Fungal Toenails

What are fungal nails?

Fungal toenails, also known as onychomycosis, are a common infection that affects the toenail and the skin beneath it. The infection is usually caused by fungi called dermatophytes, although yeasts and moulds can also be responsible. Fungal toenails are more common in adults and become increasingly prevalent with age.

Many people assume these changes are simply a normal part of aging. However, healthy toenails should remain smooth, relatively thin, and firmly attached to the nail bed. While aging can naturally cause nails to become slightly thicker, significant thickening, discoloration, crumbling, or separation from the nail often indicates an underlying condition such as a fungal infection.

Fungal toenails rarely resolve on their own. Without appropriate assessment and treatment, the infection may slowly worsen, spread to other nails, or increase the risk of skin infections in some individuals. People living with diabetes, poor circulation, or a weakened immune system should seek professional assessment promptly if they notice changes in their toenails.

An accurate diagnosis is important because not all thick or discoloured nails are caused by fungus. Trauma, psoriasis, eczema, and other nail conditions can look very similar. At Sooke Foot Care and Wellness, we assess your nails and, when appropriate, offer PCR fungal testing to help confirm the diagnosis before recommending a treatment plan.

What are the signs and symptoms?

A fungal infection often begins at the edge of the nail and gradually spreads underneath the nail plate. As the infection progresses, the nail may become:

• Yellow, white, or brown in colour

• Thickened and difficult to trim

• Brittle, crumbly, or uneven

• Lifted away from the nail bed

• Misshapen or distorted

• Uncomfortable or painful, especially when wearing shoes or walking

What Causes Fungal Toenails?

Fungal toenails develop when microscopic fungi enter the nail through tiny cracks in the nail or surrounding skin. These fungi thrive in warm, moist environments, making feet particularly susceptible to infection.

Common factors that increase the risk of developing fungal toenails include:

• Wearing closed-toe shoes for long periods, especially if your feet become sweaty.

• Walking barefoot in public places such as swimming pools, locker rooms, or communal showers.

• Having athlete's foot, which can spread from the skin to the toenails.

• Nail injuries or repeated trauma, such as stubbing your toe or pressure from tight-fitting footwear.

• Increasing age, as nails tend to grow more slowly and become more vulnerable to infection.

• Diabetes, poor circulation, or conditions that affect the immune system.

• A family history of fungal nail infections, which may increase susceptibility.

Fungal infections are not caused by poor hygiene alone. Even people who take excellent care of their feet can develop a fungal nail infection. Once the fungus becomes established beneath the nail, it is protected by the hard nail plate, making it difficult for over-the-counter creams to penetrate effectively.

Although fungal toenails are usually not a medical emergency, they typically do not resolve without treatment. Over time, the infection may spread to other toenails or surrounding skin, causing the nail to become increasingly thick, brittle, and difficult to manage.

PCR Fungal Nail Testing

Not every thickened or discoloured nail is caused by a fungal infection. Trauma, psoriasis, eczema, aging, and other nail conditions can produce changes that look very similar. That's why every appointment at Sooke Foot Care and Wellness begins with a comprehensive nursing assessment of your nail and foot health.

If the cause of your nail changes has not already been diagnosed by your physician or nurse practitioner, PCR fungal testing is available to detect the presence of fungal organisms. The results, together with your clinical assessment and health history, help guide discussions about the most appropriate treatment options and ensure your care is based on the best available information.

If you have already received a diagnosis of a fungal nail infection from your physician or nurse practitioner, PCR testing is generally not required.

When Should You Seek Treatment?

If you've noticed changes in your toenails that aren't improving, it's a good idea to have them assessed. Early treatment can help prevent the infection from progressing and may improve treatment outcomes.

Consider booking an assessment if you notice:

• One or more toenails becoming yellow, white, brown, or discoloured.

• Nails that are thickened, brittle, crumbly, or difficult to trim.

• A nail that is lifting away from the nail bed.

• Pain or discomfort when walking or wearing shoes.

• The infection spreading to additional toenails or the surrounding skin.

• Recurrent athlete's foot along with changes to your toenails.

• Nail changes that have persisted for several months.

You should seek professional assessment promptly if you have a fungal-looking nail and also have:

• Diabetes.

• Poor circulation (peripheral arterial disease).

• Peripheral neuropathy (reduced sensation in your feet).

• A weakened immune system.

These conditions can increase the risk of complications, making early assessment especially important.

Book a Consultation

Ready to take the next step?

Book your ToeFX Consultation and Nail Assessment to learn more about your treatment options. During your appointment, we'll assess your nails, answer your questions, and create a personalized treatment plan based on your individual needs.