Toenail fungus—known medically as onychomycosis—is a common condition that affects people of all ages. Thickened, yellow, brittle, or distorted toenails are the telltale signs, but not everything that looks like fungus actually is fungus. This makes proper diagnosis and treatment planning especially important. Let's take a closer look at some of the most common (and a few less-known) myths about toenail fungus and set the record straight.
Myth #1: Toenail fungus is just a cosmetic issue.
Not exactly.
Toenail fungus isn’t a serious infection—it won’t spread into your bloodstream or affect your overall health in most cases. However, it is still a chronic fungal infection of the nail unit. While the fungus usually stays localized to the nail, it can spread to other toenails or to the skin of your feet, leading to athlete’s foot or worsening nail damage. Left untreated, fungal nails may become so thick or misshapen that they cause pressure and discomfort in shoes. Fortunately, in many patients—especially older or frail individuals—it’s reasonable to manage fungal nails with regular trimming rather than attempting a full cure..jpeg)
Myth #2: Only people with poor hygiene get toenail fungus.
False.
Toenail fungus doesn’t discriminate based on cleanliness. In fact, athletes and active individuals are often at higher risk due to sweaty shoes, repeated minor trauma to the nails, and exposure in shared spaces like gyms or pools. Fungus thrives in warm, moist environments, and simply being barefoot in the wrong place can lead to an infection—even if you bathe daily and take good care of your feet.
Myth #3: If it doesn’t hurt, you don’t need to treat it.
It depends.
Not all fungal toenails are painful, but they can still cause cosmetic concerns or lead to other issues like ingrown nails or secondary infections. Some people prefer to treat it for aesthetic reasons, while others choose to simply maintain the nails with regular trimming. For patients with diabetes or circulation problems, thick or damaged nails can become a risk factor for skin breakdown or infection. Whether or not to treat is a personal decision, and we help patients weigh the pros and cons based on their health and goals.
Myth #4: Over-the-counter treatments work just as well as prescriptions.
Not usually.
OTC antifungal products may help with minor skin infections like athlete’s foot, but they generally don’t penetrate deeply enough to treat a fungal toenail effectively. Prescription oral antifungal medications (like terbinafine) are more effective in many cases, but they are not for everyone. Before starting oral antifungal therapy, it’s essential to confirm the diagnosis—because not all thick or discolored toenails are due to fungus. Conditions like psoriasis, trauma-related changes, or nail dystrophies can look similar. A small nail biopsy or sample can be sent to a lab to confirm fungal infection before committing to months of oral medication. In some cases, removing the nail temporarily and applying a prescription-strength topical antifungal directly to the nail bed can also be a good treatment option.
Myth #5: You can just file or scrape the fungus off.
Not effective.
Fungus invades the nail from underneath and lives in the nail bed and deeper structures. Simply filing the top of the nail won’t remove the infection. In fact, aggressive scraping at home can cause damage and worsen the condition. However, professional trimming and thinning of the nail by a foot and ankle specialist can help reduce discomfort and is an important part of managing fungal nails—especially if a cure isn’t the goal.
Myth #6: Vinegar or garlic will cure fungal nails.
Very unlikely.
There’s no strong scientific evidence that home remedies like vinegar soaks, tea tree oil, or garlic can cure fungal nail infections. These substances may have mild antifungal properties, but they typically do not penetrate the nail well enough to eliminate a true infection. In some cases, they can irritate the skin or delay more effective care.
Myth #7: Once you treat it, it won’t come back.
It can.
Even after successful treatment, fungal infections have a tendency to return. Reinfection can happen if the environment that allowed the fungus to grow in the first place—like sweaty shoes or athlete’s foot—isn’t also addressed. Preventive care like keeping feet dry, disinfecting shoes, wearing breathable footwear, and not walking barefoot in communal areas can reduce the risk of recurrence.
Not Sure About Your Nails? Come See Us.
It’s important to remember that not all thick or discolored nails are fungal, and guessing wrong can lead to unnecessary or ineffective treatment. If you're concerned about your toenails, our foot and ankle team can help confirm the diagnosis and tailor a treatment plan that fits your lifestyle and goals—whether that means curing the infection or simply keeping things comfortable and under control.
If your nails don’t look or feel right, schedule an appointment with our office. We’re here to help you put your best foot forward.
