By Dr. Cathleen A. McCarthy
Pinnacle Peak Podiatry
Proper Treatment of Fungal Infections of the Feet, Whether Skin or Toenails, Requires Proper Treatment of Your Shoes!
This is a bit off my usual topic of reviewing shoes (and I’ll spare you accompanying visual) but I thought – as long as I am encouraging you to invest in proper shoes – it would be appropriate to spend some time discussing the proper care and treatment for your shoes if you are trying to rid yourself of a fungal toenail or skin infection.
If you do have a fungal toenail infection or suffer from a chronic athlete’s foot infection (also fungal) – it is impossible to clear up the toenails if you do not clear up the skin infection and vice versa.
More importantly, even if you do clear up those infections, if the shoes are not properly treated also, there are fungal spores that have been shed in your shoes and threaten to “break open” and re-infect your skin and toenails months after the infection has cleared.
“Scary Mary!” What to do??
Well, here are my comprehensive recommendations for clearing toenail and skin fungal infections permanently:
- Stop walking barefoot! This will greatly decrease the chance of picking up fungal as well as viral infections such as warts. Not to mention foreign bodies, etc.
Wear Croc Rx clogs around the house with the strap to the back for more biomechanical control.
- When you do wear shoes – follow the 4 Rules of Proper Shoegear:
- Thick-rigid sole,
- Arch support,
- Wide, soft square toebox, and
- Firm rearfoot control.
A wide toebox is important because a tight toebox applies pressure to the toenails, which causes injury to the toenail (onychauxis) which is what sets out the “welcome mat” for setting up fungal infections of the toenails.
Injury (even if it is constant repetitive micro-trauma to the toenails from a tight toebox or a flimsy sole on the shoe that allows too much motion through the forefoot area) will cause the onychauxis that sets up a perfect environment for a fungal infection to start.
The typical presentation for a patient with fungal toenails is, “I dropped something on my toe and now it’s thick and discolored.”
Injury = Fungal Infection. Protect the toenails!
- Spray your shoes every morning before putting them on with an over-the-counter topical anti-fungal spray such as Lamisil or Tinactin. You don’t have to break the bank – a good spray may cost anywhere from $4 to $10.
Bowling Alleys use Lysol spray, which is also effective.
You can also use over-the-counter anti-fungal powders, but I have been informed by several of my patients who are Shoe Repair Professionals that powders will decrease the lifespan of your shoes as they tend to “build up” within the shoe and break down the sole more quickly.
- Avoid wearing the same shoes every day. Try to switch off shoes every other day to allow the shoes a full 24 hours to dry out. Fungus loves a moist, dark, warm environment, which is basically inside a shoe after a long day’s wear.
- Store with cedar shoe trees. Cedar Shoe trees that you place within a shoe help absorb the moisture and keep the shoes dry. There are other over-the-counter ultra-violet products that help to treat shoes while you are not wearing them…and for a severe infection, they may prove useful.
- If you have a chronic infection of your feet and/or toenails and nothing clears it up (i.e. you’ve tried everything and nothing works) – it’s probably not a fungal infection!
Follow up with your Podiatrist.
Worst case scenario, we (podiatrists) can take a biopsy and send it out to a Pathologist to look at under a microscope and tell us what it is so that it can be properly treated. I rarely have to do this but it is always an option. It could be Psoriasis, Eczema, Dermatitis and any number of other skin conditions that are commonly mistaken for an athlete’s foot infection. The same thing goes for the toenails – it is very easy to trim off a piece of the toenail and send it to a pathologist for what is called a KOH and PAS test to confirm the diagnosis of a fungal infection. There are many conditions that mimic a toenail fungal infection and, unless it is properly identified, it is hard to properly treat it.
- Talk candidly with your Podiatrist about treating your toenail and skin fungal infections. Whether you choose to use oral anti-fungal prescription medication (i.e. Lamisil), topical antifungal prescription medications (i.e. Penlac), over-the-counter antifungal medications (Formula-Three) or homeopathic remedies such as white vinegar, tea tree oil or Vick’s Vapor rub – use something!
Your Podiatrist will be able to dialogue about the pros and cons of each type of treatment and together you can decide what is best for you.
- The “Golden Rule” with fungal foot infections:
If you don’t treat it, it won’t get better.
If you do treat it, it probably will get better.”
Go to your Podiatrist or Dermatologist and get an accurate diagnosis of your foot infection – this will greatly skyrocket your chances of successful treatment!
Once you do start treatment, you must be “consistent and persistent” with any treatment plan and it should resolve.
Hope this has been helpful!
- ~Dr. Cathleen A. McCarthy