Different Types of Toenail Fungus and How to Identify Them

Written by an Expert Aesthetic Content Writer Lisa.
Reviewed by Expert Medical Director Dr. Raj Thethi
Published on: January 13, 2025
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different types of toenail fungus

Toenail fungus is a common condition that makes the nails look unhealthy. There are different types of toenail fungus, each with its own signs or symptoms. Knowing what kind you have is important because it helps you get the right treatment.

To steer clear of confusion—Let’s see the different types, how to figure out which one you might have, and what other problems can look like toenail fungus.

Toenail Fungus

In medical terms, toenail fungus is known as Onychomycosis—a common condition that affects toenails. When small cuts or cracks are under the toenail skin, fungi enter and start growing. Sweaty feet, diabetes, ageing, weakened immune system, and unhygienic habits lead to onychomycosis.  

This fungal growth makes the toenail appear thickened, brittle, and discoloured, and it can sometimes cause discomfort. In some cases, the infection may cause an unpleasant odour. This condition may compromise your comfort and confidence as it is cosmetically displeasing. 

Here are Common Types of Toenail Fungus

There are several kinds of toenail fungus. All of them differently affect your toenails. So, let’s take a look at the most common types below:

1. Distal Subungual Onychomycosis (DSO)

It often begins when the skin beneath the nail (the nail bed) becomes infected. The cause of DSO is Dermatophytes, a group of fungi that love warm, moist environments—the same ones that cause ‘Athelet’s foot’. 

When you have the DSO type, the nail may appear:

  • Yellow or white patches at the very end of the nail.
  • Thickened and may even start to break off.
  • Raised from the nail bed due to underlying debris.

2. Proximal Subungual Onychomycosis (PSO)

This type begins at the base of the nail and works its way up, so it is less common than DSO. It is commonly associated with people with weak immune systems (such as diabetes or HIV). 

The toenail affected by PSO:

  • Appears white or yellowish at the base of the nail, closer to the cuticle. 
  • As the nail grows, discolouration spreads to the tip. 

This type can indicate an underlying health condition, so you should consult a doctor if you observe these symptoms.

3. White Superficial Onychomycosis (WSO)

WSO is caused by fungi such as Fusarium or Acremonium. They only affect the surface layers of nails. WSO looks like:

  • White spots or patches on the surface of the nail.
  • The nail becomes rough, brittle, and crumbly but does not thicken as much as with other types.

This is the easiest type to treat because the infection stays on the surface and doesn’t penetrate the nail. If left untreated, it may spread across the entire nail and get bad.

4. Candida Onychomycosis

The cause of Candida Onychomycosis is yeast. It occurs in people whose hands or feet remain wet, such as swimmers and dishwashers. There are about 60 species of Candida, but not all of them are responsible for causing nail infections. 

  • The nail affected by Candida onychomycosis:
  • Turn white, yellow, or brown. 
  • It may start pulling away from the skin or become soft and crumbly.

The skin surrounding the nail is red, swollen, and tender.

5. Mould-Associated Onychomycosis

Molud infections are caused by non-dermatophyte fungi, which are more common among the elderly.

Trauma to the nail increases the susceptibility of the nail to infection by mould. They are less common but can cause significant nail damage if left untreated.

The nail becomes: 

  • Dark brown, black, or green.
  • Thickened and distorted with a lumpy appearance.

How do you tell me what kind of Toenail Fungus you have?

Identify the types of Toenail Fungus

Determining what type of fungus you have can be challenging. Here’s how you can narrow it down:

Look at the Colour

  • Yellow nails may indicate DSO or PSO.
  • White spots are usually WSO.
  • Brown or black nails may indicate a mould infection.

Determine the Starting Point

  • If the nail changed at the tip, it’s likely DSO.
  • If the base of the nail looks strange, it might be PSO.

Knowing the Toenail Fungus Type You Have is Essential

Each type of toenail fungus requires a different treatment. If you do not know the exact type, the treatment might not work. For example:

  • DSO and WSO are usually treated with creams or antifungal pills.
  • PSO and Candida infections may be more severe to treat, particularly if you have another underlying health condition.

Moreover, knowing the signs that toenail fungus is dying is helpful if you are getting the treatment.

What can be Mistaken for Toenail Fungus?

Not all nail problems are caused by fungus. Here are some other things that can look like toenail fungus:

1. Nail Injury

If you stub your toe or drop something on it, the nail might turn black or red. Unlike fungus, this will go away as the nail grows.

2. Psoriasis

Psoriasis causes thick, discoloured nails. You can also see patches of red, scaly skin.

3. Bacterial Nail Infection

The greenish colour could be a sign of bacterial infection, not fungus. These infections will often make the nail area painful and swollen.

4. Melanoma

Dark spots under the nails may be a symptom of melanoma, a form of skin cancer. If you have dark streaks on your nails, talk to a doctor. 

Best Treatment for Toenail Fungus

Here are some treatment options that may help you treat your toenail fungus. 

1. Oral Antifungal Medications

Medications like terbinafine and itraconazole work from the inside out to clear the toenail fungus. 

2. Topical Antifungal Creams or Nail Polishes

Over-the-counter or prescription solutions are applied directly to the nail to treat the fungus. 

3. NeoGen Plasma

Neogen Plasma is a noninvasive method that uses plasma energy to kill the toenail fungus instantly and reduce its chances of recurrence. 

4. Toenail Removal 

For severe cases, removing the nail allows direct treatment to the nail bed.

5. Home Remedies

Vinegar soaks, tea tree oil, and baking soda may relieve mild infections.

Final Remarks

There is no one type of toenail fungus, but many kinds of infections with their own symptoms. The shape and colour of the toenails and even the sensation of the nails may indicate a particular infection type. Sometimes, psoriasis, nail injury, and melanoma are confused with toenail fungal infections—knowing the difference helps choose a treatment strategy.

Suppose you cannot determine what kind of toenail fungus you have. In that case, a consultation with a physician can help you choose the cause and obtain a proper regimen, such as NeoGen Plasma treatment, to kill the fungus instantly.

Healthy nails are possible with the right care!

FAQs

1. What is the best treatment for toenail fungus?

Antifungal medications (oral and topical)  are the treatment for toenail fungus. However, NeoGen plasma is a non-invasive technique that uses plasma energy to kill fungus instantly.

2. What deficiency causes toenail fungus?

There is no direct link, but sometimes, biotin deficiency may increase the risk of toenail fungal infection. 

3. What is the best anti-fungal for toenails?

Terbinafine and itraconazole are the most effective antifungal medications for toenail fungal infections. 

4. What worsens toenail fungus?

Ageing, wearing tight footwear, sweaty feet, and having athlete’s feet in the past may increase the chances of toenail fungus worsening.

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About the Author

Dr. Raj Thethi

Yorkshire Skin Centre in Leeds is a CQC-registered medical clinic. It is led by Dr Raj Thethi who completed his core surgical training in hospitals around West Yorkshire before branching into aesthetics. Dr Raj Thethi is a Northern Territory Regional Expert for an international dermal filler company called Teoxane. He also sits on their National UK Faculty.

View all posts by Dr. Raj Thethi

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