Toenail fungus often seems like a minor nuisance at first, but for many older adults, it quickly becomes more than just a cosmetic concern. Thickened, yellowed, or cracked nails can lead to pain, difficulty walking, and even secondary infections. And it’s far more common than most people realize, nearly 1 in 2 adults over 70 are affected by some form of toenail fungus, according to the American Podiatric Medical Association.
Nancy, 72, from New Jersey, put off dealing with her thickened toenail for over a year. “I thought it was just part of aging,” she says. “But it got painful, and I started hiding my feet.”
So why is toenail fungus so persistent and what actually works to get rid of it?
Why Toenail Fungus Gets Worse With Age
According to Connecticut-based podiatrist Dr. Arnold J. Zuckman, the issue is often tied to age-related changes in the body. “Fungal infections are opportunists,” he explains. “As we age, our nails grow slower, circulation decreases, and immune response declines. That combination makes it easier for fungus to take hold and harder to fight off.”
In older adults, even small cracks or nail changes can create entry points for fungal spores. If left untreated, the infection can gradually worsen, causing discomfort and affecting mobility especially in those with diabetes or poor circulation.
How Toenail Fungus Is Treated Today
Treating toenail fungus takes commitment and consistency. It’s not a quick fix, but the good news is that there are more options than ever today. Dr. Zuckman outlines several treatments worth considering:
Prescription oral medications like terbinafine (Lamisil) target the fungus from the inside and are often the most effective solution. Treatment typically lasts 6 to 12 weeks and may require occasional liver monitoring.
Topical antifungal lacquers, including Jublia and Penlac, are ideal for milder cases or for those who cannot take pills. These are applied directly to the nail, but require daily use and patience.
Laser therapy uses focused light to kill fungus beneath the nail. It’s a newer, non-invasive option with promising results, though it can be costly and may not be covered by insurance.
At-home approaches like tea tree oil, Vicks VapoRub, or Listerine foot soaks are popular for managing mild symptoms. While these remedies aren’t cure-alls, they may help slow the spread and keep the nail healthier while using other treatments.
“If your toenail has been thick and yellow for months, don’t just file it down and ignore it, “The sooner you start treatment, the better your chances of clearing it up.”
Can You Prevent Toenail Fungus from Coming Back?
Yes and prevention is key, especially after successful treatment. Fungal infections love moist, enclosed spaces like shoes and socks, so changing your daily habits can help keep your feet clear and comfortable.
Dr. Zuckman’s top tips for preventing toenail fungus include:
Wash and dry your feet thoroughly every day, especially between the toes
Wear breathable shoes and moisture-wicking socks to keep feet dry
Rotate your shoes and change socks daily to avoid buildup
Avoid going barefoot in public areas like locker rooms or hotel showers
Sanitize nail tools and never share them with others
Use antifungal powder if your feet sweat often
“Foot hygiene might not be exciting,” Dr. Zuckman adds with a chuckle, “but it’s one of the most powerful tools we have.”
About the Expert
Dr. Arnold J. Zuckman is a board-certified podiatrist based in Connecticut, with decades of experience treating toenail fungus and other foot disorders. He’s affiliated with Bridgeport Hospital and specializes in diabetic foot care, sports injuries, and nail pathologies. Dr. Zuckman is known for his thorough care and compassionate approach to helping patients stay active and pain-free, regardless of age.
