Toenail Fungus Questions

Is Toenail Fungus Hereditary?

Technically, toenail fungus (onychomycosis) is not a hereditary condition. It is caused by specific species of fungi, including Candida (yeasts), dermatophytes and non-dermatophytes. Fungi are microorganisms that require certain conditions to thrive. Once they find these conditions, they will proliferate in this area, causing a fungal infection of the nail(s).

Genes cannot cause toenail fungus. However, even though you cannot directly inherit a toenail fungus, you can be genetically predisposed to be vulnerable to the type of fungus that causes toenail fungal infections. For example, diabetes, a condition that weakens immune system function and peripheral circulation, can run in families. People with diabetes have a higher risk of having toenail fungus.

Although a family history of toenail fungus is not guaranteed to affect you, it’s possible that if someone in your family has a nail fungus that you may get it as well. Find out how toenail fungus can be passed to other family members and whether you’re at risk.

Diabetes and Toenail Fungus

Diabetes and conditions that cause poor peripheral circulation are common risk factors for toenail fungus. People with diabetes are more prone to developing toenail fungus because their high blood sugar levels can affect immune system function. A poorly functioning immune system will not be able to fight off a fungal infection, allowing the fungus to multiply.

  • Acta Dermato Venereologica studied the prevalence of onychomycosis among 271 patients with type 1 and type 2 diabetes. 22% of the patients had toenail fungus, of which 55 (93%) of the infections were caused by dermatophytes and 4 (7%), by yeasts.
  • Researchers found a correlation between toenail fungus, age and the severity of the nail fungus symptoms. This shows that it is common in diabetic patients, especially among people who are older and with significant nail changes. Furthermore, Der Hautarzt suggests that the presence of toenail fungus may predict the development of foot ulcers and diabetic foot syndrome.

Type 2 diabetes is a hereditary condition, but this doesn’t mean you’re guaranteed to develop it. It means that you have a higher chance of developing type-2 diabetes than people with no family history of diabetes. However, lifestyle plays a huge role as well. Even if you do have a genetic mutation that makes you prone to develop diabetes, maintaining a healthy and active lifestyle can effectively prevent it.

Genetic Risk Factors

There’s no concrete evidence that toenail fungus is a genetic condition, but you may be genetically predisposed to infection.

  • The Journal of European Academy of Dermatology and Venereology suggests that the low prevalence of fungal infections among people whose spouses have toenail fungus, versus the high prevalence among their children having it indicates a genetic risk factor.
  • Research published in the New England Journal of Medicine, the presence of a genetic trait called autosomal recessive CARD9 deficiency can increase one’s risk of developing a dermatophyte infection of deep tissues that can become life-threatening.

Toenail fungus is most common in men under the age of 60. Therefore, if you have a family history of toenail fungus or have other risk factors for the infection, see a doctor as soon as possible to prevent the condition from worsening.

Other Risk Factors for Toenail Fungus

About half of all nail diseases are a result of fungal infections. Fungi are tiny microorganisms that can thrive beneath your nail beds, causing toenails to become discolored, brittle, painful, and putrid.

While anyone can get onychomycosis, some people are more vulnerable. Age, genetics, gender, overall health and your care habits can play a significant role in the development of toenail fungus.

Some common risk factors of toenail fungus include the following:

1) Wearing Boots

Your job could be put you at risk for developing toenail fungus, especially if you’re required to wear, heavy, non-breathable boots for prolonged periods. Boots and other shoes made of materials with poor ventilation, such as rubber and vinyl, create a warm, dark and sweaty environment that’s perfect for fungal growth.

Additionally, wearing occlusive footwear and not following proper care instructions to prevent toenail fungus, can put you at risk for developing athlete’s foot – another infection caused by the same fungi responsible for toenail fungus.

To reduce your risk of toenail fungus while keeping your job, consider alternating several pairs of footwear to allow each pair to dry before you wear them. It’s also important to change your socks frequently, even during work hours to ensure your feet stay clean and dry.

2) HIV/AIDs and Cancer

According to a study published in the British Journal of Dermatology, HIV infection and cancer therapy causes immunosuppression in patients, making them more susceptible to developing toenail fungus.

3) Age

The most common risk factor for developing toenail fungus is old age. According to a study published in the Journal of the American Academy of Dermatology, toenail fungus occurs in 18.2% of the patients who are 60 to 79 years of age.

The research also suggests that men are three times more likely to have toenail fungus than women. However, the cause of this difference in gender is still not understood.

4) Family Members with Toenail Fungus

Toenail fungus can spread to family members due to sharing nail tools, towels, shoes, and other belongings among each other. Sharing washrooms with a family member with toenail fungus can also put you at risk because fungus can travel from the bathroom floor to your feet.

To prevent this from happening, you should avoid sharing personal items with family members and if you do have a member with toenail fungus, consider using flip-flops or shower slippers while showering.

5) Nail Trauma

Your nails act protective barriers for your skin. Anytime, a toenail gets injured, there is a high risk for moisture getting trapped under the nails, creating an ideal condition for fungi to grow. Moreover, using nail clippers or other tools that are exposed to toenail fungus (for example, in a nail salon) puts you at a higher risk of developing toenail fungus.

Therefore, if you do have an injury to your nail, be sure to clean the area carefully and treat it with a topical antiseptic to prevent infection. You must also avoid sharing towels and nail tools, or getting pedicures at a salon until the damage grows out.

6) Nail Polish

Heavy nail polishes tend to block light, creating a dark environment that’s more suitable for fungal growth.

Therefore, consider giving your toenails a break every now and then. If you are using nail polish, consider using breathable formulas as they may create an environment that’s less favorable for fungi. There are antifungal nail polishes available.

Is Toenail Fungus Hereditary?

Furthermore, on days you treat yourself to a pedicure, take caution. Toenail fungus can be easily transferred to foot baths, nail clippers and nail files. Make sure the salon you visit sanitizes all tools after each customer. Ideally, you should book your appointment for early morning because pedicure instruments and baths are usually cleanest at the start of the day.

7) Tight Shoes

Air circulation helps to prevent toenail fungus. Wearing closed-toe shoes with narrow toe boxes can cause trauma to the nails, causing them to weaken. This can make them more susceptible to toenail fungus.

Therefore, get your feet professionally measured and wear footwear that allows room for your toes to move.  If your shoes cause pinching, consider replacing them with a better-fitting pair that’s more breathable, such as open-toe shoes.

Wearing nylon stockings can also cause your feet to sweat, increasing your risk of toenail fungus. If you wear stockings, you should put some baby powder or antiperspirant on your feet before putting them on.

8) Working Out

Toenail infections are common among runners and other athlete’s. If you’re a distance runner, participate in any sports activity or workout on a regular basis, chances are you’ve probably already noticed that your feet can sweat quite a bit. Fungi love sweaty shoes, sweaty socks, and non-breathable, tight-fitting shoes. These factors create an ideal environment for fungal growth.

If you participate in sports or workout regularly, consider using moisture-wicking socks that are designed to keep feet dry. It also helps to alternate running shoes so that each pair has a chance to dry completely.

Prevention is better than cure because toenail fungus isn’t easy to treat. Even if you recover from it, there is a high risk for relapse. Numerous factors contribute to toenail fungus recurrence.  Individuals with a genetic predisposition to toenail fungus, who have diabetes or have weakened immune systems, are more likely to experience toenail fungus again, without reaching a permanent cure.

Not only is toenail fungus unpleasant and unsightly, but it can also spread to other body parts. Therefore, if you have a higher risk of developing toenail fungus, it is imperative that you take the necessary precautions to prevent toenail fungus in its tracks.