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Do your toenails start to smell after going swimming? Or do they have a yellowish-brown discoloration days after visiting the nail salon? If you have been experiencing these symptoms, there’s a huge chance that you have a fungal infection that is damaging your toenails. This condition is known as fungal nail infection or onychomycosis.

Nail and foot fungus usually begins as a harmless little yellowish spot under the tip of the nails. But if not addressed, it can spread, thus infecting the whole nail and its nearby structures, such as the healthy tissues and blood vessels underneath.

Fortunately, we at Florida Foot & Ankle Associates can restore your nails through proper treatment methods, such as oral medications and fungal nails laser treatment.

Get rid of your yellowish, brittle nails by consulting one of our expert podiatrists in one of our clinics near you. 

We have locations throughout South Florida, our specialists serving the Greater Miami Area, including Miami-Dade (Miami, Kendall, Miami Beach, Hialeah, Coral Gables), Broward County (Hollywood, Pembroke Pines), and Palm Beach County (Boca Raton). Find your doctor here!


What Is Fungal Toenail Infection?

Fungal nail infections or onychomycosis refers to a condition that typically affects the toenails and sometimes the fingernails. It is caused by different species of fungi that may develop in your nails in two ways:

  • Fungi that live in the environment can get inside your nails through an open wound or small cracks in the skin.
  • Fungi already present in your body (normal flora) may overgrow or proliferate because of a weakened immune system or environmental factors (e.g. moist and dirty shoes).

Toenail fungal infections have four different types. It is differentiated based on its location and the type of fungal species that caused the infections.

Distal Subungual Onychomycosis or DSO

This is the most common type of onychomycosis, occurring in 60 to 70% of reported nail infection cases. It is also known to occur 20 times more common in the toenails than the fingernails. 

Distal subungual infection occurs when a fungal species called dermatophyte infects the nail bed and nail plate. The disease starts as a yellowish spot at the edge of the nail, which can spread throughout the underlying nail matrix.

Proximal Subungual Onychomycosis

Proximal subungual nail infection starts at the base of the nails, specifically in the lunula (the white, half-moon-shaped structure in the nails). It begins at the center of the toenail, then infects the proximal nail fold area. 

Like DSO, it is also caused by dermatophytes, specifically by the organism called Trichophyton rubrum. However, this condition occurs rarely and only affects people with weakened immune systems, such as persons living with HIV/AIDS.

White Superficial Onychomycosis or WSO

White superficial onychomycosis is another uncommon toenail infection that only occurs in 10% of all reported cases. It mainly affects the nail surface, causing “white islands” to appear on the infected area. Over time, the areas with white spots may become powdery, causing the nail to crumble.

Additionally, WSO may be caused by both dermatophytes and molds, like the Aspergillus species.

Candidal Onychomycosis

This type of nail infection is caused by a yeast species called Candida albicans. It usually infects the structure underneath the nails (nail bed), causing it to get inflamed, edematous, and reddish.

Candidal infections usually occur on the fingernails after an injury or as a complication of another disease called chronic mucocutaneous candidiasis. However, it can also infect the toenails, penetrating the soft tissues underneath and causing the entire nail to come off.

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What Do Fungal Nails Look Like?

Generally, nail fungal infections in the feet manifest, more or less, the same way despite its many types. You’ll know that it’s a fungal infection when there’s a discoloration of the nails, a change in texture, a change in shape, or a combination of the three. Here are some of its most common symptoms:

  • Whitish, yellowish, or brownish spots in the nail, which may spread over time.
  • Thickened, brittle, or crumbling nail.
  • Oddly looking nail that features a distorted shape.
  • A nail that looks like it’s coming off the nail bed.
  • An unpleasant odor coming from the infected toenail

Source: https://www.nhs.uk/conditions/fungal-nail-infection/ 

Furthermore, a fungal nail infection usually starts at the edges of the nail (left photo) and only features a slight nail discoloration. If left untreated, it can infect the soft tissues underneath the nail and even affect nearby toenails or the entire foot (right photo).

What Causes Toenail Infections?

Fungi, molds, and yeast overgrowth primarily cause fungal toenail infections. But how do they actually develop in, under, and on the toenails? Here are some of the most common situations or environmental conditions that might make you contract onychomycosis:

  • Walking barefoot in warm, moist public spaces. This includes public swimming pools, communal showers, and gyms.
  • Contact with a person (or their things) with fungal infection.
  • A nail salon that does not disinfect or sanitize its materials properly. 
  • Old age may cause the toenails to become dry and brittle, causing tiny cracks in the nails. This then may become the entryway for fungi in the environment.
  • Foot fungus such as Athlete’s foot, ringworm, and jock itch can also spread to the toenails. 
  • Underlying medical conditions, such as diabetes, weakened immune system, or poor blood circulation.
  • A minor skin or nail injury, which can serve as the entry point of fungus.

Anyone can develop a nail fungal infection. However, studies suggest it occurs mainly in males than in females and older adults than in children. 

Additionally, fungal infections can be hard to treat without antifungal pills and fungal nails laser treatment. So, avoid resorting to home remedies you see on the internet if you have a foot fungus, or else it will develop into a nail infection that can be difficult to get rid of.

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When Should I See a Podiatrist or Foot Doctor?

Fungi, yeast, and molds tend to spread over time if left untreated. The best thing to do is seek the help of an expert podiatrist to get a proper diagnosis, treatment, and preventive interventions for your condition.

Your podiatry specialist will perform a physical exam of your toenails and a medical history check to diagnose your condition. They might also do other tests to confirm their diagnosis, such as

  • Microscopic examination of nail clippings or scrapings.
  • Fungal culture

If you think you might have a fungal problem with your nails, then you should visit one of our many podiatric offices right away. Use our practice locator tool to find the doctor’s office closest to you.

How Do You Treat Fungal Nails?

Fungal infections can be difficult to cure using self-care remedies and over-the-counter products. Podiatrists usually prescribe topical and oral medications or laser treatment for fungal nails. Typically, treatment strategies will depend on the severity of your condition and the type of fungus that caused it.

Topical Medication

Topical antifungals refer to medications you can apply to your infected nails through rubbing or brushing. An example is a medicated nail polish called ciclopirox or antifungal nail cream. 

However, doctors rarely prescribe topical medications alone since they’re only effective for mild and superficial infections. 

Oral Medication

Doctors usually prescribe oral antifungal medications as the first line of defense for nail fungal infections. They can recommend it together with topical creams to completely remove the inhabiting fungus in your nails. Some examples of antifungal pills are:

  • Terbinafine
  • Itraconazole
  • Griseofulvin
  • Fluconazole

Generally, the treatment course can range from 6 to 12 weeks. These drugs will eliminate the nail infection and help a new nail grow as a replacement.

Fungal Nails Laser Treatment

Laser treatment for fungal nails uses energized light to destroy the fungus without affecting nearby healthy tissues. Furthermore, the heat emitted by the laser will decompose the affected skin and nails while also sterilizing the surrounding areas to prevent another fungal growth. 

Laser therapy may be a relatively new treatment option against nail infections. However, studies proved that patients with fungal toenail infection showed 91% clinical improvement after their laser treatment.

Besides its effectiveness, this treatment is also painless, fast (lasts for 30 minutes or fewer), and requires no anesthesia.

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Where Can I Find the Best Podiatrist in Florida?

If you are tired of seeing your unsightly nails, then it’s time to seek the help of the podiatric experts at Florida Foot and Ankle Associates. We specialize in treating all kinds of foot, ankle, and toenail problems using the latest techniques and technologies, such as fungal nails laser treatment.

Besides nail and foot fungus, our experienced foot doctors also provide other services that focus on podiatric care. This includes:

And more!

So, whether you’re looking for a heel pain doctor or an expert ankle surgeon, we’ve got you and your foot problems covered! Just contact us by calling at 786-662-3893 or scheduling an appointment, so we can start your consultation and treatment planning. 

You can also visit our website to find one of our many offices closest to you.


The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.


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8200 NW 27th St
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