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What Causes Swelling, Brittle And Pus Discharge From Toenail?

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Posted on Mon, 16 May 2016
Question: My toenail on my big toes are getting very thick and yellow/brown and a smelly clear liquid is coming out
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Answered by Dr. Bonnie Berger-Durnbaugh (46 minutes later)
Brief Answer:
Toe nail fungal infection

Detailed Answer:
Hello XXXXXXX

What you are describing sounds like a toe nail fungal infection. These commonly affect the big toes and cause thickened brittle yellow brown nails. A discharge can happen too if it starts to infect the underlying tissue.

Fungal infections, unlike bacterial infections, take time to treat and go away only slowly.

Starting to treat it as soon as it starts is key to nipping it in the bud, but not always possible.

So about treatment: You paint the toe nails with medicated anti fungal polish (Kerydin, Jublia, Penlac). There is also an oral anti fungal (pill) but I tend to stay away from those if possible as it goes thru your whole system and can be hard on the liver and cause other side effects. But the oral anti fungal pills are quicker and more effective.

There are some home remedies (tea tree oil, Vick's Vaporub) that show some effectiveness, but only if started very early in the course of the infection. I am thinking, from your description, that yours is a bit farther along, and so you may need the prescription medication (toe nail lacquer). Sometimes toe nail removal is needed.

It usually takes about 3 months of persistent treatment with topical medications (prescription or home remedy) to cure the toe nail fungus.

Make sure your feet stay as dry as possible. Walking around barefoot is good. After shower/bath, dry your feet with a towel and then on the low setting with a blow dryer. Change socks if they get wet. And make sure your shoes aren't too tight. Trim off the effected parts of the nails when they grow out.

Toe nail fungus isn't pretty, but is usually only a medical concern if you have diabetes or a lowered immune system.

So, at this point, call or see your doctor to get started on treating this, but know that it can take some time to fully get over.

I hope this helps. Please let me know if you have any questions about it.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh (28 minutes later)
here's a picture. they seem very far gone. I don't have insurance until next month though. what do you think I should do?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
The nail on the right foot.

Detailed Answer:
I looked at the pictures. I am not too concerned about the nail on the left foot. You can try home remedies on it or buy a non-prescription anti fungal nail polish if you want, or the nail may grow out and fall off.

But I am quite concerned about the situation on the right foot as it looks like the infection may be going down into the soft tissue and you can develop a secondary bacterial infection in the soft tissue/skin below the nail.

I know you don't have insurance until next month, but is there a free or reduced clinic you can go to for a prescription oral anti fungal?

Although moisture isn't good for a nail with fungus, because I am concerned about the underlying tissue becoming or already infected, I recommend putting the toe under very warm water for a few minutes several times a day, and then drying/blow drying well after wards and going without shoes and socks. This is to help the skin infection (not the fungal infection). And apply a topical antibiotic like Neosporin.

You will need to watch that toe very carefully since the skin is involved, you can develop cellulitis. It really might be worth it if you can to shell out money for this before it gets worse.
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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What Causes Swelling, Brittle And Pus Discharge From Toenail?

Brief Answer: Toe nail fungal infection Detailed Answer: Hello XXXXXXX What you are describing sounds like a toe nail fungal infection. These commonly affect the big toes and cause thickened brittle yellow brown nails. A discharge can happen too if it starts to infect the underlying tissue. Fungal infections, unlike bacterial infections, take time to treat and go away only slowly. Starting to treat it as soon as it starts is key to nipping it in the bud, but not always possible. So about treatment: You paint the toe nails with medicated anti fungal polish (Kerydin, Jublia, Penlac). There is also an oral anti fungal (pill) but I tend to stay away from those if possible as it goes thru your whole system and can be hard on the liver and cause other side effects. But the oral anti fungal pills are quicker and more effective. There are some home remedies (tea tree oil, Vick's Vaporub) that show some effectiveness, but only if started very early in the course of the infection. I am thinking, from your description, that yours is a bit farther along, and so you may need the prescription medication (toe nail lacquer). Sometimes toe nail removal is needed. It usually takes about 3 months of persistent treatment with topical medications (prescription or home remedy) to cure the toe nail fungus. Make sure your feet stay as dry as possible. Walking around barefoot is good. After shower/bath, dry your feet with a towel and then on the low setting with a blow dryer. Change socks if they get wet. And make sure your shoes aren't too tight. Trim off the effected parts of the nails when they grow out. Toe nail fungus isn't pretty, but is usually only a medical concern if you have diabetes or a lowered immune system. So, at this point, call or see your doctor to get started on treating this, but know that it can take some time to fully get over. I hope this helps. Please let me know if you have any questions about it.