Running is a great way to lose weight, beat stress, increase strength and maintain an overall healthy lifestyle. Unfortunately, runners are sometimes plagued by a nasty little fungus that can cause some serious infections. Where does this fungus hang out? Toenails. The infected toenails often turn black, become brittle, and emit a foul odor. But, what causes this to affect runners? Here are the five major causes of toenail fungus among runners:

Long Periods of Exposure of Runners’ Feet to Warm and Moist Conditions

Virtually all runners expose their feet to warm and wet conditions. The warm and moist conditions commonly result from the sweating of the feet during intense running exercises within the shoes while running and these conditions make an ideal environment for the growth of fungus. This risk intensifies for runners who run daily because their shoes never completely dry out. If they continue to wear the same shoes the rest of the day the risky grows even more allowing the fungus to grow and breed while spreading on to the nails and under the nail-bed. The nail-bed is the most moist and warm environment of the feet.

Barefoot Running and Walking

Barefoot running, which has also become increasingly popular on beaches, can increase chances of fungal growth because the foot is not protected at all. When a runner is barefoot they can come across bacterial in pools, shower areas, even on the grounds they choose to run on.

Injury

Injury to the toes and nails is also a common cause of toenail fungus because they break and the nails and skin increasing potential exposure and vulnerability to fungal infections. Anytime skin is open bacteria is more easily able to enter and cause an infection.

Running with dirty feet and/or dirty socks

If you don't clean your feet regularly and you run with yesterday's socks, you're asking for trouble. You should be cleaning your feet, and your body too for that matter, regularly and always putting on a fresh clean pair of socks before going for a run.

Loosely-laced and poorly-fitted shoes

Wearing loosely-laced shoes or shoes that do not fit because they are either too small or too big can worsen the problem by increasing chances of getting injured and creating a moist, warm, and unventilated environment within the shoes due to sweating. Tightly fitting shoes or loosely-laced shoes that restrict the motion of the feet or increase the shoe’s movement can cause excessive tightness and rubbing of the skin, which causes bruises. Your shoe should fit snugly, but also allow a little room for the foot to slide forward while running. However, if the shoes are too tight, the sliding of the foot forward causes to toes to bump onto the toe-box and possibly get injured. Tightly laced shoes can also cause compression on the toenails, which when coupled with the repetitive movements of running can cause bruising that increases vulnerability to fungal infections. Lengthy periods of running exacerbate the problem because such runs increase the stress exerted on the feet, and feet swelling that often occurs during long runs can also worsen the problem.

​Bottom Line

The chances of fungus breeding and fungal-related infections are high among athletes with sweaty feet that are often confined in shoes for extensive exercising periods without ventilation. The longer a runner’s feet are kept in such conditions, the higher the chances of the runner getting vulnerable to the fungi and even experiencing the fungal infection. To combat against this always dry out your shoes daily, consider using a different pair of shoes for daily wear vs. running, wash your feet regularly and use fresh socks for every run. That combined with removing your shoes after running and drying them completely before putting on a different pair of shoes should decrease your risk for fungal issues.​

Dr. Christopher Segler is Board Certified, American Board of Pediatric Medicine. He see patients at home in San Francisco, Palo Alto, Menlo Park, and San Jose so that they can get cutting edge diagnosis and treatment of toenail fungus infections right in the comfort and convenience of their own homes. If you think you may have toenail fungus and have a question about it, you can reach him directly at 415-308-0833 or email him at DrSegler@DocOnTheRun.com .

Toenail fungus is one of the most commonly treated foot infections in many countries. Nail fungus is a slow-growing ailment caused by dermatophyte fungi. This group of fungi infects nails, hair, and even the skin. While dermatophytes cause more than 90% of fungus-related toenail infections, other fungi such as molds and yeasts can also cause the disease. How do people contract the toenail fungus that causes these infections? Toenail fungus may stem from scores of different places, but below are the top five sources of toenail fungus infections.

​1. Swimming pools

Some studies show that many people unknowingly contract toenail fungus infections via swimming pools and other related facilities. Naturally, dermatophytes such as Microsporum, Trichophyton and Epidermophyton, which cause toenail infections, are found in warm and humid environments. Thus, people who visit the swimming pools are more likely to come into contact with the organisms. When they enter into contact with keratin surfaces, dermatophytes may get attached especially if the conditions are suitable. Later, the fungi penetrate and start to feed on the surface of the toenail and nail bed subsequently leading to infection.

2. Gyms and Nail Spas

People who get pedicures from nail salons that don't disinfect their tools appropriately are more at risk for contracting toenail fungus. Tools, such as nail clippers and emery boards can spread fungal infections from one person to another. Gyms are also harbors of fungus because of the hot and sweaty conditions. Like tools used in pedicures, gym equipment should be regularly sanitized to minimize the spread of the fungus.
 
3. Public showers

Public baths can also harbor toenail fungi. Most public showers are hot and wet making them ideal breeding grounds for fungus. Unsurprisingly, the risk of fungus contraction is even higher among people who use poorly maintained public showers.
 
4. Tight fitting shoes and dirty socks

Wearing tight fitting shoes is a common risk factor that promotes the development of toenail fungus. Since most dermatophytes thrive well in warm, moist and damp conditions, wearing tight fitting shoes and socks encourages the development of fungi. Heavy foot perspiration combined with inadequate sock ventilation can also lead to fungal growth. It is important to maintain high standards of hygiene such as putting on clean socks and wearing well-ventilated shoes to discourage the growth and development of toenail fungus and other infections.

5. Nail trauma and walking barefoot

​Like other microbial infections, toenail fungi penetrate open wounds to cause toe infections. The presence of open wounds, injured toes, and long toenails can promote infection by toenail fungus. Walking barefoot in damp areas such as bathrooms, locker rooms or gyms can also lead to toenail infections. When walking in humid conditions, individuals should wear waterproof shoes or avoid walking under such conditions completely when possible.

These are just some of the sources of toenail fungus infections. There are many others. The important thing to remember is that there are things you can do to reduce your risk of contracting a toenail fungus infection. At the top of the list is to regularly clean and dry your feet. Wear dry shoes and dry socks regularly and when you can let your feet breathe. Things like this won't guarantee that you'll never encounter toenail fungus, but it'll certainly help you be less likely to deal with it. 

Dr. Christopher Segler is Board Certified, American Board of Pediatric Medicine. He see patients at home in San Francisco, Palo Alto, Menlo Park, and San Jose so that they can get cutting edge diagnosis and treatment of toenail fungus infections right in the comfort and convenience of their own homes. If you think you may have toenail fungus and have a question about it, you can reach him directly at 415-308-0833 or email him at DrSegler@DocOnTheRun.com.

Is your nail salon the culprit behind toenail fungus? Well, according to several studies and reports, your trusted nail salon that provides those glittering pedicures can in fact be spreading nasty toenail fungus that can cause infections. How do nail salons spread toenail fungus? It all boils down to one simple concept – when nail salons don't maintain a sterile environment and use clean tools, fungus and subsequent infections can easily be spread. 

Breaking Down the Sources of Fungus in Salons

• Cuts and bruises along the toenail – If your salon uses a tool on you that was used on someone who has fungus and manages to cut you or bruise you while working on your feet, you are more likely to contract that same fungus. These cuts expose your cells and tissues, and according to expert podiatrists like Dr Segler, even the most trained and skilled pedicurists will occasionally be sloppy in their job slipping and cutting the skin. While this is a rare scenario today when compared to a few years ago (since pedicurists are now more trained and sensitive on hygiene), it still happens from time to time. Even if they use clean tools, the accidental cutting of your skin exposes you to any other germs that may be in the air. So, if they don't regularly clean their area, you could still be in trouble.

• Infections from using artificial toenails – Believe it or not, some people do get artificial nails on their toes, and this is another possible cause of toenail fungus stemming from your nail salon. However, most cases are usually not the direct result of your pedicurist. Artificial toenails increase the risk of hurting the skin around your toenail when wearing sandals. Fake nails also increases the area below which fungi breed and overgrow. It also brings the additional work of cleaning your toenails more carefully. Placing and removing artificial nails can also result in cuts and bruises.

• The pedicurist not wearing gloves and/or not maintaining good hygiene themselves – Even when an attendant uses fresh tools and has a clean area, their own hands and bodies are consistently coming into contact with other people's skin, and thus any infections/fungus them may have. If you don't see your attendant washing their hands before working on you and/or wearing gloves, you could come into contact with fungi and bacteria that leads to infection.

What Can you Do to Prevent Contact With Fungus?
Since we are exposed to fungus and bacteria at all times, contact and subsequent infections are always a possibility. Still, protecting yourself could be as simple as following these practices: 
• Use anti-fungal powders/ sprays before and after your pedicure
• Make a habit off washing your hands and feet regularly and after touching infected surfaces
• Take time to dry of your feet after showering and remember between the toes
• Only use trustworthy professional salons for your pedicure
• Bring your own items to the salon for your pedicures, or at least make sure that fresh, sterile tools are being used
• Choose moisture-minimizing socks and never stay barefoot in public spaces
• Reduce the number of times you use nail polish and artificial nails

There is nothing wrong with getting pedicures. Just make sure you are protecting yourself by only going to reputable salons and following the tips provided above. Fungi and bacteria may be everywhere, but it doesn't mean you have to subject yourself to risk of infection.

If you think you may have gotten toenail fungus from a pedicure at your nail salon, make sure you treat it as quickly as possible. The fungus may only look like spots initially, but it gradually gets worse...and yes, it gets even uglier. You can call Dr. Christopher Segler directly to ask about your toenails if you are concerned that you have toenail fungus infecting your toenails. 415-308-0833 or email him at DrSegler@DocOnTheRun.com.