Onychomycosis or toenail fungus during pregnancy could result in pain and discomfort while walking. Sweaty feet and lack of proper hygiene for feet could cause fungal infections in the toenails. However, some over-the-counter (OTC) antifungal creams and ointments used to treat this condition may not be safe in pregnancy. Hence, it is recommended to seek your doctor’s advice to know the right medications for you. Topical medications can cure onychomycosis in most women, while a few may require systemic medications. Read this post to learn more about the causes, symptoms, diagnosis, treatment, and prevention of toenail fungus in pregnancy and how to care for your feet.

How To Know If You Have Toenail Fungus?

If you find any of the below symptoms, then it might be toenail fungus.

The nail turns yellow or brown.

It may become thick and overgrown.

In some cases, the nail might turn white and become soft, dry, and powdery.

When left untreated, foul-smelling debris may accumulate under the feet.

Ultimately, the nail might fall off or cause discomfort and pain

Causes For Toenail Fungal Infections During Pregnancy

Around 85-90% of fungal nail infections are caused by fungal organisms such as Trichophyton rubrum and Trichophyton mentagrophytes. These are highly resistant and can survive in damp or moist environments (1). According to a research paper published in the Harvard Health Publishings, the following factors may make your toenails more susceptible to fungal infections (2).

Wearing tight-fitting shoes and hosiery.

Poor foot hygiene

Covering the nail with multiple layers of nail polish

Conditions such as diabetes mellitus

Is Toenail Fungus Treatable During Pregnancy?

According to the Global Nail Fungus Organization, when detected in the early stages, fungal toenail infections can be cured (3). There are several natural and medicinal treatment options available; your doctor will treat you depending on the symptoms shown by you.

Safe Treatment Options For Toenail Fungus During Pregnancy

The treatment options for nail fungal infections can be divided into three categories. Most of these medications are available over-the-counter. However, go by your doctor’s recommendation.

1. Topical antifungal medications

Creams: Imidazoles, clotrimazole, itraconazole, and miconazole are considered safe for topical therapy for fungal skin infections during pregnancy (4) (5). These creams could be purchased over-the-counter but it is not advisable to self-medicate, especially when pregnant. Consult your doctor for the right diagnosis and appropriate medicine.

Nail polishes: These may be tried during the initial stages of the infection. The affected nail is removed as much as possible before applying the nail polish. Penlac is one such brand of nail polish you may use. The USFDA has categorized this drug under “Pregnancy Category B,” which means animal studies have not shown any risk to the fetus, and there are no adequate studies on pregnant women So, your doctor might prescribe this medication when the benefits outweigh the risks (6).

2. Oral antifungal medications

The use of oral antifungal agents should be limited during pregnancy, as they may affect the fetus. Research suggests that some medicines for fungal infections could increase the risk of fetus malformations (7). But there is no conclusive evidence on it. So, your doctor may weigh the benefits and risks of oral fungal medications before prescribing them to you.  Self-medicating with antifungal medicines during pregnancy is not advised (8).

3. Natural remedies

Here are a few natural remedies that have been in use but not all of them may be having conclusive scientific evidence.

Tea tree oil: According to a randomized study, tea tree oil might be helpful in treating onychomycosis (9). The US National Association for Holistic Aromatherapy suggests that properly diluted tea tree oil may be safe for use during pregnancy (10). Image: iStock

Vicks VapoRub: According to a study published in the Journal Of The American Board Of Family Medicine, 15 out of 18 participants displayed a positive effect with the use of Vicks VapoRub for onychomycosis, and hence could be an option for treating toenail fungus (11).

Cornmeal: Cornmeal has anti-fungal and anti-inflammatory properties. In a tumbler, add one cup of cornmeal and two cups of warm water. Soak your legs in it for 15minutes. This home remedy is useful and safe too

What Happens If Toenail Fungus Is Left Untreated?

Early signs of toenail fungal infections (scattering white spots across the nail) are subtle and often go unnoticed. But, with time, the nails could display the following conditions:

Nails could become thicker than usual, thus making them difficult to cut.

Yellow-brown stains appear. White, green, and black flecks could appear. White, green, and black flakes could appear.

The nails may give out a foul smell.

One could feel pain and numbness at the nailbed.

If left untreated, the infection can spread to other nails as well. Severe cases may cause the entire nail to separate from the nailbed, thus causing pain and discomfort while walking (12).

How To Prevent Fungal Nail Infections Naturally During Pregnancy?

Here are a few natural ways that may help prevent fungal nail infections.

Practice proper foot hygiene by regularly washing them with soap and drying them thoroughly at least once a day.

While showering in public showers, wear rubber shoes, flip flops, or shower clogs.

Choose shoes that fit properly, with enough space around the toes.

Make sure there is proper air circulation within your footwear.

Choose socks that are made from cotton material.

If your feet sweat excessively, then change your socks every day and wash them regularly. Image: iStock

Avoid sharing nail clippers with others.

If your feet tend to be wet, consider using dry powders that can help keep your feet dry (13).

These pointers may help reduce the risk of fungal infection. If you notice any abnormal changes in your nails, then consult your doctor.

If the infection requires surgery, your doctor might ask you to wait until the end of your pregnancy (7).

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