Toe Talk: Fighting Fungus | Ugly truths, lingering culprits and non-invasive testing

Posted by Sara Carpenter on Jul 17, 2020 3:17:23 PM
Sara Carpenter
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No one wishes for ugly, crumbling yellow toenails caused by nail fungus, yet that’s exactly what’s endured by an estimated 1 billion people globally and 10% of the U.S. population. Nail fungus can affect both fingernails and toenails, although it’s more common in the latter, so let’s talk toes.

Highly distinguishable from a healthy nail, a toenail infected by fungus typically presents with one or more of

Startling Statistics

1 billion

Foot fungus infections occur globally every year.


Fungal nail infection accounts for 50% of all nail conditions.


≈10% of the U.S. population battles toenail fungus.

these symptoms:

  • Thickened nail
  • Nail surface discoloration of creamy yellow or brown
  • Distorted shape
  • Ragged edge
  • Brittleness/dystrophy
  • Greenish-black build-up under the nail
  • Foul-smelling odor
  • Loosening of the nail at the nail bed
  • Curling of the nail
  • Pain

In the Beginning

In its earliest stages, toenail fungus – its medical names are onychomycosis and tinea unguium – doesn’t start out with such extreme symptoms. In fact, in the early stage, it appears as a small white or yellow spot under the nail tip.

The big and little toes are affected most often, primarily because they are exposed constantly to shoe friction. The fungus typically develops on the front or edge of the nail vs. the nail base. As the infection spreads, more noticeable numbers of symptoms, such as those listed above, become apparent.

The Culprits

Fungal nail infections are caused by various fungal organisms related to mold and mildew in the fungi kingdom, the most common of which is dermatophyte. Yeast, tied to a number of medical disorders, is another nail infection culprit, although yeast infections more commonly occur on fingernails. More on that later.

Psoriasis can cause similar toenail issues that present similarly to a fungal infection, and both psoriasis and onychomycosis can affect the same toenail. Fungus also can infect the areas between the toes and the skin on the feet, which results in tinea pedis (athlete’s foot), but the difference is that nail fungus invades the nails, whereas athlete’s foot affects the skin. However, the presence of athlete’s foot increases the risk for developing toenail fungus.

Risk Factors and Common Causes

Key Takeaways

Toenail fungus is a highly prevalent issue with many causes and risk factors.

√ Toenails have important purposes, making timely fungus detection and treatment paramount.

√ Diax Lab’s simple, non-invasive Molecular Onychomycosis Nail Fungus Testing identifies the generic material of pathologic fungi within one week.   

People of any age can develop a fungal nail infection, although the disease is predominant among older  adults, and more commonly in males than females. A study performed by a Florida skin specialist found that children whose parents were susceptible to a certain fungus had a 75% likelihood of developing that same susceptibility.

There’s a wide net of factors that put people at risk for developing toenail fungus. At highest risk are people with chronic health issues such as peripheral artery diseases and blood circulation problems; with type 2 diabetics being twice as likely to experience toenail fungus. A suppressed immune system also increases risk, including transplant patients, particularly for renal transplantation, who’ve taken medication immune system suppression. 

More common causes of toenail fungus are:

  • Wearing tight-fitting shoes, socks or hosiery

  • Having hot, sweaty feet

  • Going barefoot in locker rooms and public showers

  • Walking barefoot on carpeting, both in hotels and at home, where fungi can linger in the fibers

  • Wearing shoes that have fungus breeding in them

  • Smoking

  • Having damaged nails

  • Using manicure tools that aren’t properly disinfected

  • Wearing layers of toenail polish, which cuts off air to the nails

  • Applying toenail polish with a fungus-infected brush

  • Practicing overall poor foot hygiene

Based on many of these common causes, athletes often battle toenail fungus, which is an unfortunate result of their sport. Runners in particular experience repetitive nail damage, which weakens the nail plate and makes it vulnerable to infection. Similarly, military personnel and miners have an above-average probability for toe fungus because of the spread of fungi from foot to foot on commonly trafficked floors.

Nails with Purpose

Toenails are much more than a thin transparent plate covering the upper surface of the end of a toe. In fact, they serve important purposes. Toenails:

  • Protect soft tissue from external injuries
  • Help with balance
  • Interpret surroundings

Regardless of how clean a person’s feet, fungi and bacteria lurk between the toenails and on the skin under the nails. In fact, the 125,000 sweat glands on each foot are a literal factory of fungi and bacteria. Of course, nails don’t have sweat glands, but the constant presence of warm moisture creates a fungus breeding ground.

Given the purposes for toenails, coupled with the importance of fighting any infection in the body, detection and treatment of toenail fungus are paramount. There’s no lack of self-care remedies and over-the-counter medications to combat toenail fungus, but getting rid of fungal nail infections isn’t easy because toenails are slow growing. Even if these treatments are successful, nail fungus oftentimes returns.

Left untreated, toenail fungus can disfigure and even destroy a toenail. Early detection and an accurate diagnosis of a nail fungal infection is particularly important for diabetics because of their higher risk for more serious complications such as foot ulcers and gangrene and, in the most extreme case, amputation.

Testing for Fungal Pathogens

Diax Labs offers a molecular genetic test that helps clinicians identify the fungal pathogens found in nail tissue.

While traditional cultures can take up to four weeks for results, Diax Labs’ assay can accurately identify the genetic material of pathologic fungi within one week. Our Molecular Onychomycosis Nail Fungus Testing, performed with non-invasive nail clippings, can detect multiple pathogens with one simple test.

Here to Assist You

Are you an independent physician or laboratory marketing professional that sells to independent physicians? We welcome the opportunity to talk with you about Diax Labs’ Molecular Onychomycosis Nail Fungus Testing. To learn more or to schedule a virtual presentation, please click Learn More below.


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