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Your footwear may cause toenail fungus

Footwear is important in so many ways. Not only do well-fitting shoes provide skeletal and muscular support, they also help prevent a variety of foot problems like calluses, hammertoes, circulation problems and even toenail fungus. The primary factors that lead to toenail fungus are mechanical pressures from ill-fitting shoes and moisture. Gregory Alvarez, DPM, a podiatrist and foot and ankle surgeon at Piedmont, shares some tips for keeping toenails healthy for sandal and flip flop season.

“It is important not just to treat the fungus, but to get to the root of the problem,” says Dr. Alvarez. “I always evaluate a patient’s footwear and encourage changes in footwear to prevent ongoing bouts of fungus. It can be an endless battle if you just treat the fungus and not the instigator.”

Signs of toenail fungus

  • Yellow or brown discoloration

  • Thickening of the nail

  • White patches (superficial fungus affecting the outer layer of the nail)

Mechanical pressures

Toenail fungus often starts at pressure points, where toes are pressed up against shoes, creating added tension. People with bunions, hammertoes, and calluses are more prone to getting toenail fungus.

“For a long-term remedy, it’s important to eliminate points of contention. It is also easier and quicker to treat if you catch it early on,” Dr. Alvarez adds.


Fungus thrives in damp places. While open-toe shoes are great for airing out toes, be sure to choose a pair with proper arch support. It is also wise to change your socks daily and remove them immediately after exercise.

Dr. Alvarez cautions women against keeping nails painted all summer long. Regularly applying nail polish without giving nails a break to air out can trap moisture in the nail bed. He also recommends throwing out old nail polish and buying fresh polish every year. Over time, nail polish may become contaminated, which may increase the chance of infection.

Treatment options

For most cases, Dr. Alvarez recommends both thinning and softening techniques to help eliminate toenail fungus. Talk to your doctor before treating toenail fungus at home.

Thinning technique

Use an emery board to file the top of the entire toenail. This helps thin the nail and remove the dead layers.

Softening technique

Applying cream after filing the nail will help soften the skin around the nail bed. This allows the nail to grow freely without being stifled by hard, stiff skin.

Topical solutions

There are over-the-counter topical solutions specifically designed to treat toenail fungus. They can be found at any grocery store or pharmacy and are most effective when applied before bedtime.

Oral antifungal and laser treatments

For those who have put off treatment and have a severe case of toenail fungus, there are options like oral prescription pills and laser treatments to remove the damaged area of the nail or skin.

“The further back the fungus grows on the nail, the harder and longer it takes to treat, so it is always best to treat toenail fungus as soon as possible,” says Dr. Alvarez. “It is also extremely important to understand why you are getting the fungus. Permanent eradication is dependent on treating the root of the problem.”

For more ways to keep your feet in top shape, click here.

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