A fungal toenail infection is caused by a germ called a fungus, which grows in warm, moist places. Kids with a fungal toenail infection have one or more toenails with white, yellow, or brown streaks or patches. The nails may feel thick or ridged, and they may break or crumble easily. There may be pain around the infected nails. In most kids, a fungal toenail infection does not lead to other medical problems, but it can be hard to treat.

• If medicine is prescribed, use it exactly as directed. Do not stop the medicine early or give it longer than directed.
• Encourage your child not to touch or pick at the infected area.
• To lower the chances of your child getting another fungal toenail infection:
  • Make sure your child wears flip-flops or waterproof shoes in locker room showers and around swimming pools.
  • Teach your child not to share personal items, such as nail clippers and towels.
  • Teach your child to dry the feet well after swimming, bathing, and exercising, especially around the toes.
  • Choose socks made of fabric that takes moisture away from the skin. Encourage your child to change socks often.
  • Choose shoes that are breathable and not too tight. Let shoes dry out before your child wears them again.

• The new nail that grows in still seems to be infected, even several months later.
• The infection spreads to other nails.
• The area around the infection becomes painful, red, itchy, warm, or swollen, or drains pus.
• Your child has trouble using the recommended medicine.
• Your child has pain when walking.
• The toenail is too thick to cut. Your doctor can recommend ways to make the nail softer and easier to cut.

How do people get a toenail fungal infection? A fungus can enter the body through a cut near the toenail or under the toenail when a person:

• walks barefoot in areas where a fungus lives, like in a shower or by a pool
• shares personal items like nail clippers
• has a fungal skin infection (like athlete's foot) that spreads to the toenail
• has a weakened immune system (the system that fights infection in the body)

How are toenail fungal infections treated? Toenail fungal infections usually don't lead to other problems, but they won't go away on their own. If the infected toenail bothers your child, treatment may include one or more of these:

• a medicine taken by mouth for several months. It can sometimes have side effects. Your health care provider may recommend blood tests before starting this medicine and/or during treatment to check for side effects.
• a medicated polish, cream, or lotion to put on the nail
• surgery to remove the nail

Sometimes treatment does not make the infection go away. Or the infection may go away and then come back.