Five “Fails” for Fungal Nails - Jeffrie C. Leibovitz, DPM

Five “Fails” for Fungal Nails

Here’s a simple truth:

No one wants to look down at their toes and see ugly nails that are discolored, distorted, and perhaps even a bit ragged.

Those are all telltale signs of a fairly common condition—toenail fungus.

This particular infection is an especially frustrating one. Sure, the symptoms themselves are, to put it mildly, less than desirable. But there’s an even bigger issue:

A case of fungal toenails isn’t going to clear up on its own. Ignoring the nail changes is not the solution.

While your body might be able to overcome a variety of other infections by itself, this ain’t one of them.

In fact, toenail fungus is highly stubborn. And when you look at the contributing factors, it makes complete sense. After all, the optimal conditions fungi best thrive in are found right down in your feet!

If you remember your high school biology lessons, you should be able to recall that fungal spores need dark, damp, and warm environments.

Now, if we are describing a foot encased in a sock in a shoe, we are talking about “dark,” “damp,” and “warm,” right?

(“Smelly” might be another one that comes to mind—especially if hyperhidrosis, excessive perspiration, is in the picture!)

With those ideal conditions, fungal spores can feel quite at home. Accordingly, getting them to leave can sometimes be quite challenging—and even more so when various situations exist, or certain factors are at play.

Today, let’s look at these “fails” so you can see what gives you the best chance of evicting the annoying houseguests who’ve overstayed their welcome.

Fail #1 – The chronic nature of fungal nail infections

From the “sad but true” file:

Patients who have fungal toenail infections rarely seek treatment early because most people are unaware of the early signs.

This is a problem when the offensive fungus settles in and claims “squatter’s rights” in the affected nail tissue.

The longer an infection goes untreated, the more opportunity for these fungal spores to damage toenails—and they will take advantage of every opportunity you give them.

The point is, don’t wait!

We’re talking about a chronic condition and the earlier you come see us, the better the odds of success.

Of course, for you to know when to reach out for professional care—and, as we’ll see, professional treatment is your only hope—you need to be able to recognize the problem early.

To that end, you should always be on the lookout for yellowing, brittleness, nail thickening, and (in severe cases) even a slightly foul odor. As soon as you observe any of these, give us a call and set up an appointment.

If you don’t, the problem will persist. More than that, it’ll become worse over time. As we noted just a moment ago, your body cannot fix this on its own.

In a similar spirit, you can’t fix this on your own, either. (But hold that thought for a second…)

Five Failures for Fungal Nails

Fail #2 – Inconsistency in treatment

Naturally, it’s important to always follow doctor’s orders—but, sadly, we know that not all patients are going to follow their treatment plans to a “T.”

See, when you’re prescribed oral medication, you are supposed to take it daily for three months. And you should consistently apply any prescribed topical mediation to affected nails for somewhere between one year and a year-and-a-half.

Why so much time? Well, blood flow to the toes tends to be lower—which is a major reason your toenails grow so much slower than your fingernails do.

We know it can be easy to forget about this medication, especially since A) everyone’s life is incredibly hectic nowadays and B) toenail fungus doesn’t have the same importance or urgency ascribed to it as does something like taking beta blockers to reduce high blood pressure (for example).

Because forgetting can be easy, one suggestion we offer is to put the medication on your nightstand. That way, it’s right next to your bed and one of the first things you see in the morning—and last things you see at night.

Going back to the point about toenail growth being a slow process, keep that in mind as we look at this a bit more closely.

Your fungal nail medication doesn’t clear up a nail that has been infected for a good reason:

It can’t.

Once a toenail is discolored, it doesn’t change back to its original state—no matter what you do to it.

Instead, your medication kills active fungal spores and makes them unable to infect new nail growth. The new protected nail pushes out and replaces the existing, discolored nail tissue over time.

You can think of this as being a lot like how you might dye your hair—or perhaps if you will at some point down the road—with the gray pushing the dyed hair out as the strands continue to grow. If you don’t touch up your roots, the natural gray will eventually overtake all your hair.

With consistent fungal nail treatment, a similar thing happens:

The natural healthy and clear tissue will push out the ugly, discolored stuff.

And that’s the result you want.

Fail #3 – Inappropriate treatment

When we talk about inappropriate treatment for fungal toenails, we are not talking about the kind you get from a podiatrist. Rather, the focus is on so-called “home remedies” and the old wives’ tales.

Here’s the thing:

Just because you read it on the internet, or heard it from your cousin’s best friend’s mom, doesn’t mean it’s true.

And there are plenty of mistruths out there about fungal nail treatment!

You might have heard that tea tree oil, cider vinegar, or Vicks VapoRub will restore your nails back to natural radiance and beauty. Or perhaps you’re familiar with the virtues of oregano oil and Listerine in fighting back the offensive fungus.

Something to consider:

If any of those methods were so effective, how come Big Pharma hasn’t capitalized on them yet?

You have to know that if any major pharmaceutical company could make a buck off treatments like these, they absolutely would have.

But they don’t, for a really simple reason:


Sure, it’d be great if they did, but it would also be great if money grew on trees. (Actually, that would probably be bad for inflation and lead to a total collapse of our economy, etc.)

Okay, so if they don’t work, why do people promote them as miracle cures?

Well, what do they all have in common? They’re liquids, right?

And when your toenails are wet, it affects how light is reflected—and that makes it appear as though the nails are better, even though that’s not the case.

If you want treatment that actually has a chance to works, you need to see a podiatrist. We can prescribe antifungal medication—in most, but not all, cases (something we’ll touch on shortly)—that actually does target and destroy fungus.

Close-up with male fungal disease male toenails

Fail #4 – Nicotine use

Remember how we said that your toes receive less blood flow than pretty much every other part of your body? Well, smoking (and other forms of nicotine) constricts blood vessels—and shut down tiny ones known as capillaries—thereby making it even more difficult for your toes (and their nails) to receive the medication and nourishment they need.


Smoking is bad for you.

(Hopefully that wasn’t too shocking to hear!)

And it’s easy to think about other consequences of this habit—such as yellowed teeth, terrible-smelling clothes (and car, furniture, house, etc.), and increased risk of heart attacks and strokes.

Plus, that doesn’t even venture into the realm of secondhand smoke, and how bad that can be for your friends and loved ones (if you smoke around them).

But the simple fact of the matter is that smoking can also play a role in unhealthy feet, including the example of fungal nail infections.

Taking this a step further:

If you want to keep smoking, you’re probably best off not even trying to treat toenail fungus. (Seriously.)

Fail #5 – Impatience

If you’ve started treatment and are getting concerned because you aren’t seeing progress right away, please have a little patience.

As you might be picking up by now, this process is a long-term challenge. You need to consistently apply the prescribed topical medication for up to a year-and-a-half.

Basically, the infection won’t go away overnight.

This can be a bit like fitting into a wedding dress. It’s important to remember that the big day isn’t for several months, so you need to stay the course and trust that the activities you’re performing (better food choices, more exercise, etc.) will pay off.

Keep doing everything right, and you will fit in the dress—but it might not be happening tomorrow.

Bonus Fails

It’s time for us to channel our inner infomercial host:

But, wait…there’s more!

The truth of the matter is that there are many failures/barriers when it comes to treating fungal nails. These include things like:

  • DON’T wear the same shoes every day. This is an especially important consideration since your footwear will be hosting the offensive fungus.
  • Thinking treatment is permanent. Sure, it would be great if the fungal infection would never return once it’s been cleared up, but it just doesn’t work like that. If you want to avoid reinfection, you need to be vigilant (including following the measures we’ll outline in just a moment).
  • Medication conflicts. We might not be able to prescribe oral mediation if it will affect your other meds. For example, some diabetes and cholesterol drugs should not be taken at the same time as antifungal medication. Although it is not a medication, grapefruit juice should not be used during the treatment. (Am I the only one that likes grapefruit juice?)
  • Issues related to liver enzymes. Oral anti-fungal meds have a small chance of causing liver irritation. We will order blood tests for liver enzymes before and during treatment to monitor for changes. If the results are less than encouraging (a potential side effect from oral medication for some people), we’ll stop treatment.
  • One of the things that usually happens as we become older is our blood flow starts to slow down. Naturally, your extremities farthest from your heart are going to be most impacted—and this means your toes (and nails). If there is not enough blood flow to get the medicine to the end of the toe there is no reason to risk liver irritation.
  • Thickened nails. We noted earlier that this is one of the symptoms of the condition, and it can affect the effectiveness of treatment. Fortunately, you can fight back against it by thinning down fungal nails with a file. Think of this as a bar room fight. World you rather fight 1 or 1, 000 intoxicated fungi?

Don’t Wait—Get Treatment Today!!


We’re talking about an infection that DOESN’T go away on its own.

Well, why would it? Your feet provide ideal conditions (warm, damp, dark) for fungal growth. In fact, it’s basically Party Central down there for fungi, and especially if you use nail polish!

Since this infection is stubborn, it’s absolutely essential to take appropriate measures, which include:

  • Keeping your feet cool and dry (but not too dry)
  • Protecting your feet in “high risk” environments, such as pool decks, gym locker rooms, etc.
  • Alternating between two pairs of shoes every other day (thereby giving each set a full day to dry out between uses)

Most importantly:

Please be careful to keep your appointments and follow your treatment plan!

Sure, we can start the treatment process all over again…but it’s best to keep things moving forward.

If you want any chance of overcoming this condition and restoring your toenails back to health, contact us today!