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Toe Nail Fungus | Causes and contributing factors

What causes toe nail fungus? This article discussed the onset and treatment options for toe nail fungus (also called onychomycosis).

What causes toe nail fungus?toe nail fungus

Contributing factors to onychomycosis

Toe nail fungus, also called tinea unguim or onychomycosis, is a common problem found in adults throughout the world.  The prevalence of toe nail fungus increases with age.  Toe nail fungus is estimated to affect over 50% of people over the age of 50 years, including over 50 million Americans.  What is toe nail fungus?  Why is it more common in the toes and not the fingers?  And what are the contributing factors to toe nail fungus?  Let's answer each of these questions.

Fungus is a saprophyte or saprobe.  Saprobes are plants that have no chlorophyll and subsequently make their living by using the cells to which they attach.  In the case of toe nail fungus, the fungus is actually using the nail cell for nutrition.

Toe nail fungus is much more common than finger nail fungus for the following reasons:

  • Toes reside in a shoe and are not open to the air and UV light.
  • Moisture inside the shoe is required for growth of the fungus.
  • Toe nails sustain repetitive damage from the shoe or bumping into the leg of the couch.
  • We wash our hands often and not our feet.

There are a number of contributing factors to toe nail fungus.  Many of the contributing factors have to do with our lifestyle and habits imposed by society.

  • No shirt, no shoes, no service.  We've all seen the signs.  But by wearing shoes we create a unique and somewhat hostile environment.  The environment inside the shoe is dark, warm, and damp.  This is a perfect environment for the growth of fungus.

What changes can you make to prevent toe nail fungus infections?  Follow these simple tips:

  1. Wear the right shoes for the activity.  Splitting firewood in a pair of tennis shoes isn't smart.  Nail injuries always precede fungal toe nail infections.
  2. Rotate your shoes - if you wear a pair of shoes on Monday, let them dry on Tuesday.  Damp shoes are a significant contributing factor to onychomycosis.
  3. Know the signs of toe nail fungus.  When you see discoloration or thickening of the nail, get started on a topical antifungal.
  4. Wash your feet regularly and be sure to dry between the toes.
  5. Socks help to wick moisture away from the skin and nail of the foot.  Be sure to change socks at least once a day if not more.
  6. Wear open shoes that allow UV light and open air.


Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Advisor

Updated 3/23/2021

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