What Is the Best Treatment for Fungus on Your Toe?

Toe fungus treatment may involve over-the-counter (OTC) topical antifungal products, foot powder or talcum powder, prescription oral antifungals, lasers, and photodynamic therapy.

Skin fungal infections are skin diseases caused by fungus, such as mold or mildew. The most common types of fungus that occur on the toe include:

• Tinea pedis (“athlete's foot”)
  • A contagious fungal infection caused by a ringworm
• Onychomycosis
  • Fungal infection of the nails 

Treatment to get rid of fungus on the toes includes:

• For mild cases affecting less than 50% of one or two nails for onychomycosis
  • Over-the-counter (OTC) topical antifungal products
• To kill athlete’s foot fungus
  • OTC topical antifungal products 
• For chronic tinea pedis 
  • Adjunctive therapy such as foot powder or talcum powder may be needed to prevent skin softening
• For chronic or extensive fungus 
  • Prescription oral antifungals 
    • Itraconazole (Sporanox)
    • Fluconazole (Diflucan)
    • Terbinafine (Lamisil Oral Granules)
• Non-drug treatments
  • Lasers that emit infrared radiation    
  • Photodynamic therapy using 5-aminolevulinic acid or methyl aminolevulinate followed by exposure to red light 
  • Iontophoresis and ultrasound are being studied for use to enhance the delivery of antifungal drugs to the nail plate

Symptoms of fungal infections of the toes may include:

• Redness
• Scaly, cracked skin
• Swelling
• Itching
• Ring-shaped rash
• Deep fungal infections
  • Red, swollen, itchy, peeling skin between toes 
  • Toenails, soles, and heels may be affected
  • Blisters (in severe cases)

Onychomycosis may be caused by:

• Dermatophytes such as Trichophyton rubrum (T. rubrum), T. interdigitale (tinea unguium)
• Yeasts such as Candida albicans and rarely, non-albicans Candida species
• Molds such as Scopulariopsis brevicaulis and Fusarium species.

Athlete’s foot (tinea pedis) is usually caused by human dermatophytes, a type of fungus transmitted by direct contact with human ringworm sores. Ringworm may also be acquired from the soil or through exposure to animals such as household pets.

Risk factors for developing athlete’s foot include:

• Use of public showers or locker rooms
• Athletes involved in contact sports, such as wrestling
• Excessive sweating in tight shoes 
• Close contact with affected animals such as household pets
• Living in a warm, humid climate
• Close contact with a person who is infected
• Working with soil that has ringworm fungus
• Sharing bedding, towels, or clothing with a person who is infected
• People who have a weakened immune system (such as from HIV/AIDS, cancer, chemotherapy, diabetes, or certain medications)

Fungal infections of the toes are diagnosed with a physical examination of the affected skin. 

Tests that may be used to help diagnose fungus on the nails include:

• Skin scraping that is examined under a microscope or sent to a laboratory for a fungal culture
• Ultraviolet light may be used to diagnose two species: Microsporum canis and audouinii