Toenail Fungus – Causes, Symptoms and General Treatment

Onychomycosis or nail fungus is a common malady of the nails of the feet. In medical parlance, onychomycosis is a type of fungal nail infection. Today, this trouble affects more than 30 million Americans each year.

Onychomycosis might be caused by one of three types of common fungi: dermatophyte fungus, non-dermatophyte fungi and common yeasts.

Yeast infections in both men and women share some common characteristics with toenail fungus, such as its growth in warm and moist places.

Toenail fungus does not lend well to home remedies, and will not go away without professional treatment.

Medical diagnosis

Confirmation of the presence of nail fungi is done through culturing of nail samples from patients. Doctors do this by placing nail samples in a pre-mixed compound.

The compound used for confirming the presence of nail fungi is potassium hydroxide, diluted to about 20% of its original strength.

Heating is then done, and under a microscope, fungi species are examined and identified to confirm diagnosis. Presence and proliferation are both key to successful diagnosis of nail fungi.

Under a microscope, the nail fungi exhibits branching-off characteristics and root structures.

Types of nail fungi

The most common ailment of human nails is distal subungual onychomycosis or DSO. “Subungual” means “beneath the nails”. This particular ailment is caused by the Tinea rubrum fungus species.

Onychomycosis that manifests itself near the cuticle is called proximal subungual onychomycosis. This particular nail infection has been categorized as one of the secondary symptoms of AIDS.

Superficial onychomycosis on the other hand is the third sub-form of nail fungus.

This particular nail infection is caused by the tinea mentagrophytes species. It is characterized by generalized spread of white spots on the surface of the nails.

Sources of infection

Age plays a significant part in the proliferation of nail fungus. The ailment is more common to adults than on children. But there are also instances of onychomycosis in children. This is called pediatric onychomycosis.

In diabetic patients, it has been found that infection from Trichophyton mentagrophytes is common.

For non-diabetics, venous insufficiencies such as problems with lymph nodes has been pointed as possibly one of the causes.


Treatment of onychomycosis is done through the application of topical remedies and through the ingestion of oral antifungal drugs.

Griseofulvin has been used for a long time to combat nail fungi. Unfortunately, this particular drug yielded low success results. The cure rate for Griseofulvin was only 23.8%

Other oral medications prescribed to patients with nail fungus infections are Itraconazole (often known by the brand name Sporanox) and Terbinafine (often known by the more popular name Lamisil).

Both Terbinafine and Itraconazole require ingestion for about 12 weeks. Sporanox comes in 200 gram tablets while Lamisil comes in 250 gram tablets.

For patients taking Rifampin, the FDA has cleared both drugs for safe use in conjunction with the other drug.