Toenail Discoloration, Fungus & Treatments

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Concerned about the color of your toenails? Do you shudder at the thought of sandal season or showing your feet in public? If you’ve noticed a discoloration of your toenails—particularly a yellowish hue—you might be experiencing the signs and symptoms of toenail fungus.

The most common cause of toenail fungus is called onychomycosis, and nail discoloration is one of the first indications you’ve acquired this infection. Although it isn’t life-threatening, it can certainly take its toll on your personal or social life. However, you’re not alone; in fact, it is estimated that 10% of people in the United States have this condition.1 Plus, there’s an increased chance of developing toenail fungus as you age—while onychomycosis is uncommon in pediatric patients, its prevalence in geriatric populations is estimated to be as high as 60%.1

Toenail discoloration stemming from a fungal infection may present in a variety of ways, such as:2

Your toenails have a yellow-brown hue to them.
You see white spots on your toenails.
Your toenails have become brittle, break easily, and have jagged edges.
You notice your toenails are misshapen.
Your toenails increase in thickness and become more difficult to trim with standard nail clippers.
If dirt and debris accumulate under the nail, the toenail may appear dark.
There’s a foul odor emanating from your feet.​

In some instances, toenail fungus doesn’t cause discomfort, though misshapen nails can pose a problem when wearing shoes. On other occasions, toenail fungus can wind up being more than just an unsightly cosmetic issue. In more severe cases of infection, the toenail may loosen from the nail bed or fall off altogether. Furthermore, a toenail fungal infection can spread to the surrounding skin, causing an uncomfortable, itchy condition known as athlete’s foot.
How Do You Treat Toenail Discoloration?

Unfortunately, toenail discoloration related to fungal infections is challenging to treat, rarely goes away on its own, and typically requires medical intervention.2 Even though your toenails may take a while to become healthy, there are several over-the-counter and prescription options to choose from to help you address the root of the problem.

Over-the-Counter Medications (OTC)

If you take a walk through your local pharmacy aisles, you’ll find plenty of creams, polishes, and powders purporting nail repair benefits. But a search for OTC medications yields a mixed bag of results with regards to treating toenail discoloration and nail fungus. Some sources claim you should expect to see results in a few days or weeks, while others say OTC medications are only for mild cases of toenail fungus.

But there are two things almost everyone can agree on: First, make sure that your toenail discoloration is actually due to a fungal infection. While that’s the most likely reason, it’s not the only reason your toenail color could be off; 50% of cases of nail disease can be attributed to causes other than fungus or yeast infections including other infections or diseases and trauma.1 So OTC medications might not be geared toward your specific needs.

Second, if you’ve tried an OTC product for a few months without seeing results, schedule an appointment with your doctor. You may need to implement a different strategy for banishing toenail discoloration.

Prescription Medications

Your doctor may prescribe a medication to treat the underlying cause of toenail discoloration. For example, your doctor might place you on an oral, antifungal drug regimen. These drugs include Lamisil (terbinafine) and Sporanox (itraconazole).2

The downside to using oral medications is that they take several weeks to months to work, and you might not see results until a new toenail grows back. Also, oral antifungals can cause side effects—most commonly, headaches, stomach upset, rashes, and liver toxicity. Since some of these medications can be hard on your liver, your doctor may require you to have periodic blood tests to see if your body’s tolerating the treatment well.

Unlike oral medications, many creams and ​topical antifungal agents haven’t proven as effective at treating toenail fungus. The main reason for this is because the medications can’t permeate hard nails, though some experts suggest the effectiveness of creams can be enhanced by first filing your nails, so you make them thinner. Like other treatments, you may have to wait a significant amount of time before results are visible.

Enter nail lacquers, which you paint on your toenails and the surrounding skin. Ciclopirox is an antifungal drug that is mixed in a nail lacquer such as Loprox and Penlac. But they are not very effective when used without oral drugs.2

The use of nail lacquers requires commitment and compliance, because you may need to use the product daily for several months. However, there are some side effects associated with topical nail lacquers, which include itching, rashes, and scaling skin, among other things.

Laser Treatments

The Food and Drug Administration has approved some different types of laser treatments for toenail fungus, and initial evidence suggests they may be helpful at reducing the symptoms.3 However, your insurance company might not cover the cost of laser treatments, and you could be stuck with a hefty price tag. While the emerging research is promising, the overall evidence is still lacking to know if this technology works better than other types of treatment.

Surgery

In some cases, medications may not resolve the condition, and surgical intervention might be necessary.4 Your doctor may consider surgery to remove the toenail if you have an infection that is resistant to drug therapy. Or, your doctor may determine that it’s necessary to remove a nail to place medication directly on the infected portion of the skin. Finally, surgery might be the best course of action for your condition if you’re experiencing intense pain and discomfort.
A Word From Verywell

No matter what treatment you choose, it’s going to take time to see results. But if you begin to notice some discoloration on your toenails, don’t be afraid or embarrassed to talk with your doctor. The sooner you get treatment, the more likely you are to successfully tackle a fungal infection and grow a healthy nail.