Onychomycosis: What It Is, How It Spreads, and What Actually Works

When your toenails turn yellow, thicken, or crumble, it’s not just dirt—it’s onychomycosis, a fungal infection of the nail that affects up to 10% of adults worldwide. Also known as tinea unguium, it’s not just a cosmetic issue—it can hurt, make walking difficult, and spread to other nails or even skin. This isn’t something you catch from a dirty shower floor alone. It thrives in warm, moist environments like sweaty shoes, public pools, and gym locker rooms. Once it takes hold, the fungus hides under the nail, where most creams can’t reach.

That’s why treating onychomycosis is so tricky. Over-the-counter antifungal creams often fail because they don’t penetrate deep enough. Oral antifungals like terbinafine or itraconazole work better but come with risks—liver stress, drug interactions, and long treatment times. Even then, recurrence is common. And if you’re on a proton pump inhibitor for acid reflux, that could be making things worse—proton pump inhibitors reduce stomach acid, which in turn lowers absorption of key antifungals like itraconazole. Meanwhile, antifungal treatments like topical ciclopirox or efinaconazole have improved, but they require daily use for months. There’s no quick fix.

What’s clear from real-world data is that success depends on early action, persistence, and combining methods. Some people clear the infection with oral meds. Others need laser therapy or even nail removal in severe cases. Prevention matters just as much: drying feet thoroughly, rotating shoes, avoiding tight socks, and never walking barefoot in public showers. And if you have diabetes or a weakened immune system, this isn’t something to ignore—it can lead to serious skin infections.

Below, you’ll find real guides on what treatments actually work—like how Lotrisone helps some fungal skin infections but isn’t always right for nails, why PPIs interfere with antifungals, and how to avoid reinfection after treatment. These aren’t theory pieces. They’re based on what patients and doctors have seen work—and what doesn’t.