For some people, the idea of ​​wearing sandals or open shoes on a dressy occasion or in hot weather is something to be avoided at all costs. They feel ashamed, because they represent the 35 million Americans, or 10 to 15 percent of the population, who suffer from toenail fungus. They avoid showing feet with brittle, brittle nails that have turned black, yellow, or green.

According to the Mayo Clinic, aging is the most common risk factor for toenail fungus and is more likely to affect men than women, particularly those with a family history of the infection. The organization offers the following reasons why aging is a factor:

• Decreased blood circulation
• More years of fungal exposure
• Nails can grow more slowly and thicken with age, making them more susceptible to fungus.

People with toenail fungus do not need to spend more time hiding their feet. There are solutions. However, it’s important to first understand the cause of the infection, the various treatments available, and how to keep your feet healthy to help prevent recurring infections, because people who get toenail fungus tend to get it again and again.

Causes of toenail fungus

Dermatophytes, a type of fungus that can grow naturally on hair, nails, and skin, are never a problem because they can’t penetrate the skin. However, the fungus, Trichophyton rubrum, can feed on keratin, the protein-rich portion of the toenail that gives the nail its hardness and strength. This fungus can eventually invade the body through a small cut, blister, or exposed nail bed.

Because toenail fungus is contagious, sharing personal items such as shoes, socks, nail files, nail clippers, shower and locker room floors, and rugs can spread the infection.

Additionally, keeping your feet in shoes also promotes fungal growth. Each human foot sweats up to eight ounces a day. While socks can absorb some sweat, what doesn’t evaporate ends up in our shoes. That, combined with the dark, damp environment of shoes, creates a breeding ground for fungi and bacteria that can cause toenail fungus, as well as athlete’s foot and shoe odor. The Mayo Clinic lists “wearing socks and shoes that hinder ventilation and don’t absorb perspiration” as a factor that can increase your chances of developing toenail fungus.

Toenail Fungus Treatments

There are many claims, especially on the internet, about toenail fungus remedies. Some of these include tea tree oil, foot powders, Vicks Vapor Rub, an apple cider vinegar injection, or vinegar foot baths, Listerine or cornmeal and water.

The Mayo Clinic says that over-the-counter antifungal nail creams and ointments aren’t very effective. The organization does note that studies have shown oral medications such as terbinafine (Lamisil) and itraconazole (Sporanox) to be “the most effective treatments.”

Medications are usually prescribed for six to twelve weeks, although it may take at least four months for the nail to clear toenail fungus when the infected nail fully grows out. Dr. John Sigle, of the Foot and Ankle Center in Illinois, says: “Terbinafine is effective 60 to 65 percent of the time, with a 35 to 40 percent cure rate. Side effects can include rashes and liver damage. Weekly liver tests are often necessary during treatment. People with congestive heart failure or liver disease should not take these medications.”

The fact is, there is no quick fix with topical creams, prescription hairsprays, or oral medications. Each involves a long, slow process that works less than 50 percent of the time. Buyers should be aware that many advertisements may be misleading and may not provide complete information about effectiveness and risks.

One of the most promising treatments is laser treatment. Laser technology is approved by the FDA to treat toenail fungus. The effectiveness varies from 60 to 75 percent and the average treatment takes from 10 minutes to an hour and requires up to four sessions. There are no reported side effects and no medication is required. The cost can range from $600 to $1,000. Insurance companies don’t cover it, because they consider the procedure “cosmetic.” Although laser treatment is expensive, it can be the most effective option.

keep feet healthy

Keeping your feet healthy is critical to a long-term toenail fungus solution. One of the reasons people get reinfected is due to the fact that they put their feet in shoes, which harbor infection-causing organisms. A 2012 article in the Journal of the American Podiatric Medical Association stated, “The presence of fungus in shoes has been postulated as a major reason for reinfection. Therefore, removing infective fungal spores from shoes will likely break the cycle of reinfection.”

Think about it. We wash all clothes except shoes. Those who spend hundreds or thousands of dollars on laser treatments and then put their feet in fungal shoes are likely wasting their money and increasing their risk of re-infection.

There is no solution on the market that can prevent reinfection. However, proper foot hygiene and limiting exposure to fungus is the best answer. One way to maintain proper foot health is to disinfect the inside of your shoes with a shoe sanitizer. Be sure to choose one that is clinically tested and recommended by podiatrists. Putting on a clean shoe will make your feet feel better and help you perform your best.