Professional Podiatry Services of New York

Skin & Nail

Fungal toenails

Toenail fungus (onychomycosis) causes nails to thicken, discolor, and crumble. It is common, stubborn, and treatable — but not every discolored nail is fungal, so an accurate diagnosis comes first.

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What is it?

Fungal organisms infect the nail and nail bed. Other conditions, such as nail trauma and psoriasis, can look very similar.

What causes it?

  • Athlete's foot spreading to the nails
  • Damp shoes and communal showers
  • Repeated nail trauma
  • Diabetes and reduced circulation
  • Age

What does it feel like?

  • Yellow, white, or brown discoloration
  • Thickened nails that are difficult to trim
  • Crumbling edges
  • Discomfort in shoes from thick nails

How is it diagnosed?

A nail sample can be sent for laboratory testing to confirm fungus before starting treatment.

When should you see a podiatrist?

  • Nails that are thick or painful
  • Discoloration spreading to other nails
  • Nail changes with diabetes

Nonsurgical treatment

Professional debridement
Thinning thick nails reduces pain and improves response to topical treatment.
Topical antifungals
Useful for mild to moderate cases; require months of consistent use.
Oral antifungals
More effective for extensive cases; require screening for suitability.
Prevention
Treating athlete's foot, drying shoes, and protecting feet in communal areas.

When is surgery considered?

Nail removal is occasionally considered for painful, severely damaged nails.

What is recovery like?

Healthy nail replaces infected nail slowly — a big toenail takes roughly a year to grow out completely.

Frequently asked questions

Why does toenail fungus take so long to treat?

Toenails grow slowly. Improvement is visible only as healthy nail grows out from the base.

Does toenail fungus come back?

It can. Ongoing prevention reduces the chance of reinfection.