The most common foot infections affect the nails —onychomycosis, which thickens them, makes them brittle and changes their colour— and the skin, particularly between the toes and on the sole, where they cause itching, flaking or cracks. The warm, damp environment inside footwear is what encourages them.
The first step is knowing what it is, and that is not a detail: a dark nail may be fungal, but it may equally be an old knock, and a thickened nail may simply be the result of pressure from footwear. Treating something with antifungals when it is not fungal achieves nothing and delays what is actually needed. Once an infection is confirmed, treatment is long —a nail takes months to renew completely— which is why reviewing and correcting what encourages it matters so much.
Not every dark nail is fungal: if it has turned black without an obvious knock, black toenail without a knock explains what to watch for and when to get it checked.
And if what you notice is itching or peeling skin between the toes, what to do if the skin between your toes itches or peels explains what to watch for and when to get it checked.
What is assessed at the appointment
- The appearance of the affected nail or skin, and how long it has been like that.
- Telling apart infection, an old injury and thickening caused by pressure.
- Reducing a thickened nail to ease discomfort and help treatment work.
- A treatment and follow-up plan, bearing in mind that improvement takes months.
- Advice on footwear, drying and socks to keep it from coming back.
Has a nail changed colour or thickness, or is the skin between your toes itching?
Book an appointmentFrequently asked questions
- Do I need to do anything about my shoes and socks?
- Yes, and this is the part of the treatment that depends on you. Fungus thrives where it is warm and damp, so the aim is to remove that environment: rotate your footwear so no pair is worn two days running and can dry out inside, air it outside the wardrobe, and change socks daily — and again after training, even if the day is not over. When you get out of the shower, dry thoroughly between the toes: that is where water stays and where most of these infections begin. And if you have had an affected nail for months, look at the footwear from those months: renewing the pair you have worn most is reasonable.
- Can I paint my nails while the treatment lasts?
- Better not, for two specific reasons. The first is that polish covers exactly what needs looking at: improvement in a nail is judged by the new part growing from the base, and with colour on top you cannot compare one check-up with the last. The second is that a waterproof layer over the plate holds moisture underneath, which is precisely the environment you are trying to remove. Gel polish adds the filing of the nail surface every time it is applied. Once the treatment is over and the nail has renewed, you can paint them again without any problem.
- I have been treating it for weeks and the nail looks the same. Is it not working?
- Almost always it means you are looking at the wrong part. The area of the nail that is already damaged does not recover: it stays that way until it grows out and is cut off. What to look at is the NEW part, the one emerging next to the cuticle, and whether it looks normal. If healthy nail is coming through there, the treatment is doing its job even if the rest of the plate still looks the same, and the improvement is complete when that new nail reaches the edge: a toenail takes months to renew completely, and the big toe longer still. At each review the comparison starts from the base, not from the whole nail.
