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Types of Toenail Fungus: Understanding the Varieties and Their Treatment


Toenail fungus, medically known as onychomycosis, is a common ailment that affects millions of individuals worldwide. This condition occurs when fungi invade the nail bed, leading to discoloration, thickening, and deformation of the toenail. Understanding the types of toenail fungus is crucial for accurate diagnosis and effective treatment. In this article, we’ll delve into the various forms of toenail fungus, shedding light on their characteristics and potential treatment options.

Types of Toenail Fungus

Distal Subungual Onychomycosis (DSO)

Distal Subungual Onychomycosis, or DSO, is the most prevalent type of toenail fungus. It typically starts at the tip or edge of the nail, working its way towards the cuticle. As the infection progresses, the nail becomes discolored, usually turning yellow or brown. Additionally, the affected nail may thicken and crumble, leading to discomfort and aesthetic concerns.

White Superficial Onychomycosis (WSO)

White Superficial Onychomycosis, or WSO, manifests as white, powdery patches on the surface of the nail. Unlike DSO, WSO affects the nail plate directly, leaving it weak and brittle. This type of toenail fungus is often caused by specific species of fungi, such as Trichophyton mentagrophytes and Trichophyton interdigitale.

Proximal Subungual Onychomycosis (PSO)

Proximal Subungual Onychomycosis, or PSO, is a less common but equally troublesome form of toenail fungus. This variety starts near the base of the nail and slowly progresses towards the tip. In PSO, the nail may appear yellow or white, and a chalky substance can be observed at the proximal portion. This type of toenail fungus is frequently associated with immune-compromised individuals.

Candidal Onychomycosis

Candidal Onychomycosis is caused by yeast-like fungi, primarily Candida species. This type of toenail fungus is often seen in individuals who have been exposed to moist environments for extended periods, such as those who frequently wear closed-toe shoes. The nails may appear white, green, or black, and can become soft and crumbly.

Endonyx Onychomycosis

Endonyx Onychomycosis is characterized by the internal invasion of the nail plate, with minimal involvement of the nail bed or nail fold. This type of toenail fungus often leads to a milky or cloudy appearance of the nail, with little to no surface changes. It is relatively rare but can be challenging to diagnose without a thorough examination.

Total Dystrophic Onychomycosis

Total Dystrophic Onychomycosis is an advanced form of toenail fungus that affects the entire nail unit. In this type, the nail may become severely thickened, deformed, and discolored. It can lead to significant discomfort and interfere with daily activities. Total Dystrophic Onychomycosis often results from long-standing, untreated cases of other types of toenail fungus.

Treatment Options

Topical Antifungal Agents

For milder cases of toenail fungus, topical antifungal creams or ointments may be prescribed. These medications are applied directly to the affected nail and surrounding skin. While they can be effective for superficial infections, they may be less successful in treating more advanced cases or certain types of toenail fungus.

Oral Antifungal Medications

In cases of moderate to severe toenail fungus, oral antifungal medications may be recommended. These medications work systemically, traveling through the bloodstream to target the fungal infection. They are often more effective than topical treatments, but they may come with potential side effects and require careful monitoring.

Laser Therapy

Laser therapy is an innovative treatment option that targets the fungus without harming the surrounding tissue. It’s particularly effective for certain types of toenail fungus, including DSO. This non-invasive approach can provide promising results, although multiple sessions may be required for optimal outcomes.

Natural Solutions for Toenail Fungus

In addition to conventional treatments, natural remedies can play a role in managing toenail fungus. 

  • Homeopathic remedies such as Calendula officinalis 12C, Silicea 12C and Thuja occidentalis 12C. These are highly diluted substances with natural antifungal and anti-inflammatory properties.

Most recommended:

H-Nail Fungus Formula

Manufactured by Natural Healing Oils.

  • Tea tree oil, known for its antifungal properties, can be applied directly to the affected nail.
  • Apple cider vinegar, with its acidic nature, may create an inhospitable environment for fungi.
  • Soaking the affected foot in a mixture of warm water and a few tablespoons of apple cider vinegar can be soothing and potentially effective.
  • Additionally, maintaining good foot hygiene, wearing breathable shoes, and avoiding prolonged exposure to damp environments can aid in preventing the recurrence of toenail fungus.


Understanding the different types of toenail fungus is essential for accurate diagnosis and effective treatment. Whether it’s the common Distal Subungual Onychomycosis or the less frequently encountered Total Dystrophic Onychomycosis, early intervention is crucial. Consulting a healthcare professional for a proper diagnosis and personalized treatment plan is the first step towards healthier, fungus-free toenails. With the right approach, individuals can regain confidence and comfort in their stride.

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