White stuff under your toenail is often a sign of a fungal infection (onychomycosis) or nail psoriasis, both leading to keratin buildup (subungual hyperkeratosis) that makes the nail thick, crumbly, and discolored, potentially with pain from pressure. While mild cases might resolve, it's best to see a doctor for proper diagnosis and treatment, which can involve antifungal creams, oral medication, or nail care to prevent worsening.
The first step to treating keratin granules is to give your nails a break from nail polish. Let them “breathe” for a few weeks so they can recover. You can also hydrate your nails by applying a strengthening oil or cream with ingredients like vitamin E, jojoba oil, or keratin proteins.
Can You Scrape Out Toenail Fungus? No. You may be able to scrape a bit off the top of or from under your nails, but that won't cure the infection.
The best way to get rid of keratin granulation is to give your nails a several-week-long break from nail polish, nail polish remover and chemicals in conjunction with using moisturizers and/or hand creams to replenish the moisture balance of the nails.
Treating fungal nails during pregnancy requires caution, with topical treatments preferred over oral medications, but even topical options like medicated nail polish (ciclopirox) need doctor approval, while oral antifungals (like fluconazole, itraconazole) are generally avoided due to potential fetal risks, and laser therapy is also not recommended; always consult your doctor for the safest approach.
There's a chance toenail fungus will go away on its own, but most often, early treatment is key. The longer you wait to seek treatment, the more pronounced your symptoms will become. Early on, Dr. Rhinehart might recommend oral medication, a topical antifungal ointment or cream, or a medicated nail polish.
Factors that can increase your risk of developing nail fungus include: Older age. Wearing shoes that make your feet sweat heavily. Having had athlete's foot in the past.
If toenail fungus goes untreated, it worsens, causing the nail to thicken, discolor (yellow/brown), become brittle, crumble, and potentially separate from the nail bed, leading to pain, odor, and difficulty walking; it can spread to other nails/skin (athlete's foot) and, in rare cases, lead to serious bacterial infections like cellulitis, especially for those with diabetes or weakened immunity, potentially causing permanent nail damage or systemic issues.
Often mistaken for a fungus, keratin granulations appear as white “chalky” spots or streaks on the nail plate.
Yes, toenail fungus is contagious. Typically toenail fungus spreads through: Direct contact with the infected person. Common household objects, such as towels or clothing.
To permanently kill toenail fungus, you need professional treatment, with oral antifungal medications like terbinafine (Lamisil) being the most effective for clearing the infection, though they require months of use and liver monitoring. Prescription topical creams (e.g., Jublia, Kerydin) and medicated nail polishes (Penlac) are also options, often used with nail thinning or combined with oral meds. Laser therapy can be effective by heating the fungus but isn't a first-line treatment and lacks strong evidence for a permanent cure.
If you touch an infected toenail and then touch an uninfected toenail, you can spread the fungus to the uninfected nail. If you use the same tools, like nail files or clippers, on an uninfected toenail or fingernail after using them on an infected nail, the fungus can spread to the uninfected nail.
Soaking your foot in peroxide can, in some cases, help get rid of toenail fungus. However, because it is difficult for hydrogen peroxide to reach all of the areas of the toe where the fungus can grow, such as under the nail, in the nail bed, it can be difficult to completely treat advanced fungus with peroxide alone.
What is most interesting is when the contaminated socks worn by patients with tinea pedis and onychomycosis were laundered in a domestic washing machine at 40ºC. Thirty-six percent of the socks revealed positive fungal cultures at the end of the cleaning and drying cycle.
White toenails can be a red flag because they may signal underlying issues like mineral deficiencies (iron, zinc), fungal infections, skin conditions (psoriasis), or more serious systemic problems such as liver disease, kidney disease, heart failure, or diabetes, though often they're just from minor trauma and grow out. Key signs to watch for include white patterns (like half-white nails from kidney issues), powdery texture (fungus), or other symptoms like fatigue, prompting a doctor visit.
Nail psoriasis sometimes causes too much keratin to grow under the nail. This overgrowth is called subungual hyperkeratosis. People with hyperkeratosis may notice a white, chalky substance under the nail. When this occurs in the toenails, the pressure of shoes pushing down on the nails might cause pain.
Your podiatrist can detect a fungal infection early, perform a lab test, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail.
Keratin granulation
If you remove your nail polish only to find that part of your nail is white and dry underneath, you may have this common condition. It's caused by wearing toenail polish for too long. If you have this, it's best to let your nails heal for a while.
An ill-advised barefoot romp around the pool deck or even a pedicure gone wrong may be all the fungi need to gain access to the space underneath a toenail. Once there, the fungi set about their task of “mining” your nail for nutrients—and leaving it discolored, thickened, misshapen, and more.
Vinegar solutions can work for toenail fungus in some cases — especially if you only have a mild infection. However, there is no scientific evidence to back the use of vinegar foot soaks. The main benefit of trying out a vinegar soak (or any other natural remedy) is that it is easy and cheap for you to try at home.
Sweaty socks and shoes.
Fungi love dark, sweaty spaces—and your shoes fit the bill nicely. This is especially true if you've had fungal nails in the past and not gotten your shoes treated. If the fungi lives on in your shoes, they can infect you again and again.
Additionally, biotin deficiency can increase the risk of fungal nail infections and subsequent nail plate discoloration. Changes in nail shape and surface.
Anyone can get toenail fungus, but it's more common in people older than age 60. Those with diabetes or circulation problems are vulnerable to infection, too. So are people with a weakened immune system. Fungus presents a much larger problem for these groups than for healthy people.