By: Dr. Jere J. Mammino, D.O.


Nails in good condition can be very attractive, as well as serve
many important functions. They help us pick up and manipulate objects and support the tissues of the fingers and toes. Sometimes these can be infected with a fungus. This is more common in the toenails because they are confined in a warm, moist environment. The fungus often causes the end of the nail to separate from the nail bed. Additionally, debris can build up under the nail and cause the nail to become discolored.

How is this treated?

If the nail infection is early, with only mild separation and debris at the end of the nail, topical medications can be used. This is applied in the form of a gel or lacquer. Most infections however need oral medication. The most effective pills are Lamisil and Sporanox, which are taken for three to four months.

How do I prevent recurrence?

  • Keep feet cool and dry.
  • Wear socks made of cotton, wool, or similar absorbent material.
  • Apply antifungal foot powders to shoes daily (e.g. Zeasorb AF)
  • Wear shoes of correct size and fit to reduce biomechanical stresses and microtrama to toenails; limit the use of narrow-toed shoes and high heels.
  • Discard or rest footwear that may have a high density of fungal spores, such as old worn shoes or those worn without socks.

  • Avoid walking barefoot over surfaces that may have a high density of fungal spores: carpeting, bathroom floors, showers, gymnasiums, and locker rooms. Wear sandals or appropriate footwear in these areas.
  • Keep toenails short, cutting them straight across. Do not round out the edges. Do not use the same clippers to cut normal and abnormal nails.
  • Family members and close friends should be examined for foot/nail fungus. If found, they should be treated.
  • Examine for and treat any other fungus infection on the body, especially the groin.
  • Keep a high index of suspicion for recurrence of foot/nail fungus. Return to the office if there is any abnormal itching, redness, blisters, or scaling. Also return if there is any abnormal appearance in previously normal appearing nails.
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