are often painful and could permanently damage toenails. For those with taking medication or have a condition that causes a suppressed immune system, onychomycosis could lead to infections that spread to other areas. Those with diabetes often have reduced blood circulation in the feet and a higher risk of cellulitis, which is a bacterial skin infection. Because of this, toenail fungus could lead to health complications. It’s important to see a foot and ankle surgeon to avoid these complications.