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White crust on toenails: Pictures of Toenail Colors and What They Mean


What Causes Toenail Fungus? How to Prevent Onychomycosis, or Crusty Yellow Nails​

Ever look down at your fingernails or toenails and see yellow, chalky material hiding inside? If you’re thinking, “Gross, what’s that?,” don’t freak out: it’s actually pretty common and treatable.

That chalky substance is likely keratin debris, which is formed when keratin protein (a.k.a. fibrous protein found in the nails and outer layer of the skin) breaks down, usually due to fungal infection. If left untreated, it can spread to other areas. Basically, it’s a yellowish, thick, and chalk-like substance that appears on the nails and it’s usually sharp and brittle to the touch.

While it might sound gnarly, the condition is fairly common and accounts for about half of all nail disorders, says Sonia Batra, MD, MSc, MPH, a dermatologist in Santa Monica, California, and co-host of the television show The Doctors.

“Nail keratin debris results from a fungal infection of the nail. In medical terms this is called onychomycosis or tinea unguium,” says Batra.

The fungal infection breaks down the keratin in the nail to form a white or yellow chalky substance under the nail plate.

“As keratin debris spreads under the nail, the nail plate typically becomes lifted up off of the nail bed. This separation creates a warm, moist pocket, which is even more conducive to infection,” Batra explains.The nail itself will then take on a white or yellowish color.

The nail plate itself becomes thickened from fungal infection, with crumbly, chalky keratin debris under the nail. The nails are often more fragile and jagged, she says, making it easier for them to catch on clothing or other materials.

Related: 7 Ways to Avoid Getting a Gross Toenail Fungal Infection

To prevent keratin debris from forming, you must take pains to avoid getting a fungal infection. Keep your nails clean and away from germ-filled areas, and wear flip-flops or shower sandals in moist areas, such as a public pool or shower, Batra says. When you get out of the shower, thoroughly dry your feet so moisture does not collect between the toes.

“If a fungal infection of the skin occurs (commonly known as athlete’s foot), use an antifungal cream to treat it before it spreads to nails. Also, cut nails short to prevent fungus or bacteria from finding a safe harbor under the nail,” she suggests.

If keratin debris doesn’t go away with time, you might need some extra intervention. “Some dermatologists and podiatrists treat toenail fungus and the resulting keratin debris with lasers,” Batra says. “A near infrared laser beam can be used to pass directly through the nail and vaporize the fungus, yeast or mold that is causing the infection.” The treatment usually requires two to four sessions to sufficiently kill the fungus; when completed, a healthy nail usually grows back between 9 and 12 months.

Your doctor might also prescribe topical antifungal gels or creams, lacquers and liquid solutions that can be applied topically to the nails, or oral antifungal treatment drugs, such as Terbinafine or Itraconazole, she says.

Above all else, if you’re not experiencing any toenail pain, do not try to remove the debris yourself. “Aggressive digging under the nail may worsen the ‘pocket’ for infection,” she says. So if you think you have nail debris, don’t freak out — simply head to your dermatologist to figure out the best treatment plan.

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Prevention and Treatment of Toenail Fungus

Preventing Toenail Fungus From Spreading

While you can’t avoid contact with the microscopic organisms that cause toenail fungus — it’s present anywhere that is warm, dark, or moist — keeping your feet clean and dry and clipping your nails properly can help prevent an infection.

For fungus to grow, “there needs to be some type of trauma to the nail where the nail-skin junction, or natural barrier, is disrupted,” says Sheth. “For example, from a pedicure, ill-fitting shoes, or the repetitive trauma of running or hiking that causes the nail to lift or get pressed on from shoes or boots.”

Still, some people are more vulnerable than others, she adds. “Some people have it only on one toe or one foot, and some have lived with a partner who has it but they never get it,” Sheth says. “And for some you see it in their entire family. It’s not as straightforward as it seems, and it’s an annoying problem.”

If you do get a toenail fungus infection, these measures can help stop it from spreading:

  • Wash your feet and dry them thoroughly before putting on your socks and shoes.
  • Clip your toenails straight across so the nail doesn’t extend past the tip of the toe — this helps protect the delicate tissue beneath the nail.
  • Wear properly fitting shoes that allow your feet to breathe. If your feet become damp, change your socks to a dry pair as soon as possible.
  • Spray your shoes with an over-the-counter antifungal product. ”Your shoe is a great environment for fungus to thrive,” notes Sheth.
  • Wear shower shoes in public places where others typically walk barefoot, such as in locker rooms and around pools.
  • Thoroughly clean your nail clippers and other pedicure tools between use.

Getting rid of established toenail fungus can be difficult. Successfully eliminating it depends on careful adherence to a treatment plan.

“What happens over time is that the fungus breeds in the nail tissue and goes from being just a little bit on the nail, to a really discolored and thickened nail, to a nail that is totally embedded with fungus,” explains Marlene Reid, a doctor of podiatric medicine in Naperville, Illinois, and a spokesperson for the American Podiatric Medical Association.

Treating Toenail Fungus Medically

How a toenail fungal infection is treated may depend on its severity.

In white superficial onychomycosis, for example, the white patches of fungus that form on the nails can sometimes simply be filed off and an over-the-counter antifungal topical medication can be applied to the nail to kill the fungus.

For infections affecting deeper layers of the nail, over-the-counter topical medications often don’t penetrate the nail deeply enough to kill all of the fungus and prevent the infection from recurring. Repeated applications of the medication or a prescription-strength drug may be necessary.

The symptoms of more severe infections include thickened, discolored toenails that may eventually become painful. In these situations, you should see a podiatrist who can devise a treatment plan that may include these actions:

Debridement The thickened portions of the nail can be debrided, or removed, to reduce pain and allow a topical treatment to penetrate more effectively.

Topical Medication Medications that are applied like nail polish or hand cream are sometimes used to treat nail infections. However, topical medication often fails because it doesn’t move deeply enough into the nail to reach the fungus or users forget to apply it daily for almost a year, as is required.

Oral Medication Oral medications used to treat toenail fungus include terbinafine (Lamisil) and itraconazole (Sporanox, Onmel). Both medications require at least a three-month course of treatment for toenails; if used consistently, they have a good success rate. Because both drugs can affect the liver, however, blood tests of liver function are recommended before treatment is started and every four to six weeks during treatment. A third medication, fluconazole (Diflucan), is sometimes used on an off-label basis for toenail fungus caused by yeast.

Nail Removal, Home Remedies, and Laser Treatment

In the most serious instances of toenail fungus infection, the toenail may be removed surgically or dissolved with acid. This can be done to just a portion of the nail in the hope that the remaining nail will grow back healthy. In cases where the entire toenail has to be removed, artificial nails and products using light-cured resins to form a temporary covering can be used to protect the underlying tissue until the nail grows back.

If you prefer to go the home-remedy route, such as applying tea tree oil or Vicks VapoRub to your nails, keep in mind that the effectiveness of these products for treating toenail fungus hasn’t been well studied, and they are not recommended by podiatrists.

Finally, the Food and Drug Administration has approved several laser devices for “temporary increase in clear nails in patients with onychomycosis.” But while laser treatments are vigorously marketed, clinical trials of lasers have reported mixed results, and the treatments may not be covered by health insurance. If you wish to try laser treatment of toenail fungus, speak to your doctor about what to expect from the treatment, and call your insurance carrier to find out whether the treatment will be covered.

Additional reporting by Susan Jara.

Nail psoriasis or fungus?: Differences, symptoms, and outlook

Psoriasis is an autoimmune disease that causes plaques and lesions on the skin. When symptoms develop on toenails and fingernails, they can resemble nail fungus. However, fungal infections are contagious, and psoriasis is not.

The autoimmune activity in psoriasis causes the rapid overgrowth of skin cells. These cells build up in the skin, contributing to the characteristic lesions of condition.

Nail fungus is a type of infection. People often pick up fungal nail infections in moist locations, such as pool decks and locker rooms. However, the fungus can have many other sources.

Knowing the difference between nail psoriasis and nail fungus can prevent symptoms from becoming worse or the infection spreading.

In this article, we explain the symptoms of each condition and how to tell them apart.

Nail psoriasis and nail fungus might look similar, but the causes, symptoms, and treatment are different.


About half of all people with psoriasis exhibit symptoms of the condition on their nails.

Symptoms occur more frequently on the fingernails than the toenails.

Most people with lesions under or on the nails develop psoriasis symptoms elsewhere, too. In some people with psoriasis, nail symptoms are the first to appear.


A person can pick up a fungal infection through physical contact with an object or surface that another person with a fungal infection has touched.

Nail fungi thrive in moist, warm environments. People whose hands or feet are often wet have a high risk.

However, people with a suppressed immune system, such as those with diabetes or HIV, may develop sores that do not heal after a fungal infection. Prompt treatment is essential for this reason.

Quickly starting treatment will yield better results and reduce the risk of a severe infection. Any delay in treatment may permanently damage the nail bed.

Here, learn more about nail fungus.

A few specific clues may suggest that psoriasis is the problem and not a fungal infection.

Some telltale signs of fingernail and toenail psoriasis include:

Other psoriasis symptoms

When other symptoms of psoriasis accompany lesions on the nails, symptoms are likely to indicate that psoriasis is affecting the nails too.

Symptoms of psoriasis include:

  • red, scaly, or peeling patches of skin
  • itchy, dry patches of skin
  • skin patches that open, bleed, and do not heal
  • smooth, raw-looking patches of skin
  • tiny bumps on the chest or back of the body
  • silvery-white patches on the skin

Different types of psoriasis produce different symptoms, and these may change or get worse over time.

Learn about the symptoms of psoriasis here.

Nail pitting

People with nail psoriasis develop a telltale pattern of yellowing nails with pits that continue to get deeper.

At the outset, the nails might look a little dry, then develop ridges that end up forming deep pits or even holes.

Nail loss

Psoriasis is more likely than a fungus to make the nails detach from their beds, leading to nail loss.

The nails may fall off entirely or break off in pieces. Before a nail falls off, a gap usually develops between the nail and the fingertip.

Fungal infections tend to change the shape and appearance of the nails but rarely cause the nails to fall off.

Nail color and structure changes

Keratin is a protein that promotes the development of the skin and nails. Nail psoriasis sometimes causes too much keratin to grow under the nail. This overgrowth is called subungual hyperkeratosis.

People with hyperkeratosis may notice a white, chalky substance under the nail. When this occurs in the toenails, the pressure of shoes pushing down on the nails might cause pain.

Symptoms of nail psoriasis often appear after an injury in the affected area. It is possible to overlook a small injury, such as a cut or bruised toe because people sometimes cram their feet into tight shoes or expose them to the ground.

Psoriasis symptoms may also flare up after the following:

  • breaking or damaging a nail
  • a painful hangnail
  • slamming a finger in a door
  • experiencing an injury from a pedicure or manicure

While an open wound on the hands or feet makes it easier for fungal infections to enter the body, the wound will not directly trigger a fungal infection.

Most people with fungal infections do not experience an injury before the infection begins.

Fungal infections usually affect the toes, not the fingernails. This is because the feet are more likely to come into contact with fungus when walking barefoot.

People who get regular manicures or whose hands are often wet, however, are equally vulnerable to fungal infections of the fingernails.

Some characteristics of fungal infections of the nails include the following.

Nail color

Fungal infections can cause hyperpigmentation, or changes in the color of the nail.

The infection may begin as a faint gray, greenish, or brown spot that gets darker and wider over weeks or months.

Psoriasis does not typically cause dark spots on the nail.

Nail shape

Unlike psoriasis, fungal infections do not cause pits in the nails. Instead, the nails tend to change shape over time. They may become thin or develop thick patches and sometimes break.

Nail growth pattern

Nail fungus often grows with the nail. It attaches to a specific portion of the nail, and as the nail grows and that portion of the nail moves, so too does the fungus.

As the fungus tends to spread, though, this pattern can be hard to detect.


Both psoriasis and fungal infections tend to get worse with time. Psoriasis, however, does not spread through contact in the same way as a fungal infection.

People with a fungal infection of the toenails may notice color changes between the toes, or other signs that the infection has spread to the skin between the toes.

The infection may also eventually spread to the fingernails or from one toe to multiple toes.

Knowing the difference between nail psoriasis and nail fungus can prevent people with fungal infections from spreading it to others. However, people with nail symptoms from either condition should not self-diagnose.

Psoriasis and fungal infection are not mutually exclusive. It is possible to have both at the same time.

People with psoriasis may also be more vulnerable to fungal nail infections. This can complicate the process of getting an accurate diagnosis.

Only a doctor can confidently determine the cause of any changes in the fingernails and toenails. Prompt medical care can address symptoms of both nail psoriasis and nail fungus.

White Chalky Patches on Toenails: Fungus or Dehydrated Nails? -Jennifer Moller MS, PA-C

Posted on 5/1/18

Have you ever been to the nail salon and your polish was removed only to uncover white patches?  And when the nail technician is questioned she usually states it is due to wearing dark polish, or leaving the polish on too long.  You may then nod, and agree to cover the unsightly nail again with polish. Read why this is not the best idea, what could be causing it, and what the remedy is.

White chalky spots on toenails, is if fungus or something else?

White chalky patches on the nail can simply be a result of excessive dehydration of the keratin molecules on the nail surface, causing keratin granulations.  It is generally caused by wearing nail polish for too long, using dehydrating nail polish remover too often, or constantly exposing your nails to harsh or drying chemicals (like cleaning products, for example). All of these products can dry out the nails, causing the keratin molecules of the nail plate to clump together into chalky-looking formations.

The best way to get rid of keratin granulation is to give your nails a several-week-long break from nail polish, nail polish remover and chemicals in conjunction with using moisturizers and/or hand creams to replenish the moisture balance of the nails.


However, we all also need to be aware of white superficial onychomycosis nail fungus. This type of infection is the second most common type of infection you can get that commonly affects the toenails and not the fingernails. The main cause of this type of nail fungus infection is the dermatophyte, Trichophyton mentagrophytes.  This fungus has the unique feature to develop on the top layers of the nail, and eventually spreads on the entire nail-plate.

Initially, tiny white patches appear on the surface of the nail-plate. As the fungus spreads, the nails may dry out and the surface of the nails flake and crumble.

The fungus feeds on the nail protein, keratin, to obtain its nutrients, which further weakens the nail-plate, and makes it distorted. White superficial onychomycosis is spread like any fungus – unsanitary tools and files for one – but also locker rooms and other places people go bare feet.  Often times an injury or trauma to the nail occurs, leaving the nail predisposed for infection.

Nail fungus can be difficult to treat, and we encourage patients to begin topical treatments early on, as it can take up to a year sometimes to completely clear an infection.  If the nail fungus is advanced and the nail shows signs of thickening, lifting, or discoloration, an oral medication may be advised.

Trouble differentiating keratin granulations from toenail fungus? We recommend you seek a diagnosis from a medical professional so that you may receive the appropriate treatment.

keratin granulation

white superficial onychomychosis

Symptoms and diagnosis of fungal nail infections

Fungal nail infections, also called onychomycosis, are among the most common nail disorders. With rising prevalence of conditions like diabetes and increasing number of the aged population the numbers of individuals with these infections are also on the rise.

Types of fungal nail infection

Fungal nail infections may be classified according to the part of the nail affected. (1-5) They can be categorised into Distal and lateral subungal onychomycosis (DLSO), superficial white onychomycosis (SWO) and so forth.

Distal and lateral subungual onychomycosis

Distal and lateral subungual onychomycosis is also called DLSO. This is the most common form of onychomycosis. It is caused commonly be dermatophytes and may affect a healthy nail or one already diseased, e.g. by psoriasis.

The most common feature is affliction of the lateral edges or sides of the nail bed initially. The spread occurs over the nail bed leading to yellowish or creamy discoloration of the nails. The white and creamy patches indicate places where the nail has been detached from the nail beds.

The nail also becomes thickened. The nail becomes soft or brittle and crumbles or breaks away. The spread may be limited to one side of the nail or spread sideways to involve the whole nail bed.

The progress of the nail infection usually takes weeks or more slowly over months or years. As time progresses the nail becomes opaque, thickened and cracked, friable and raised from the nail bed.

Skin around the nail becomes inflamed, scaly and shows signs of fungal infections. Toe nails are more commonly affected than finger nails with 80% of cases affecting the feet.

Superficial white onychomycosis

Superficial white onychomycosis is also known as SWO. This is less common form of fungal nail infection. It is caused by T. mentagrophytes.

There is usually a white chalky plaque on the nail and occurs almost exclusively on the toenails. The top of the nails or nail plate is more commonly affected than the nail bed unlike DLSO.

Nail plate may become eroded and even lost. There is a whitish yellow discoloration of the nails and flakes over the nail plate. The nail may become brittle and friable and break off.

Fungal infection of the skin around the nails or elsewhere is less common than seen with DLSO.

Proximal subungual onychomycosis

This is a rarer form of fungal skin infection. It is seen in those with a suppressed immunity like those with HIV infection and AIDS. It is also seen in those with diabetes and those with poor blood supply to fingers and toes.

This is usually caused by dermatophyte infection. The infection begins with a white spot beneath the nail bed that fills up the nail bed completely.

There is concomitant athlete’s foot or fungal foot infection. The nail becomes white especially towards the base of the nail and remains normal at the tips.

Candidal onychomycosis

This may be of three types. Candida paronychia occurs as swelling of the nail bed with pain. There are usually patchy opaque spots that may be discoloured appearing white, yellow, green or black. Sometimes furrows may be seen over the nails.

Most cases are on fingernails usually the middle finger. There may also be a Candida granuloma where there is direct invasion and thickening of the nail plate. It is uncommon and seen with Candida paronychia.

Subungual abscess with DLSO is another form where there is collection of pus in the nail beds.

The third type of infection is Total nail dystrophy that leads to thickening of the entire nail. Those dealing with water exposure and psoriasis are more at risk of this condition. There is complete destruction of the nail.

Secondary bacterial infections

Fungal nail infections may be complicated by superimposed bacterial nail bed or nail infections. This is extremely painful and there may be formation of pus.

In rare cases (especially those with diabetes or the elderly) there may be a risk of cellulitis or bacterial infection under the skin or osteomyelitis or infection of the bone.

Diagnosis of fungal nail infection

Diagnosis of fungal nail infection is usually made clinically. However, only about 20-50% of discoloured nails have a fungal infection confirmed with dermatophyte.

The rest may be due to:

  • eczema
  • damage to nails
  • other conditions like Lichen planus
  • psoriatic nail disease
  • poor foot care
  • bacterial nail infections
  • discoloration of nails due to health conditions like thyroid disease, diabetes etc.
  • drug reactions or side effects e.g. with tetracyclines or quinolone antibiotics (1, 5)

For appropriate diagnosis the affected nail is clipped and sent to the laboratory for microscopic examination. The nail bits are stained with special dyes and under the microscope the organism may be seen.

The specimen can be immersed in a solution of 10 to 30% KOH or NaOH mixed with 5% glycerol before examination.

Results are usually obtained in around 3 to 4 days.

For DLSO cases a scraper like instrument is used to take bits of tissues from under the nails or the nail beds.

For SWO the top of the nail is scraped and sent to the laboratory. Sometimes diagnosis may be confirmed by allowing the fungi on the nail to grow in culture media in the laboratory and examine once the growth is obtained. This usually may take weeks for a confirmed diagnosis.

The nail anatomy under the microscope helps determine other causes of nail discoloration and deformity like psoriasis. (1, 5)

Further Reading

Causes, Symptoms and Treatment Options

Medically reviewed by Drugs.com. Last updated on May 5, 2021.

What is Toenail Fungus (Onychomycosis)?

Toenail fungus is a condition that disfigures and sometimes destroys the nail. It is also called onychomycosis  

Toenail fungus can be caused by several different types of fungi. Fungi are microscopic organisms related to mold and mildew.  

These fungi thrive in the dark, moist and stuffy environment inside shoes. As they grow, fungi feed on keratin. Keratin is the protein that makes up the hard surface of the toenails.  

Factors that increase the risk of developing toenail fungus include: 

  • Wearing tight-fitting shoes or tight hosiery 
  • Practicing poor foot hygiene 
  • Wearing layers of toenail polish, which doesn’t allow the nail to breathe 
  • Being a military personnel, athlete or miner. This is because toenail fungi may spread from foot to foot on the floors of showers and locker rooms.  
  • Having a chronic illness, such as diabetes 
  • Having a circulatory problem that decreases blood flow to the toes 

However, many people with toenail fungus have no clear risk factors. 

Toenails on the big toe and little toe are the most likely to develop a toenail fungus. This may be partly because the big toe and little toe are constantly exposed to friction from the sides of shoes. 


When a toenail develops a fungal infection, it typically turns yellow or brown. It becomes thick and overgrown. Foul-smelling debris also may accumulate under the nail.  

As the infection continues, the nail may crumble gradually and fall off.  Or, it may become so thick that the affected toe feels uncomfortable or painful inside shoes. 

A less common variety of toenail fungus is called white superficial onychomycosis. The nail turns white rather than yellow or brown. The surface becomes soft, dry and powdery.


You will describe your foot symptoms to your doctor. He or she will ask about any factors that may increase your risk of toenail fungus. These include: 

  • A high-risk occupation 
  • Sports participation 
  • Tight-fitting shoes or hosiery 
  • Poor foot hygiene  
  • Use of heavy toenail polish 
  • A history of illness that may decrease your resistance to infection or interfere with blood flow to your toes, such as poor circulation or diabetes. 

A skin disease called psoriasis sometimes can cause nail problems that look similar to a fungal infection. As a result, your doctor may ask whether you or a family member has psoriasis. It is possible for psoriasis and a fungal infection to affect the same toenail.  

Your doctor will examine your affected toenail or toenails. Often the diagnosis can be made based on the appearance of toenails. Your doctor may take small samples of the affected nails. These samples will be sent to a laboratory where they are tested for fungi and other infectious agents. 

Expected Duration

Toenail fungus rarely heals on its own. It is usually a chronic (long-lasting) condition. It can gradually worsen to involve more and more of the nail. Even if the affected nail comes off, the new nail may be infected with fungus. 


To help to prevent toenail fungus:  

  • Wear comfortable shoes and hosiery that allow your feet some breathing space.  
  • Wear shoes, sandals or flip-flops in community showers or locker rooms.  
  • Wash your feet every day. Dry them thoroughly, and use a good-quality foot powder.  
  • Wear clean socks or stockings every day.  
  • Keep your toenails trimmed.  
  • Disinfect pedicure tools before you use them.


Treatment may begin with your doctor removing as much of the infected nail as possible. This can be done by trimming the nail with clippers or filing it down. 

If the infection is mild and limited to a small area of your nail, your doctor can prescribe a topical antifungal agent in the form of a cream, solution or medicated nail polish.  

If the infection is in a wider area of your nail, or several nails, a topical agent alone is less likely to be effective. So, your doctor may prescribe an oral antifungal medication. Most commonly doctors prescribe terbinafine (Lamisil) first. A commonly used alternative is itraconazole (Sporanox), but it can cause serious drug interactions.  

In very severe cases, when toenail fungus is resistant to treatment, it may be necessary to remove the entire nail surgically. 

When To Call a Professional

You don’t need to call your doctor unless you have pain or difficulty walking. You can show your doctor your toenails at your next office visit or schedule an appointment if you want to discuss treatment with a prescription medication. 


Most people treated with an oral antifungal medicine are cured after a few months of therapy. However, even after the fungus is dead, the nail may never become clear and normal-looking. 

The fungus returns in some people even after successful treatment with an oral antifungal medication. 

Learn more about Toenail Fungus (Onychomycosis)

Associated drugs
Medicine.com Guides (External)

External resources

National Institute of Arthritis and Musculoskeletal and Skin Diseases


American Podiatric Medical Association (APMA)


American Academy of Dermatology


Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

What Causes Toenail Fungus, and How Can I Get Rid of It?: Bruni Leka, DPM: Podiatrist

If your toenails are crusted with white, yellow, or brown patches, or are crumbly or flaky, scraping them or painting them over with regular nail polish won’t solve your problem. Most of the time, when your toenails look deformed or discolored, you have a fungal infection.

Nail fungus, or onychomycosis, can spread to your feet, too. A fungal infection between your toes or on the soles of your feet is referred to as athlete’s foot, or tinea pedis. 

At Foot and Ankle Excellence in Philadelphia, we know how embarrassing and frustrating onychomycosis can be. Our expert podiatrist, Bruni Leka, DPM, has a few tips for preventing toenail fungus, which accounts for about half of all nail diseases. 

Onychomycosis is difficult to resolve, so if you suspect you have a case of it, be sure to get it diagnosed and treated as soon as possible.

Your feet are a feast

Most cases of onychomycosis are caused by fungi called dermatophytes. Dermatophytes need the fibrous protein keratin to grow and thrive. 

Your toenails are composed of 80% hard keratin and 20% soft keratin. Keratin also makes up your skin and hair, and other mammals’ nails, quills, hooves, and horns. 

When the dermatophytes find their way to your feet, they feast on your keratin, breaking it down into smaller particles. The crumbly residue on your infected toenails is actually keratin debris. 

Keep the dermatophytes away

Onychomycosis is highly contagious and difficult to treat. Prevent a fungal infection by protecting your feet in public or shared spaces. Wear flip-flops or beach sandals in the following spaces:

  • Gym
  • Public shower
  • Locker room
  • Swimming pool
  • Beach
  • Sauna
  • Steam room

Dermatophytes love warm, moist environments, so be sure to wash your feet daily and towel them dry thoroughly. Also dry your feet — including between the toes — when you get out of the pool, ocean, or shower. 

You can use foot powders on the tops of your toes, in the toe webs, and on your soles to absorb excess moisture. Always wear clean socks and change them at least daily (more often if your feet sweat a lot).

Keep your toenails trimmed short and straight. Gently file down sharp edges that could wound your nail bed, making it more susceptible to infection. Make sure you disinfect your nail clippers after each use, and only entrust your toenails to nail salons that disinfect all their tools between customers.

Other tips to reduce your risk of onychomycosis include wearing footwear that’s made of breathable, natural materials that give your toes plenty of space. Choose socks made of cotton or a wickable material that keeps them dry.

Treatment takes time

If you suspect you have onychomycosis, Dr. Leka first examines your toes and may send a scraping of your toenail to a lab. If she diagnoses onychomycosis, she treats your toenail with topical antifungals in a cream or nail-polish form. She may recommend an oral antifungal, such as terbinafine or itraconazole, too. 

If your nails are crusted with keratin debris, she scrapes it away with specialized tools. If your infection is severe, she may recommend toenail surgery to temporarily remove the infected nail and treat the nail bed topically. Clearing onychomycosis can take up to a year.

To keep your toenails and feet healthy and fungus free, call us, send us a message here on our website, or use the Request Now button online to set up a consultation.

Niine Nahakliinik »Fungus on feet and nails

Foot fungus is an infection of the skin, hair and nails caused by a dermatophyte fungus. Dermatophytes are aerobic fungi capable of decomposing and absorbing the horny substance and parasitizing in keratinized human tissues (hair, nails). The disease occurs very often: on average, at different periods of life, 70% of people become infected with it.

The prerequisites for the disease are contact with the skin of a large amount of infectious material (for example, when wearing someone else’s shoes, walking barefoot in a bath or a shared shower) and the presence of a favorable environment for the growth of the fungus.Risk factors are microtrauma, profuse sweating of the feet, skin maceration, closed shoes, warm and humid climate, circulatory disorders in the lower extremities, diabetes, suppression of the immune system.

Symptoms of a fungal disease: itching, peeling, unpleasant odor, profuse sweating of the feet, cracks, tingling and pain. There are 3 forms of fungal disease of the feet:

  • Interdigital (interdigital) – usually begins between the 4th and 5th toes; the skin is moist, macerated (wrinkled), pale.Cracks form between the toes and under the toes, and slight peeling occurs.
  • Hyperkeratotic (“moccasin type”) – there are slight redness on the feet and whitish small-scale peeling of the skin in the skin grooves. The inflammation spreads from the heel up to the lateral surfaces of the foot, and the superficial side of the foot is free of disease.
  • Vesicular or dyshidrotic – after a long period without symptoms, itchy blisters with cloudy or purulent contents suddenly appear, usually in the arch of the foot or big toe.When the bubbles break down, erosion, peeling and redness occur. As a complication, a bacterial infection can join with the formation of purulent vesicles. In case of severe scratching, bubbles with bloody contents will be visible.

When the nail is damaged, the color of the nail plate changes, the nail becomes covered with spots or grooves, deforms and begins to crumble.

For the diagnosis of fungal disease, microscopic and cultural research is used, for which material is collected from skin scales, the contents of vesicles, nails, etc.in which the pathogen can be detected.

Treatment of fungal disease is either local or systemic. Local therapy (gel, ointment, cream) can be used to treat mild infections. Systemic treatment (tablets, capsules) is required in case of extensive or intensely manifested disease. Systemic treatment may also be needed in patients with diabetes or circulatory problems in the extremities, as well as those whose immune systems are suppressed (due to drugs or diseases).

90,000 causes and methods of treatment of pathology of the nail plate

Hyperkeratosis of the nail bed – excessive thickening of the stratum corneum against the background of slowing down the desquamation of dead cells. As a result, the nail acquires a spherical shape, its color becomes yellow and uneven, and the nail plate becomes brittle and inelastic. The disease is chronic. The pathological focus can spread to neighboring structures – to affect other nails and skin of the foot. Against the background of mycoses, itching and an unpleasant odor are possible.

  • Frequent nail injuries.
  • Wearing tight shoes.
  • Diabetes mellitus and other endocrine pathologies.
  • Hereditary dysfunctions.
  • Psoriasis, lichen planus, ichthyosis, keratoderma, papillomatosis, chronic eczema.
  • Imbalance of vitamins and minerals.
  • Poor hygiene.
  • Imbalance of the intestinal genome, including after antibiotic treatment.
  • Unbalanced diet.
  • Sleep disturbance.
  • Severe stress.
  • Allergy to cosmetics.

As a rule, the disease develops against the background of a fungal infection of the nail, often against the background of immunodeficiency.

Hyperkeratosis is treated by a narrow-profile specialist – podiatrist. The therapy combines systemic and local methods and is prescribed after a comprehensive diagnosis. This approach allows you to accurately influence the cause of the pathology, shorten the treatment time, and avoid complications and relapses.Since in most cases, subungual hyperkeratosis develops against the background of nail fungus, the patient is prescribed antifungal drugs – tablets, varnishes and ointments.

Local antifungal treatment and medical pedicure

Local treatment is aimed at suppressing the fungal microflora and reducing keratinization. For this, a medical pedicure is done in the clinic – the surface layers of the thickened nail are removed with a cutter.


It is recommended to do warm foot salt baths every day – 100 grams of sea salt is dissolved in 10 liters of water.After the procedure, the steamed tissues of the surface of the nail and the skin around it are removed with a pumice stone and buffs. Then the topical preparation prescribed by the doctor is applied.

Removal of the nail plate

In advanced cases, in order to ensure the delivery of drugs to the affected tissues, complete removal of the nail plate using mechanical cutters, special compounds and plasters is shown.


To get rid of the fungus, it is recommended to adjust the diet. Sweets and yeast pastries are excluded from the menu.The diet is balanced in terms of proteins, fats, carbohydrates, vitamins and microelements under the supervision of a nutritionist.


If an immunodeficiency is detected during the diagnosis, the immunologist prescribes immunomodulatory therapy.


The fungal infection actively multiplies in a warm, humid environment, therefore, the inner surface of the shoe is daily treated with a pharmaceutical disinfectant solution, and socks, tights and stockings are washed daily. Shoes are changed if necessary – they should not stimulate foot sweating.Scissors and nail files should be strictly individual and treated with disinfectant after use. You will also have to temporarily not go to saunas and swimming pools in order to exclude contact infection.

Traditional methods

Fungi are not sensitive or weakly sensitive to nonspecific agents, therefore, traditional methods of treating nail hyperkeratosis are ineffective. Under their action, the fungal flora develops immunity and affects new structures. The disease becomes severe.Doctors-podologists strongly recommend that if you suspect hyperkeratosis of the nails, immediately contact a specialist.

It is impossible to restore the nail plate affected by hyperkeratosis – you can cure the disease and wait until a healthy nail grows. The course of therapy is from 2 to 6 months. After 2 weeks and 2 months after the complete elimination of symptoms, control tests are taken for the presence / absence of the fungus.

Treatment of nail hyperkeratosis in “SM-Clinic”

We apply the methods of treatment of nail hyperkeratosis with proven efficacy.In addition to traditional devices, we use innovative nail corrective systems that avoid removing the nail plate and preserve the appearance of the foot.

Podiatrist’s appointment in our clinics

90,000 Look at your nails. These 12 deviations can tell a lot about your health

What is the norm

Nails of a healthy person are smooth, shiny, pale pink in color, with a pronounced whitish hole at the base. At the same time, the nail plate is constantly renewed, growing by about one millimeter in a week.


With age, the nail plate thickens and becomes more brittle. It is part of the body’s natural aging process. Fragility is also characteristic of the nails of pregnant women. But within six months after giving birth, everything usually returns to normal.

It is acceptable if nails break due to lack of vitamins or turn yellow due to poor-quality varnish. Sometimes the nail plate may even turn black and fall off if the finger is pinched or hit.

In a healthy person, the nails on the hands are fully restored within 4–6 months, on the legs – within 6–8 months.

But there are persistent pathologies that we often do not even pay attention to. But in vain. Some changes in the shape, color and texture of nails, as well as the skin around them, may indicate disturbances in the functioning of internal organs and the presence of a variety of, sometimes serious diseases.

What are the deviations

1. Excessive fragility


If the nail breaks, barely looking over the edge of the finger, the body is probably deficient in vitamins A, E and C, as well as iron and zinc.Sometimes fragility can be a consequence of thyroid disease and a harbinger of diabetes.

2. White spots


They are popularly considered a good omen, but in medicine this pathology is called leukonychia. Microscopic air bubbles form between the layers of the nail plate, which on the surface look like white dots and stripes.

Leukonychia is punctate (a couple of spots on several nails) and total (when the entire plate is affected).The reasons are varied: from injuries and unbalanced nutrition to exhaustion of the nervous system and heart failure.

3. Spot grooves


In shape and color, the nails look as usual. But if you look closely, the nail plate is riddled with tiny indentations (as if pierced with a needle). Doctors even have such a term – thimble-like groove.

This is almost always a sign of psoriasis. Sometimes eczema or arthritis can manifest itself this way.

Olga Aleinikova

nurse, master of manicure and pedicure

Having discovered this or any other nail pathology, you should not self-medicate.The first thing to do is make an appointment with a therapist and / or dermatologist, get tested. Only a professional doctor and clinical research are able to give an exact answer, what is the cause of the pathology. Maybe this is some stage of psoriasis, or maybe just a malfunction in the thyroid gland or gastrointestinal tract.

4. Large or small lunulae


Lunulae or dimples are a light crescent moon at the base of the nail. They should occupy about a third of it and be clearly visible.

Holes that are too big are sometimes used by athletes and people doing hard physical work. Sometimes they can indicate malfunctioning of the heart and blood vessels, low blood pressure.

Small lunulae, barely peeking out from under the cuticle, can be a sign of a lack of vitamin B12 and iron, as well as problems with blood circulation.

5. Transverse grooves


These are the so-called Bo lines. The pathology of the nail plate in the form of transverse lines up to one millimeter deep was first revealed by the French military surgeon Joseph Honore Simon Bo.

Bo lines are formed due to damage to the matrix of the nail plate. When she lacks nutrition, the chemical composition of the nail changes and its plate deforms. Most often this happens due to strict diets bordering on fasting.

Also, these injuries can be mechanical (when the nail was hit in the area of ​​the hole) or toxic nature (due to potent drugs or chemotherapy). Sometimes Bo lines can appear against the background of cardiovascular diseases, fungal and other infections.

6. Longitudinal grooves


If for the elderly such a change in the relief of nails can be considered the norm, then for people under 50, protruding vertical stripes most likely indicate a lack of B vitamins and trace elements (zinc, iron, magnesium).

It can also be the result of poor manicure or pedicure: the cuticle was pushed too far and the root of the nail was damaged. But in these cases, only a few vertical stripes stand out.

If more than 25% of the nails are affected, the health of the internal organs should be checked.First of all, the cardiovascular and digestive systems.

If the pathology is not of an infectious nature, you know its cause and have already started treatment, then you can give the damaged nails an aesthetic appearance. Any good salon has spa treatments for nails. For example, Japanese manicure (P-Shine) or paraffin therapy can be done to nourish and moisturize. For smoothness – grinding and polishing the nail plate.

Olga Aleinikova

nurse, master of manicure and pedicure

7.Spoon-shaped nails


This is koilonychia, that is, deformation of the nail plate, in which its center bends, and the edges are turned upwards. It does not cause discomfort, color and smoothness are preserved, but it looks ugly.

The easiest way to detect koilonychia is to drip water onto the nail. Did the drop roll freely? Everything is fine. Is the drop stuck in the groove? There is a reason to think.

Most often, concave nails are the result of a lack of iron in the body and endocrine disorders.Acquired causes of koilonychia also include injuries, contact with chemicals, and sudden changes in temperature.

In addition, spoon-shaped nails can occur due to gene mutations and are inherited.

8. Drumsticks


Another name is the fingers of Hippocrates. This is a symptom in which the nail plates thicken and become like watch glasses. Moreover, if you look at the finger from the side, the angle between the posterior nail fold and the nail plate exceeds 180 °.


Drum sticks are always a sign of a serious illness. They can manifest themselves in diseases of the lungs (from tuberculosis to cancer), heart and blood vessels (heart defects, endocarditis and others), gastrointestinal tract (ulcerative colitis, Crohn’s disease and others).

9. Detachment of the nail


In medicine, this is called onycholysis – a violation of the connection between the nail and the nail bed, when a void forms between them, and the nail plate changes color.

Trauma is the cause in 60% of cases.When struck, the vessels in the dermis are compressed, the nutrition of the nail is disturbed, its chemical composition and elasticity change. Another 30% is accounted for by fungal diseases and allergic reactions. The remaining 10% of onycholysis develops due to systemic somatic diseases.

When the nail plate begins to rise up, it no longer covers the nail bed that feeds it. This can lead to infection. If you have bumped or had any contact with chemicals and suddenly noticed that the nail began to flake off, you need to use antifungal and regenerating agents as soon as possible.

Olga Aleinikova

nurse, master of manicure and pedicure

10. Half and half


This is the name of a syndrome in which half of the nail plate is white and half, closer to the tip, is brownish.

The most likely cause is kidney failure, due to which the number of blood vessels under the nails increases and they show through the nail plate.

Half nails are also found in HIV-positive people and those who have undergone chemotherapy.

11. White, yellow and bluish nails

Change in the color of the nail plate is a signal that it is time to take care of health.

If the nails are suddenly white, it is worth checking the digestive and cardiovascular systems and paying particular attention to the liver. A yellow tint also provokes liver diseases, as well as pathologies of the endocrine and lymphatic systems. Cyanosis indicates a lack of oxygen, low hemoglobin levels, or poor circulation.

12.Single dark line


Most often, a black stripe appears on the nail plate due to injury or malfunction of the digestive system. And for some peoples, this is completely a feature of the natural pigmentation of the skin.

But if you eat normally, did not hit anywhere, and blackening suddenly appeared on the nail, it is better to consult a doctor. This could be a symptom of melanoma, a malignant skin cancer.

How to preserve the beauty and health of nails

Here are some general recommendations given by Olga Aleinikova.

Proper nutrition, healthy sleep and sports should be the default. Check your nail plates regularly and take care of your hands.

  • Manicure and pedicure. Timely trim or file the free edge of the nails, process the cuticles.
  • Do not bite your nails.
  • Wear gloves when handling chemicals and when digging in the beds.
  • Take vitamins.
  • Apply nourishing cream to hands and nails regularly.
  • Do not wear tight shoes, do not stick your fingers in crevices, and be careful with a hammer.

When going out into crowded places, use liquid gloves (this is such an emulsion). The risk of contracting infectious diseases through the hands is now very high.

When you see signs of ill health on the nail plates, use antifungal agents and regenerating drugs. If the pathology is persistent, be sure to get tested and see a doctor.

Read also

What you need to know about removing dry skin from your feet.


Beautiful, healthy legs are a matter of well-being and aesthetics. Split heels not only cause discomfort, they often hurt. Here are tips on what you need to know about removing dry skin from your feet.

Dry skin of the feet and its causes

Who doesn’t like beautiful, delicate nails with neatly drawn nails? Unfortunately, dry skin has neither softness nor beauty. As you age, the skin on your feet loses moisture and the skin becomes dry and flaky.In the summer, there are problems with wearing open shoes. Women are forced to wear closed shoes just because they do not want others to see dry, flaky, and sometimes cracked heel skin.

This also applies to men. Dry and flaky skin on the legs, sometimes with cracks, occurs due to its careless and timely treatment. The skin of the feet loses moisture and dries out. Feet tends to take the least care of parts of the human body, and a layer of dead skin cells builds up on them, especially if we don’t clean them when we wash.

Foot care does not necessarily mean that we have to go to the salon every month, spend a lot of money on a pedicure. There are some amazing ways to take care of them at home that not only help remove dry skin on your feet, but also moisturize them and keep them soft.

Causes of dry feet skin:

* Lack of moisture is one of the main culprits leading to the formation of white, dry layers of skin around the heels.Dead skin cells accumulate around the heels and other areas of the sole mainly due to dehydration.

* Pressure on the sole, unsuitable footwear also strengthens and thickens the skin of the soles. This hard and thick skin is also called burdock. This skin is formed as a protective measure. In theory, such thickened skin does not need to be removed, but people do not like this skin and are ready for any procedure to get rid of it. Hard soles and heels should not be treated at home, especially if the person has diabetes or any other circulatory or numbing problems.In such cases, self-treatment or trying to remove the hard skin of the feet can lead to serious infections.

* Dry skin of the feet is also caused by unsuitable shoes. Summer is a time when feet are mostly barefoot, so they are affected not only by weather changes, but also by the environment – walking surface, shoes, sandals, open heels and leather dries up.

* Many soaps and detergents also contain harmful chemicals that make your feet very dry.They simply remove the skin’s natural moisture, protect the oily layer from the skin’s surface, and dry out the skin.

* People who spend a lot of time on their feet also tend to have dry foot skin due to increased shoe friction and foot pressure.

* Many obese people also suffer from dry skin on their feet because their feet are under excessive pressure. As a rule, their blood circulation in the body is impaired and their skin is dry.

* Certain health problems, such as psoriasis, cancer, or an athlete’s foot, cause rough, dry, and flaky skin on their feet in some people.

We note that what people write off as uncomfortable shoes and dry skin can be a symptom of a serious illness. Doctors name 5 conditions that can be accompanied by cracked heels.
1. Varicose veins
Split heel is one of the symptoms of hidden varicose veins. The swollen veins may be deep under the skin and may not be visible. However, a blockage occurs in the blood vessels, the skin of the legs does not receive nutrition and begins to crack.Latent varicose veins cannot be completely healed. But treatment should be started as early as possible to prevent complications.
2. Renal failure
With renal failure, the amount of urea in the blood increases. This interferes with normal blood circulation. As a result, the skin becomes dry and the heels are cracked.
3. Decompensated diabetes mellitus
Decompensated diabetes is a condition in which the patient has a consistently high glucose level and does not have a therapeutic effect.In this state, the skin of the legs resembles dry, cracked earth. The cracks are usually deep. Also pay attention to the toes.
4. Mycosis
Mycosis is usually a fungus. If this injures your feet, cracks may occur. The fungus initially destroys the top layer of the skin, penetrating deeper over time. Cracked skin may turn white or green. The most important thing is to start treatment.
5. Gastritis
Almost invisible cracks in the heels may indicate gastritis.They are often supported by simple dry skin. But here you need to pay attention to the accompanying symptoms: cracks in the corners of the lips, as well as dry mouth and heartburn. Medical supervision and dietary changes are recommended.

If the skin on your hard leg becomes too dry and uncomfortable, you should see a doctor to find out if this is a symptom of a more serious condition before taking action to remove the thickened skin.
If dry skin on your feet isn’t painful but causes a lot of discomfort, there are many ways to treat and care for your skin at home using some amazing ingredients in your kitchen.

Removing dead skin from the heels.
The following step-by-step guide teaches you how to remove dry skin from your feet at home:

* Step 1:

Soak your feet in warm water for at least 20 minutes to soften tough skin.This will speed up the removal process. Use a mild soap to soak your feet in warm water. Harsh soaps are not suitable because they remove the skin’s natural oiliness.

* Step 2
Then cut the large peeled cuticles with simple scissors or tongs

* Step 3:

At the beginning of cleaning, the feet are placed on the toes. Cracks in the heels should be cleaned from top to bottom: usually cracks are vertical – going from top to bottom or bottom to top, but not horizontally.The heel itself should be brushed from right to left or left to right.

If the heels are badly cracked, the procedure will need to be repeated weekly until the condition improves.

* Step 4:

After cleaning, after washing and drying the feet, the heels should be lubricated with a fat cream. It is best to perform these treatments in the evening before bed.

* Step 5:

If your heels are badly cracked, they need more serious care.You can apply them with a nourishing or special cream specifically for chapped skin. So that the cream is well absorbed and does not clean it on the bedding, let the cream soak a little and put on socks. So go to sleep.

Advice for the future:

Perform the entire soak and brush procedure at least once a week, preferably two, with your heels on every night after showering or bathing.
Wear suitable footwear to prevent limescale and dry skin.

Diabetic foot syndrome, treatment and diagnostics – “Scandinavia” Kazan

Diabetic foot syndrome is a formidable complication associated with impaired blood glucose metabolism in patients with diabetes mellitus, leading to dysfunction of the nerves, blood vessels, bones and soft tissues of the foot, which leads to the formation of wounds, cracks, ulcers, infections of bones and soft tissues and, as a result, gangrene of the foot and legs.

1. Causes of occurrence.

There are a number of reasons that, against the background of diabetes mellitus, lead to the development of diabetic foot syndrome:

Peripheral neuropathy – pathological changes in the nerves of the legs that occur under the toxic effects of glucose in the patient’s body.Sensitivity in the legs is impaired – pain, temperature, tactile. This leads to a change in gait, the appearance of injuries, calluses, cracks, and in the future to the formation of ulcers.

Diabetic angiopathy (circulatory disorders) – high blood glucose levels lead to changes in the wall of large and small vessels, the metabolism between the blood and the tissues of the foot is disrupted. Dry skin, cracks, and long-term non-healing wounds appear.

Infection – any wound, abrasion, bruise can provoke an infectious complication on the foot against the background of diabetes mellitus, which can lead to the formation of purulent ulcers, abscesses, phlegmon of the foot and gangrene.

Smoking is an inveterate habit that increases the risk of developing diabetic foot syndrome by several dozen times. Nicotine leads to impaired blood circulation and impaired innervation of the foot, and in combination with diabetes mellitus, the risk of amputation of the lower extremities increases.

2. Types of diabetic foot syndrome.

There are 4 forms of diabetic foot syndrome:

Neuropathic – when the damage occurs mainly to the nerves of the legs.

Ischemic – when there is a predominant lesion of small (microangiopathy) and large (macroangiopathy) vessels of the legs.

Mixed (neuroischemic) – both nerves and vessels of the legs are affected.

Musculoskeletal (osteoarthropathy) or Charcot’s foot – when the musculoskeletal structures of the foot are affected.

3. Risk of diabetic foot syndrome.

Ingrown toenail – Incorrect trimming causes the corners of the nail to sink into nearby tissue, causing pain and suppuration.

Darkening of the nail – Subungual hemorrhage may be the cause, most often from the pressure of tight shoes. Hemorrhage can cause suppuration if it does not go away on its own. In this case, you should stop wearing the shoes that caused the hemorrhage.

Fungal infection of nails – nails become thicker than usual, their color changes, transparency disappears. A thickened nail can press either on the adjacent toe, or, due to the pressure of the shoes under it, suppuration can also develop.

Calluses and corns – they also often develop hemorrhage and suppuration.

Skin cuts during nail clipping – occur due to a decrease in pain sensitivity, or lack of attention, which is often characteristic of older people with diabetes mellitus. An ulcer can easily form at the cut site. The wound must be washed with an antimicrobial agent and a sterile bandage applied.Try to cut your nails correctly – do not cut them at the root. If you have poor eyesight, it is better to ask relatives for help.

Cracked heels – most often formed when walking barefoot, or in shoes with an open heel against a background of dry skin. Cracks fester easily and can turn into diabetic ulcers. Creams and ointments containing urea (Balsamed, Callusan, Heel-cream, Diacrem, etc.) are the best to get rid of dry skin on the heels.

In addition, it is necessary to treat the heels with a pumice stone during washing, try to always wear shoes with a closed back.

Fungus of the skin of the foot – May cause cracking in combination with dry and flaky skin. The cracks can become inflamed and develop into a diabetic ulcer.

Deformities of the feet in the form of an enlarged thumb bone, hammer toes (the toe is bent at the first joint) – lead to the formation of calluses on the protruding parts. In this case, it is necessary to select and wear orthopedic shoes, insoles and other means that eliminate pressure on the skin.

4. Prevention of diabetic foot syndrome.

  • Seek medical attention if even minor inflammation occurs. Even a small amount of inflammation can lead to serious consequences.
  • Feet should be washed daily, wipe gently without rubbing. We must not forget about the interdigital spaces – they also need to be thoroughly rinsed and dried.
  • Examine feet every day for cuts, scrapes, blisters, cracks, and other damage through which infection can penetrate.The soles can be viewed with a mirror. In case of poor eyesight, it is better to ask a family member to do this.
  • Do not expose your feet to very low or very high temperatures. If your feet are cold, it is better to put on socks, do not use heating pads. The water in the bathroom must first be checked with your hand and make sure that it is not too hot.
  • Inspect shoes daily to prevent blisters and other damage that can be caused by foreign objects in the shoe, wrinkled insole, torn lining, etc.p.
  • Change socks or stockings every day, wear only the right size, avoid tight elastic bands and darned socks.
  • Shoes should be as comfortable as possible, fit well on the foot, you cannot buy shoes that need to be worn out. In case of significant deformity of the feet, specially made orthopedic shoes will be required. Outdoor shoes should not be worn on bare feet, sandals or sandals with a strap between the toes are contraindicated. Do not walk barefoot, especially on hot surfaces.
  • In case of injuries, iodine, alcohol, potassium permanganate, and brilliant green are contraindicated – they have tanning properties. It is better to treat abrasions, cuts with special means – miramistin, chlorhexidine, dioxidine, in extreme cases, with a 3% hydrogen peroxide solution and apply a sterile bandage.
  • Do not injure the skin of the legs. Do not use drugs and chemicals that soften calluses, remove calluses with a razor, scalpel and other cutting tools. Better to use a pumice stone or foot file.
  • Only trim nails straight without rounding the corners. Do not cut off thickened nails, but file them. If your vision is poor, it is best to seek help from family members.
  • In case of dry skin, the feet must be lubricated daily with a fat cream, but the interdigital spaces cannot be lubricated. You can also use creams containing urea.
  • Quitting smoking, smoking can increase the risk of amputation by 2.5 times.

5. How to avoid leg amputation in diabetes mellitus?

  • Visit a diabetic foot specialist at least once a year if diabetes was diagnosed more than 3-5 years ago (unless more frequent visits were recommended).
  • Come to the appointment if you have injuries to the feet or any change in the side of the feet.
  • Show your feet to your endocrinologist or surgeon at every scheduled visit.

It must be remembered that diabetic foot syndrome is a formidable complication of the course of diabetes, which is easier to prevent than to cure!

In the “Scandinavia” (“Ava-Kazan”) clinic you can undergo a program for the prevention of diabetic foot syndrome.

Together with you we will keep your feet healthy!

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Read also:

Diabetic Foot Center
System of Bread Units
Personal Diabetes Consultant


Fungus on the foot: causes, stages, treatment and folk remedies

At the first stage, the disease is treated with ointments and creams, and if it is already started, you have to take pills.


Fungal diseases of the feet caused by parasitic microorganisms are called mycoses. A common foot fungus that affects only the skin, the sole of the foot, etc., is called dermatomycosis. If the nails are affected, this is onychomycosis. Both, including together, are treated rather hard and for a long time, albeit effectively.


Most fungal diseases of the feet are spread by sharing household items such as towels.You can also get infected from an animal and in public places. This is a beach, a bathhouse, someone else’s shoes, general personal hygiene items, a manicure or pedicure made by a master who does not disinfect the instrument.

Children under the age of twelve are considered the most vulnerable to this kind of infections, whose skin has not yet reached sufficient thickness, and the immune system has not yet been formed, which allows fungal microorganisms to sink into it.

Fungus stages

Different stages of the disease have different symptoms.

The first stage is a weak or so-called “erased” form of fungal infection. There may be a burning sensation between the toes or on the foot, and slight redness may appear.

The second stage of a fungal infection develops against the background of an untreated first. With her, a white bloom already appears on the legs and a hard crust on the skin, which is formed by rapidly growing colonies of microorganisms, interdigital folds and other places, for example, the sole, begin to itch.

The third stage is when edema threatening to burst forms between the fingers, the skin exfoliates, and deep cracks appear in it, through which the fungus rushes into the body.This stage is called intertriginous.

The fourth stage is even more difficult. As with burns, the skin turns into bubbles of fluid that burst. The cracks become even deeper, the itching intensifies. This is the so-called dyshidrotic form of the disease.


Depending on the severity of the disease, foot fungus is treated externally, internally and with the help of combination therapy. The first-second stage allows you to use only various ointments and creams, tonics, powders and sprays.

In later stages, when the fungus has already entered the body, treatment is carried out with the help of drugs taken orally. But such medicines have many contraindications: liver and kidney disease, pregnancy, breastfeeding.

If the disease is neglected and has passed into a severe dyshidrotic stage, you will be treated using the most aggressive methods, that is, loading doses of the most effective drugs in the shortest period of time, combining external and internal effects.
Medicines and ointments

Doctors-dermatologists in the initial stages of the disease advise using “Lamisil”. “Terbizil”, “Lamitel”, which are produced in the form of ointments, sprays and tablets.

For the treatment of more advanced stages, drugs based on itraconazole and ketaconazole are used. In such cases, doctors advise using Mycozoral, Nizoral, Oronazole, Itrazol and other medicines.

In the initial stages of the disease, an ointment or cream is rubbed in for one to two weeks.The third or fourth stage may take from six weeks to 3-4 months or even six months to heal. A nail infected with a fungus can grow even longer for 1-2 years, depending on the degree of damage.

Folk remedies

For the treatment of fungus, folk remedies use something that nourishes the skin well and disinfects it. These are wine vinegar, coffee, onions, laundry soap, etc.

The most exotic way is a coffee foot bath with the strongest coffee.The simplest and most practical is to dip your feet in wine vinegar and sleep in socks soaked in it. Another good recipe is a mixture of finely chopped onions and chunks of laundry soap. They rub their feet with it at night, sleep in socks.

What to do if it doesn’t pass

There are two most common mistakes in treating a fungus when it lasts a long time. The first is the confidence that everything will pass by itself, scratch and stop. And the second, when the problems seem to have disappeared – the premature termination of treatment.

In addition to these two reasons, healed mycosis can be caused by an incorrectly selected drug that does not eliminate this type of fungus. In this case, it is better to take tests so that the doctor can choose the right effective medicine.

Another case of unsuccessful treatment is reinfection due to poorly washed clothes, towels, bed linen, and untreated shoes. Or someone else in the family has a fungus, and you re-infected it from loved ones.

If the fungus does not go away, try using stronger creams, find out if someone close to you is sick, or get tested and tested, having received an exact prescription against this type of mycosis.Today, any fungus can be cured, even the most severe.


In fungus breeding grounds – beaches, swimming pools and gyms – use flip flops, bedding, and a sun lounger. It well protects against infection by preliminary rubbing the feet and interdigital space with vinegar or ointments, which are used in the early stages of treating mycosis, such as clotrimazole.

If you are sorry to change expensive shoes after healing, doctors advise treating them with antifungal sprays, for example, Lamisil.After recovery, the patient’s clothes should be boiled and ironed.


The main way to combat this ailment is diet.

90,000 White Spots on Nails: Causes, Treatment and Prevention

Nails on the hands and feet are usually pale pink in color with a lighter, crescent-shaped area at the base known as a lunula. Sometimes, white patches in the form of stripes or spots may appear on the nails. This phenomenon is called leukonychia.

Total leukonychia is a disorder in which the entire nail plate becomes white. Another form of the disease is partial leukonychia, which has 3 varieties: point (there are white dots on the nail plate), longitudinal (a strip across the entire surface of the nail) and strip-like (several white stripes appear parallel to the lunula). Areas of white skin (leukoderma) under the nail can sometimes give the impression of partial leukonychia.

Leukonychia can also be true and imaginary.When the appearance of dots or streaks is caused by damage to the nail, the violation is considered true leukonychia. In this case, the appearance of the white areas does not change with pressure, and the spots move to the free edge of the nail as it grows.

Imaginary leukonychia develops in cases of damage to the nail bed, which affects the color of the nail plate. In this case, the white spots decrease or disappear with pressure and remain in one place, despite the growth of the nail.

White spots on nails can occur in anyone, regardless of age, gender and race, under the influence of various factors.Below are the main reasons for the development of this disorder.

Injury and mechanical damage to the nail plate or the area from which the nail grows (nail matrix) can cause white spots. Injury can occur in children when they bite their nails, as well as in adults during manicure procedures, everyday injuries, and wearing improperly fitted shoes.

Poisoning and taking certain medications can sometimes cause leukonychia. This is a relatively rare cause of the development of a disorder, mainly of its strip-like shape.White spots on nails can occur with heavy metal poisoning such as lead and arsenium, chemotherapy treatments for cancer, and sulfonamides, drugs used to treat many bacterial infections.

Systemic diseases in rare cases can lead to the appearance of white dots on the nails, which become a kind of signal that a “failure” occurs in another part of the body. Disorders associated with leukonychia include iron deficiency anemia, liver cirrhosis, kidney disease, heart failure, diabetes mellitus, protein breakdown problems, zinc deficiency, hyperthyroidism, psoriasis, and eczema.It is known that complete replacement of the nail plate on the fingers takes 6–9 months, on the toes – in 12–18 months, therefore, white dots on the nails may indicate a disorder that arose several months ago.

Heredity. In very rare cases, whitening of the nails can be genetic. This usually occurs in rare hereditary syndromes.

By themselves, white spots on the nails do not require treatment. Caused by trauma, they disappear as the nail grows.In other cases, the doctor determines the cause of the symptom and treats it accordingly. To confirm the diagnosis, specialists use several tests: mycological examination (nail clippings are examined for the presence of fungus), nail biopsy (a piece of nail tissue is taken for analysis) and a blood test (screening for systemic diseases).