How to Know If Toenail Fungus Is Dying: Key Signs and Tips

Understanding Toenail Fungus

What is Toenail Fungus?

Toenail fungus, medically known as onychomycosis, is a common fungal infection that affects the toenails. It occurs when microscopic fungi enter the nail through small cuts, cracks, or trauma. 

Toenail fungus, or onychomycosis, affects approximately 13.8% of adults in North America. According to AAFP, prevalence increases with age, affecting up to 20% of people over 60.

The infection can spread to surrounding toenails, skin, or even fingernails if left untreated. Common causes include poor foot hygiene, wearing tight shoes, and walking barefoot in damp communal areas like locker rooms and pools. Warm, moist environments provide ideal conditions for fungi to thrive, making toenail fungus a widespread issue.

Types of Toenail Fungus

• Distal Subungual Onychomycosis: This type affects the skin under the nail, usually starting at the tip and spreading backward.
• Proximal Subungual Onychomycosis: Begins at the base of the nail, near the cuticle, and spreads outward. It is less common and often associated with weakened immune systems.

• Appears as white spots on the surface of the toenail. This type only affects the top layer of the nail and is easier to treat. However, it can spread quickly across the nail.

• Caused by Candida yeast, this infection is less common in toenails but more prevalent in mucous membranes and the gastrointestinal tract. It typically leads to inflammation and nail thickening.

Consider using Symptom Checker to identify potential issues and consult a professional for tailored advice. Always seek professional medical advice before taking any action.

Treatment Options for Toenail Fungus

Over-the-Counter Treatments

• Antifungal Creams and Polishes: These products contain ingredients that help kill the fungus and prevent its spread. Antifungal creams should be applied directly to the affected nail and surrounding skin as per the product instructions. Clear antifungal nail polishes can be applied once or twice a week and provide a protective layer while treating the infection.
• Home Remedies: Some people find success with natural remedies like tea tree oil, vinegar, and essential oils. Tea tree oil has antifungal properties and can be applied directly to the nail. Soaking feet in a mixture of vinegar and water may also help reduce infection. Essential oils such as lavender and oregano oil can be used due to their antimicrobial benefits, but their efficacy is not guaranteed.

Prescription Treatments

• Oral Antifungal Medications: These are often prescribed for severe or hard-to-treat infections. They work from within the body to eliminate the fungus. However, they can have side effects and may interact with other medications, so it's crucial to follow a doctor's guidance.
• Topical Treatments and Compounded Creams: Prescription-strength topical treatments are applied directly to the nail and surrounding area. Compounded creams often contain a combination of antifungal and steroid ingredients to enhance effectiveness and reduce inflammation.

Advanced Treatments

• Laser Therapy: This involves using focused light to penetrate the nail and kill the fungus. It is a newer treatment method with varying success rates.
• Professional Treatments: Consulting a podiatrist for persistent infections is essential. They can provide tailored treatments, such as surgical removal of the nail in extreme cases or advanced topical treatments.

See the doctor if:

• Persistent or worsening symptoms after several weeks of treatment.
• Significant pain or discomfort associated with the infected nail.
• Signs of the infection spreading to other nails or surrounding skin.

Stages of Toenail Fungus Recovery

Early Stage

In the early stage, you will notice initial signs of improvement such as a reduction in discoloration and slight improvement in nail texture. Over-the-counter antifungal creams or polishes, combined with good foot hygiene, can be effective at this stage.

Moderate Stage

In the moderate stage, the infected nail may still be thick and uncomfortable. The nail might show signs of healthy growth at the base, but the fungus is still present. Consistent use of prescribed antifungal medications, whether topical or oral, is essential. 

Late Stage

In the late stage, the nail may remain thick and brittle, but new growth should be more visible. The infected nail might start to separate from the nail bed (onycholysis). This stage can be frustrating due to the pronounced effects of the fungus. Intensive treatments such as laser therapy or minor surgical procedures might be required.

Full Recovery

Full recovery from toenail fungus can take 12 to 18 months, as the nail needs to fully regrow and replace the infected areas. Maintaining treatment and following preventive measures, such as good foot hygiene, wearing breathable shoes, and keeping feet dry, are essential to avoid reinfection. Patience and adherence to the treatment plan are key to complete recovery.

Signs That Your Toenail Fungus Is Dying

Changes in Color

One of the first indicators that the treatment is effective is a reduction in discoloration. Toenail fungus often causes nails to turn white, yellow, brown, or even black. As the infection begins to clear, these discolorations will gradually fade. You may notice that the affected areas become smaller, and the natural nail color starts to return.

Decrease in Nail Thickness

Fungal infections can cause toenails to thicken and become raised. An effective treatment will lead to a decrease in nail thickness over time. While this might not be immediately noticeable, consistent use of antifungal treatments will gradually normalize the nail's texture and thickness. It's important to continue the treatment as prescribed, even if the nail appears to be improving.

Healthy New Nail Growth

Another positive sign is the appearance of new, healthy nail growth. This usually starts at the base of the nail, near the cuticle. The new growth should look clear and normal, contrasting with the infected upper part of the nail. This indicates that the fungus is no longer affecting the nail bed, allowing healthy nails to grow.

Clear Delineation Between New and Infected Nail

As the treatment progresses, you will likely see a clear line between the healthy new nail and the older, infected nail. This delineation shows that the infection is being pushed out as the new nail grows. Over time, the healthy nail will continue to replace the infected portion, eventually leading to a fully healthy nail.

It's important to remain patient and persistent with the treatment. Toenail fungus can take several months to completely clear, and the nail might not look fully normal until it has entirely grown out. During this process, maintain good foot hygiene and avoid environments that can cause reinfection.