Nail It! Tips on Toenail Yeast Infections

Published: June 07, 2024
By Amelia Bryant, PharmD Candidate
Gabrielle Pierce
By Gabrielle Pierce, PharmD, MBA

What is a toenail yeast infection?
A toenail yeast infection is a type of fungal infection, which is contagious. It is caused by tiny organisms called fungi, and you can get this infection by coming into contact with someone or something that has been contaminated with these fungi. Some things that put you at risk for a toenail yeast infection are:

  • Prolonged moistness (feet being in sweaty shoes or socks for a long period of time, soaking in water)
  • Walking barefoot in a warm moist place (dorm showers, public pool deck, locker room)
  • Fungal infection on your foot (Athlete’s foot)
  • Injury to the nail
  • Medical conditions that affect the nails like psoriasis, diabetes or weakened immune systems

How do you know if you have a toenail yeast infection?
The nail will look chalky, the color may change to dull yellow or white, and it can become brittle or crumbly. There can be thickening of the nail or debris underneath the nail. The nail can also lift up from the top of the toe. If your nail looks like this, or if you have any of these symptoms, you should go to a primary care doctor, urgent care, dermatologist, or podiatrist (foot doctor).

Why is treatment important?
Although this type of infection is usually painless at first, treating it early is important. If the infection worsens from not treating it, it can then become painful to wear shoes or tight socks. If you don’t treat the infection, there is also the risk of it spreading to other nails or parts of the body, or even to other people. If the infection is treated early, there is a higher chance of the infection going away and eventually having a clean healthy nail. It is NOT recommended to just cover it up with nail polish, as this will not get rid of the infection.

What about over-the-counter (OTC) treatment?
With OTC products, you are mostly treating the infected skin around the nail, not the nail itself. OTC options are not as effective as prescription medications for treating the nail infection. Some examples of OTC options include:

  • Clotrimazole (FungiCure Intensive)
  • Tolnaftate (Fungi-nail, Opti-nail)
  • Undecylenic acid

If athlete’s foot is the cause of your toenail infection, there are different OTC treatments for that. Urea (Kerasol) is an option that can improve the appearance of the nail, but does not treat the infection itself.

How will the doctor treat it?
If you have tried over the counter solutions and your toenail has not improved, this means you need to see a doctor to treat the yeast infection. There are two options for medications that your doctor might prescribe.

Solutions are for more mild infections, and are applied to the nail almost like nail polish. These help keep the nail from getting more infected while it grows out. It can take a long time for toenails to grow out (12-18 months), but you must remember to use the medication for as long as prescribed. Side effects include redness or burning after applying the solution, swelling, or an ingrown toenail. Some examples of these solutions are:

  • Amorolfine (ex: Locetar, Amofin)
  • Ciclopirox (ex: Loprox, Ciclodan)
  • Efinaconazole (ex: Jublia)
  • Tavaborole (ex: Kerydin)

For more severe infections, your doctor may prescribe antifungal medications you can take by mouth. These medications work faster, and can clear the infection in as little as 3 months. However, there are more serious side effects. These medications also can interact with other medications, so make sure to ask your pharmacist about drug interactions before starting these. Also, because some of these medications can have an effect on your liver, you should also avoid drinking alcohol during your treatment course. Some examples are:

  • Fluconazole (ex: Diflucan)
  • Griseofulvin (ex: Gris-PEG)
  • Itraconazole (ex: Sporanox)
  • Terbinafine (ex: Lamisil, Terbinex)

How can you prevent toenail yeast infections?
Even with clearing or getting rid of the infection with medications, it can still come back, so it is important to use precautions and try to prevent any more infections.

  • If you are going to be in a public moist or wet area, wear flip flops or shower shoes.
  • Wash your feet, especially between the toes and dry them well every day.
  • Moisturize dry skin to prevent cracks (fungi can get in through small cracks in the skin).
  • Trim toenails straight across and shorter than the end of your toe.
  • Don’t share personal items like nail clipper and towels, and disinfect nail clippers before each use with an alcohol swab.
  • Wear clean socks every day and change them after they get too sweaty.
  • Prevent fungi from growing in your shoes by keeping them dry, using antifungal powder in the shoes, or alternating shoes to give them time to dry out.

Toenail yeast infections are very easy to get, from walking in public wet places or soaking in water, so it is important to take steps to prevent these infections and keep your feet and toes clean and healthy. If you do need medication to treat the infection, ask your pharmacist about any interactions with other medications you take, and remember to take the medication exactly as instructed.

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