The Dangers of Ignoring Toenail Fungal Infections

Untreated toenail fungus may spread to the surrounding area of the foot.
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With all the serious health dangers out there, like cancer and diabetes, having a yellowed nail from toenail fungus can seem pretty insignificant. Since toenail fungus (onychomycosis) usually isn’t painful, many people put off seeking treatment, says Peter Joseph, DPM, a podiatrist with Allegheny Health Network in Pittsburgh. While many people are otherwise healthy and may just think of it as a cosmetic problem, ignoring a toenail infected with fungus could have health consequences beyond appearances. Potential complications of a toenail fungal infection:

Foot pain. Over time, a nail infected with fungus can become thick and misshapen, causing pain, Dr. Joseph says. It can even make it difficult to walk when wearing shoes, according to the American Podiatric Medical Association.

Spread of the fungus. Sometimes untreated toenail fungus can spread to the surrounding skin on the foot. This may result in athlete’s foot, a condition marked by itchy, red, cracked skin. “If you wear shoes and socks all day and one of your toenails is infected, it can spread quite easily because fungus thrives in a warm, dark, moist environment,” Joseph says. The fungus can also spread to the genitals, where it becomes jock itch, a condition that can affect both men and women, according to the American Osteopathic College of Dermatology.

Widespread infection. This complication of toenail fungal infection is of particular concern for people with diabetes and other chronic conditions that weaken the immune system. If a toenail fungus spreads to the skin and causes it to crack, bacteria can get in. This may cause cellulitis, a condition that produces swollen, red, tender skin and must be treated with antibiotics, according to the U.S. National Library of Medicine. In severe cases of cellulitis, the infection can enter the bloodstream and be deadly. “And it can all start from a simple fungal infection,” Joseph says.

Loss of nails. The American Osteopathic College of Dermatology explains that toenails infected with fungus can separate from the nail bed, a condition known as onycholysis. If this happens, the loose portion of the nail will need to be removed. Even if an infected toenail doesn’t become loose, it may still need to be removed if the fungus doesn’t go away with traditional treatments. In this case, a procedure called an avulsion is used to remove the entire nail. Sometimes the nail is removed permanently through a procedure called a matrixectomy. “This destroys the growing center at the base of the nail, either surgically or chemically, so it won’t grow back,” Joseph says.

Treating Symptoms of Toenail Fungus

If you suspect you have a toenail fungal infection, see a doctor, Joseph says. Your doctor may take a small sample from your toenail and have it analyzed to confirm the presence of a fungus. If the test comes back positive, an oral or topical antifungal medication may be prescribed to help treat the fungus. Most medications are well tolerated with few side effects, Joseph says.

If the affected area of your toenail is small and doesn’t hurt, your doctor may take a wait-and-see approach and just observe the infected nail over time. While the fungus is unlikely to go away on its own, it may not get any worse. “If you can live with a spot on your nail, then it might be fine with no treatment,” Joseph says. “But if you have cosmetic concerns, then a small dose of medication will probably take care of it.

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