Nail Fungus and Ingrown Toenails: Causes, Treatment & When to See a Doctor

Nail fungus and ingrown toenails are among the most common foot conditions we see, and both are very treatable. Nail fungus (onychomycosis) causes thick, discolored nails and often requires prescription antifungals to clear. Ingrown toenails cause pain and swelling at the nail edge and can usually be managed at home, though infections may need a doctor's care. Here's what to know about causes, symptoms, and the right treatment for each.

What is Nail Fungus?

Nail fungus, also known as onychomycosis, is a condition that occurs when a microscopic fungus enters either a fingernail or toenail. While anyone can get nail fungus, it is more common in people over age 60 and those with diabetes or a weakened immune system. Nail fungus is not caused by poor hygiene and can be spread from person to person.

Symptoms of Nail Fungus

• Thick, discolored nails

• Uncommon pain in toes or fingertips

Diagnosing Nail Fungus

Your doctor may diagnose nail fungus by examining your nails and scraping some debris from under the nail to look at it under a microscope or send it to a lab for testing.

Treating Nail Fungus

Nail fungus treatment options include:

• Topical antifungals — creams, gels, or prescription nail lacquers (e.g., ciclopirox, efinaconazole) applied directly to the nail

• Oral prescription antifungals — terbinafine or itraconazole are first-line treatments for moderate-to-severe cases and have the highest cure rates

• Laser therapy — an emerging option for people who can't tolerate oral medications

• Nail removal — rarely needed, reserved for severe or painful infections that don't respond to medication

Preventing Nail Fungus

To prevent getting a nail fungus infection:

• Avoid walking barefoot in public areas, such as locker rooms

• Keep the inside of your shoes dry and change socks frequently (100% cotton socks are recommended)

• Wear shoes that fit properly (shoes with a wide toe area and ones that don't press your toes)

• Use absorbent or antifungal powder

What are Ingrown Toenails?

Ingrown toenails occur when the corner or side of the nail grows into the flesh of the toe, often affecting the big toe. This common condition can cause pain, redness, swelling, and even infection.

Causes of Ingrown Toenails

• Cutting the nails too short or not straight across

• Injury to the toenail

• Wearing shoes that crowd the toenails

Treating Ingrown Toenails

In mild cases, ingrown toenails may be treated with a 15-20-minute soak in warm water and placing dry cotton under the corner of the nail. If you experience increasing pain, swelling, or drainage, consult your doctor. Minor surgery can be performed to remove the part of the nail that is poking into the skin.

Preventing Ingrown Toenails

You can prevent ingrown toenails by:

• Wearing shoes that fit properly

• Keeping toenails at a moderate length and trimming them straight across

For more information on nail fungus and ingrown toenails, visit:

• Mayo Clinic - Nail Fungus

• American Academy of Dermatology - Ingrown Toenails

• WebMD - Understanding Nail Fungus

By understanding the causes, symptoms, and treatment options for nail fungus and ingrown toenails, you can take steps to keep your nails healthy and avoid these common foot problems.

Nail Fungus vs. Ingrown Toenail: How to Tell the Difference

Both conditions affect your toenails, but they look and feel very different — and the treatment for each is entirely distinct. Knowing which one you're dealing with is the first step toward getting better.

Nail fungus typically shows up as a gradual change in the nail's appearance. The nail becomes thick, brittle, and discolored — often yellow, brown, or white. You may notice a crumbly texture or a faint odor. Nail fungus usually starts at the tip of the nail and spreads toward the base over weeks or months. Pain is uncommon early on, which is why many people don't notice it until the infection is well established.

An ingrown toenail is a very different experience. You'll feel it almost immediately — a sharp or throbbing pain along the edge of the nail, usually on the big toe. The skin next to the nail becomes red, swollen, and tender. If the area starts to drain pus or feels warm, that's a sign of infection and you should seek care promptly.

Here's a quick comparison:

• Location of symptoms: Nail fungus affects the nail surface; ingrown toenails affect the skin at the nail edge

• Pain level: Fungus is usually painless early on; ingrown toenails are painful from the start

• Appearance: Fungus = thick, discolored, crumbly nail; ingrown = red, swollen skin alongside the nail

• Onset: Fungus develops slowly over months; ingrown toenails appear over days

It's also possible to have both at the same time — a damaged nail from an ingrown edge can be more vulnerable to fungal infection. If you're not sure what you're looking at, our AI doctor can review your symptoms and help you figure out the right next step, including whether you need a prescription antifungal, a podiatry referral, or a simple home remedy.

In general, see a doctor if:

• The affected toe is red, warm, or draining — signs of a bacterial infection that may need antibiotics

• You have diabetes or poor circulation, since foot infections can escalate quickly

• Nail fungus has spread to multiple nails or hasn't improved after 2-3 months of over-the-counter treatment

• An ingrown toenail keeps coming back after home treatment

The Bottom Line

Both conditions respond well to early intervention, with oral antifungals being most effective for fungal infections while proper nail care prevents most ingrown toenail cases. Diabetics and older adults should seek prompt treatment to avoid complications like cellulitis or bone infections. If you're experiencing persistent nail pain, discoloration, or signs of infection, Doctronic can help you determine the best treatment approach.