- The fungi that cause toenail infections typically belong to the dermatophyte family. These are tiny organisms that can be microscopic in size. Dermatophytes do not require sunlight and thrive in dark, warm, moist environments like the one created by wearing shoes. Certain molds and yeasts can also cause toenail infections.
- Dermatophytes thrive in community environments such as dormitory showers and public swimming pools. They enter the body through small, even microscopic cuts in the skin or through tiny separations between your toenail and the nail bed. If the environment continues to be moist and warm it is possible for the fungi to grow and spread.
- Fungal nail infections typically affect toenails more frequently than fingernails because of the warm, dark, moist environment created by wearing shoes. However, because there is not as much blood circulating in the toes as there are in the fingers, the body's natural immune system may have a more difficult time discovering that a threat exists in the toenails until it is too late.
- Older adults tend to be more susceptible to toenail infections than the general population, perhaps because of decreased circulation that is a common result of aging. Men tend to get more toenail fungus infections than women, and there appears to be a genetic propensity involved. People who perspire heavily, have diabetes or psoriasis, frequent warm, damp, public environments, or have weakened or compromised immune systems are at greater risk than the general public for contracting toenail infections.
- Toenail fungal infections are notoriously difficult to treat. Even though there are numerous over-the-counter medications available, they do not appear to be highly effective in treating serious cases of toenail infection. In most serious cases professional medical treatment is necessary. Oral prescription medications, including the antifungals terbinafine and itraconazole, appear to be quite effective. Other professional treatment options include prescription topical medications, laser light therapy and surgery.
