Introduction

Understanding athlete’s foot and toenail fungus

If you’ve ever experienced itchy, peeling skin between your feet, you might have had athlete’s foot. This fungal infection affects the skin on the feet, causing discomfort and irritation.¹ While athlete’s foot may seem like a minor issue, leaving it untreated can allow the infection to spread to their toenails, leading to toenail fungus (onychomycosis).

Toenail fungus is an infection that affects the nails. It begins as a white or yellow-brown spot under the tip of the toenail. As the infection progresses, the nails may become discoloured, thickened, and brittle, sometimes crumbling at the edges. In severe cases, the nail can separate from the nail bed, causing discomfort and increasing the risk of further infection.²

Importance of the topic

Toenail fungus is more than just a cosmetic concern. It can cause pain, discomfort, and trouble walking, especially in severe cases. It is also highly contagious,  meaning it can spread to other nails or the surrounding skin, worsening the athlete's foot.

Understanding how athlete's foot causes toenail fungus is important for early intervention and prevention. Treating athlete's foot quickly can stop the infection from spreading to the toenails, eliminating the need for long and sometimes difficult treatments.

Athlete’s foot: causes and symptoms

What causes athlete’s foot?

Athlete's foot is caused by fungi known as dermatophytes, which thrive in warm, damp environments such as:

• Public showers and swimming pools
• Shared towels
• Footwear or socks³

Common symptoms

Athlete’s foot can affect one or both feet. Common symptoms are:

• Itchiness, burning or stinging
• Blisters
• Scaly, peeling or cracked skin between the toes
• Inflamed skin that might appear reddish, purplish or greyish

How athlete’s foot leads to toenail fungus

Spread of infection

Athlete’s foot and toenail fungus are caused by the same type of fungi known as dermatophytes. If athlete’s foot is not treated effectively, the infection can sometimes spread to other parts of your body, such as toenails, causing a fungal nail.

Common ways the infection spreads include:

• Contaminated surfaces: Walking barefoot in communal areas like gym showers increases the risk
• Direct contact: Touching infected skin and then your toenail can transfer the fungi
• Tight, sweaty footwear: Moist environments inside shoes encourage fungal growth and allow athlete’s foot to spread to the nails¹

Once the fungus infects the toenail, it becomes much harder to treat. This is why treating athlete's foot early is key to preventing toenail fungus.

Risk factors

Several factors can increase the risk of developing athlete’s foot and toenail fungus, including:

• Sweat heavily between toes
• Frequently wearing enclosed footwear
• Older age
• Having minor skin and nail injuries
• Walking barefoot in public areas
• Having diabetes, blood flow problems, or a weakened immune system

Addressing these risk factors, you can greatly reduce your chances of developing a fungal infection.

Prevention strategies

Foot hygiene

• Wash your feet daily and dry them thoroughly, especially between the toes
• Change your socks regularly
• Keep your nails trimmed. Disinfect your nail clippers after each use. Letting your nails grow long allows more places for fungus to grow
• Alternate your pairs of shoes
• Wear breathable shoes
• Don’t share shoes or unwashed bedding and towels

Avoiding contaminated surfaces

Wear waterproof sandals or shoes in the pool and locker rooms.

Early treatment of athlete’s foot

• Use antifungal creams or sprays at the first sign of infection to prevent spreading to the toenails
• Don’t ignore persistent itching or peeling skin, as it could be the start of a fungal infection

Following these methods will lower the chance of infection and stop the fungi from spreading to your toenails.

Treatment options for toenail fungus

Topical treatments

Medicated nail polish, such as ciclopirox (Penlac) or nail cream, such as efinaconazole (Jublia) and tavaborole (Kerydin), can help mild infections but must be used consistently for several months. These are most effective when paired with regular nail trimming and filing to allow the medication to penetrate deeper.

Oral medications

Oral drugs such as itraconazole (Sporanox) can help a new nail grow free of infection, slowly replacing the infected part. This treatment normally lasts for 6 to 12 weeks, but may take a few months or longer to remove an infection.

Medical procedures

For severe cases, your healthcare provider might suggest temporary removal of the nail so that the antifungal drug can be applied directly to the infection under the nail and to allow new, healthy nail growth.

Laser therapy could also be suggested, which uses targeted heat to destroy fungal cells in the nail.

FAQs

Why is toenail fungus so hard to get rid of?

Although the fungus changes the appearance of the nails, it lives on the layer right beneath the toenail. This is why it's so difficult to treat. Your nails are made up of keratin, a strong, fibrous protein. The same hard shell that protects your toes also provides a home to the fungus.

What happens if you have toenail fungus for too long?

If you leave a nail fungus infection untreated for too long, various issues can arise. The infected nail may grow malformed and gradually separate from the nail bed. Itching and pain are unpleasant side effects; if they are too severe, you may have difficulty wearing shoes or walking.

What not to do with toenail fungus?

Do not go barefoot in public areas. Apply a fungus-fighting spray or powder to your feet and shoes. Do not pick at the skin surrounding your nails. Do not apply nail polish or fake nails to your nails.

Summary

Athlete's foot is a fungal infection that causes itching, peeling, and irritation in the skin of the feet. If left untreated, the fungi can spread to the toenails, resulting in a more persistent condition known as toenail fungus. This infection can cause nail discolouration, thickness, and brittleness, which makes treatment more challenging.

Both conditions thrive in warm, moist surroundings and can be spread by direct touch or contaminated surfaces, such as public showers and shared footwear. Early intervention is important for preventing toenail fungus, and keeping good foot care helps stop its development.

Treatment options include antifungal creams, oral medications, and medical procedures for severe cases. Proper foot care, breathable shoes, and quick treatment of athlete's foot can help avoid long-term fungal infections and keep feet healthy. You can protect your foot and avoid recurring infections by taking preventative measures.