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My toenails are gross!

by Dr. Richard Perez

Posted on May 30, 2014 at 10:47 AM

I often hear words similar to this from many of my patients who seek podiatric care for their toe nail problems. More often then not, the problem can be blamed on fungus. Toenail fungus is a very common problem seen by podiatrist. It is often ignored, starting out as a small discoloration on the tip of the nail. But with time, that small area grows and grows. And before you know it, your nails are thick, crumbly yellowish black and you have what seems like a case of really bad dry red skin to the soles of your feet. Well, you have full blown nail fungus and associated athletes foot infection and a visit to the podiatrist's office is not far behind.

As, the disease progresses, your nails can even start hurting from pressing against the tops of your shoes. Yikes!


Risk Factors Example Remedy
Living in a warm, humid climate San Antonio None
Exercise Microscopic trauma to nails from sports such as running, football and soccer cause opportunities for fungus to get under the nail and cause infection Insure you are using shoes that are sport specific and are correctly sized. Shoes that are too small or big can increase the change of trauma to the nail.
Cuticles Pushing your cuticles back Cuticles serve a vital function sealing the top of the nail to the skin. If this "seal" is damaged, fungus will have an easy time getting under the skin and causing infection.
Work Boots being inside a hot work boot all day long causes the foot to sweat, a lot. The materials in the boot will become damp. The damp, dark boot promotes fungus. Try to allow your boots to dry out by using 2 pairs and alternating the days they are used.
Communal Showers Gyms showers Wear flip flops when taking a shower. Then immediately apply an anti-fungal spray to the feet and between the toes right after your shower, before putting on your shoes.
Pedicures Nail salons Make sure your salon is properly sterilizing the instruments between each use. They should open the instruments from the sterile packs in front of you. Consider skipping whirlpool spa.
Chronic Diseases Diabetes, HIV, Lupus.. Diseases which lower your immune system make it easier for fungus to multiply once under your skin.

Home Treatments

The best podiatric treatment is prevention! But that is not useful if you already have nail fungus.

Things NOT to do

  • Soak your foot in vinegar
  • Apply bleach to your nails
  • Spray Lysol on your nails
  • Apply beta-dine to your nails

Possible treatments: Soak your feet in warm water for ten minutes, then, using an Emory board, sand down the thickness of your nails as much as possible.

  • Apply over the counter anti-fungal nail solution as directed, or;
  • Apply Tea tree oil daily to the affected nails, or;
  • Apply Vick's Vapor Rub daily to the affected nails.

Unfortunately, the chance that these treatments will provide any meaningful improvement is less the 10%!

Fungus is a very hard problem to treat and usually requires a comprehensive approach, addressing the environment of the feet, the fungal load of the shoes and the active infection.

During my podiatric consultation with patients, I discuss the multi faceted steps which will be required to effectively treat this stubborn problem!