Health experts have confirmed that fungi is present in and on the body and therefore fungal infections can affect any part of the body. Toenail fungal infections are unfortunately one of the more common infections people can contract. How can you detect whether or not you have a toenail fungal infection? Here are the top five clues to look for to determine if you have one:

1. Toenail color changes 
One of the common changes will be development of yellow streaks under the nails. Health experts consider this the initial sign that an infection is developing. If the nail in question turns green, there is definitely an infection and it is likely bacterial. White and yellow nails indicate fungal and yeast infections. Yellow nails indicate fungus. In some cases, however, the color change is more subtle. The shininess of the nail simply fades. Other times the nails turn a darker color than normal. If you regularly paint your toenails, it's a good idea to take off the polish completely once in a while to check on your nail bed’s color. 

2. Toenail texture changes
If your toenails become exceptionally brittle or have begun to thicken you could be suffering from an infection. In some cases the toenails will break, or the shape will become distorted by the growing fungus.
 
3. Toenail separation
In some cases of toenail fungal infection, the nail can completely separate from the nail bed. If you have not recently stubbed your toe or endured any similar injuries, this could be an indication of trouble. The unfortunate thing is sometimes when you have a fungus-related infection you won't even feel the separation. Therefore, it's even more critical to regularly examine your feet.

4. Pain
As the infection advances, pain may be felt on the affected part. Furthermore, the surrounding tissues may get inflamed. Pain is attributed to the thickening nails. If you gently press the nail and find the area is tender or sore, you could have an infection. It is also important to clarify that the pain is not a result of tight footwear or other toe conditions, however.

5. Odor
A bad smell is another reliable indication that you have a toenail fungal infection. As the fungus causes the toe tissues to die, an odor will be given off. This option is relatively tricky because bad smell can be caused by other factors apart from fungal infection. For example, wearing shoes for a long time can lead to the development of unpleasant odors. This is common in people whose feet sweat. Because of this many people will go undiagnosed, simply assuming they have stinky feet. If this is the case and you're not quite ready to seek medical confirmation, wear open footwear such as sandals for a couple of days. If you still have an odor, it's a pretty clear indication there is trouble afoot. 
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Other indications include a discharge of pus, running a fever and red streaks around the area. If you suspect you have a toenail fungal infection, visiting a doctor isn't a bad idea. Your case may or may not warrant prescription medication, but it's better to know what you're dealing with than play the wait and see if it gets better game.

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. 

Toenail fungus can cause an embarrassing discoloration of the toenails. Toenail fungus infections can make toenails change in color becoming whitish, yellow, or even brown. So, it is possible that the brown discoloration is caused by toenail fungus. 

If the brown discoloration is in fact caused by toenail fungus, then yes, the laser treatment may help. But if the discoloration is caused by bruising under the toenail or is the result of surface staining of the nail plate, then no, laser treatment would not help.  

A couple of questions may help determine how likely it is that the discoloration is caused by a fungal infection. 

1. How long ago did the discoloration begin.
2. Have you ever had athlete's foot?
3. Have ever had any trauma to the toenails where they became bruised under the toenail?
 
How Long Have You Had The Discoloration
Generally speaking, the longer the toenails have been infected, the more difficult it is to get rid of the fungus and return the toenails to a normal appearance. Some of this has to do with how much the matrix or root of the toenail has been stretched and or damaged by the thickening of the toenail. In some cases the thickening can become permanent. However the color will typically change significantly and improve after being successfully treated to remove the toenail fungus that is infecting the toenails. But, the toenail may remain thicker, if there has been damage to the matrix or root of the toenail. 

Athletes Foot
Athlete's foot is sometimes caused by the exact same fungus that infects the toenails. Toenail fungus is an infection of fungus in then toenails. Athletes foot is just a toenail fungus infection in the skin on the feet. If you have had athletes foot it s possible that you could have the fungus in your shoes that could lead to a toenail fungus infection.

Toenail Trauma
If you have repeatedly traumatized the nails by stubbing your type, or beating them up in running shoes, you may have bruising under the toenail. If there is bruising under the toenails, it may change the treatment options available to you. For example, if there is a large amount of dried blood underneath the toenail, the dried blood is dark in color and may absorb heat and burn the nail bed underneath the toenail if you were to have the laser toenail fungus removal procedure. In addition, a bruised toenail may look like a fungal toenail, but not actually be infected with toenail fungus. 

If you aren't sure whether or not the brown discoloration in the toenail is caused by a toenail fungus infection you can visit a podiatrist specializing in the treatment of toenail fungus. Another quicker option is to take a picture of the toenails and arrange a free remote email or phone consultation so you can get a better idea of the extent of the problem.

Dr. Christopher Segler is a podiatrist who specializes in the treatment of toenail fungus infections in San Francisco, Oakland, San Rafael and San Jose. He is board certified, American Board of Podiatric Medicine.  If you have a question about discoloration of the toenails that may be caused by toenail fungus you can call him directly at 415-308-0833.

This is a typical question from patients with mild cases of toenail fungus:

"Hi Doc...

I have a mild case of toenail fungus. Only the big toenails have the white spots and thicker nail that suggests a toenail fungal infection. However my dad’s toes are a different story. 

We recently had a house call podiatrist come to the home to check his feet. When I saw my dad’s toes, I was horrified at the sight of his toenails!  All of his toenails are yellow, thick and curving in odd directions. The big toenails are incredibly thick...nearly as thick as the toes themselves. They are crusty and flaking as well. Dad said that his toenails are so thick he hasn’t been able to cut them himself for years.

The podiatrist told us that super-thick fungal toenails are really not that rare in elderly people. He said that the appearance of dad’s fungal toenails is characteristic of a longstanding toenail fungus infection. 

My question is, “How long will it take for my mildly infected fungal toenails to get as thick as my father’s fungal toenails?”

The rate at which toenail fungus gets worse depends upon the type of fungus that has infected the toenail and your body’s ability to fight and slow the infection. 

Fortunately the most common forms of toenail fungus are not caused by overly aggressive organisms. Trychophyton rubrum and Trychophyton mentagrophytes are responsible for most of the toenail fungus infections. There are some less common fungal organisms that progress rapidly, but again, those are rare.

If you are young, healthy, have good blood circulation in your feet and have a strong immune system, you should expect the common forms of toenail fungus to get worse very slowly...almost unnoticeably slowly. You won’t notice any change from day-to-day. In fact, you may not see a change from month-to-month. 

If you takes pictures every few months and then compare over a long period of time, you may gradually notice that the areas of white and yellow discoloration are getting bigger. This may be your only indication that the toenail fungus is spreading and getting worse. If the fungus goes untreated for a long period, you may even notice that the toenail is getting thicker as well. 

But even if you are healthy and have a strong immune system that is fighting the toenail fungus infection, don’t expect your immune system to win. Toenail fungus is not something that you “get over” the way you might get over a cold or a case of the flu. When toenail fungus gets inside the toenail and starts to grow it is there to stay...unless you treat it. If you don’t treat the fungus it will simply continue to grow. 

Over time the fungus spreads throughout the toenail. As the toenail fungus grows, it begins to separate the keratin that forms the toenail. The cracks and splits in the keratin change the way light refracts through the toenail. Once that happens you notice white or yellow areas of the toenail where the keratin has been infiltrated and damaged by the thriving fungus. 

If the toenail fungus does enough damage, the nail plate may become misshapen enough to actually separate from the underlying nail bed. This usually creates large opaque white spot because the pink skin of the nail bed is no longer flush against the undersurface of the toenail. When this happens, it is usually at the end of the toenail in one of the corners.

As the fungal infection continues to get worse, the fungus bores its way through the toenail, moving closer to the root of the nail or “matrix.”  The toenails grows directly outward from the matrix. The matrix is the same size, same thickness and same curvature as a cross section of the toenail. 

If the fungus thickens the toenail and stretches out the matrix, the damage is permanent. At that point, even after you remove the fungus from the toenail, the matrix is permanently deformed and the toenail will always grow out thicker. 

If your immune system has been weakened by chronic disease, malnutrition, HIV infection or over-training, the fungus can grow and spread at a much faster rate. 

So, back to the real question. How long does it take for toenail fungus to become irreparably damaged and terribly thickened?

In many young healthy adults toenail fungus will worsen over the course of a year before the problem seems noticeable. In five years the common forms of toenail fungus can form substantial thickening and possibly permanent damage to the nail plate. But it may take ten years of more to develop the kind of grossly deformed thickened toenails like your father. The fact is, given what you describe, your father has likely had toenail fungus for decades. 

Dr. Christopher Segler offers concierge laser toenail fungus treatment services in San Francisco, Marin and Silicon Valley. If you have toenail fungus he will bring the laser directly to you.  If you have a question about laser treatment of toenail fungus, you can reach him directly at 415-308-0833.

This video explains how clear toenails turn into discolored fungal toenails.

A normal toenail is thin, clear and translucent allowing you to actually see right through the toenail to the pink nail bed underneath. However as soon as the fungal spores get in underneath the toenail the toenail fungus starts to grow within the keratin of the toenail itself. The growing fungus actually causes the layers of keratin to separate.

The separation of layers within the toenail causes the toenail to become thicker but it also changes the way that light refracts through the toenail. This causes a cloudy discoloration that is usually white or yellowish. Those thick, crumbling white and yellow areas of the toenail are the classic signs of a toenail fungus infection.

If you think you might have a toenail fungus infection, you can call 415-308-0833 to speak to an expert to find out if you might be able to get rid of the toenail fungus and have clear toenails again.