Toenails can develop a foul, unpleasant odor for a variety of reasons. Understanding the causes of smelly toenails can help you find solutions to eliminate the odor and keep your feet fresh.
What Causes Toenails to Smell?
There are several potential causes of smelly toenails:
- Fungal infection – One of the most common causes of smelly toenails is a fungal infection. Toenail fungus thrives in the warm, moist environment inside shoes and socks. The fungus causes the nail to become discolored and give off a foul odor.
- Bacteria – Bacteria can also infect toenails, especially if the nails are damaged or kept moist. Bacteria causes a condition called paronychia which leads to redness, swelling, and a foul smell.
- Poor hygiene – Failure to regularly wash the feet and toenails allows sweat, dead skin cells, and bacteria to build up. This debris emits an unpleasant odor.
- Sock and shoe materials – Wearing tight shoes and socks that don’t breathe can cause excessive moisture around the toenails. This leads to ideal conditions for bacterial and fungal growth.
- Medical conditions – Certain medical conditions like diabetes and an overactive thyroid can increase sweat production in the feet. The excess moisture encourages bacterial growth and toenail odor.
- Injury – Damaging the toenails through ingrown nails, splits, bruises, or improper trimming can allow bacteria to enter and infect the nail bed leading to odor.
Signs Your Toenails Smell Due to Fungal Infection
A fungal infection is the most likely culprit if your smelly toenails exhibit any of these signs:
- Thickening or crumbling of the nail
- White, black, yellow, or green discoloration
- Detachment of the nail from the nail bed
- Foul or musty odor, often described as smelling like cheese or stale vinegar
- Debris accumulating under the nail
The fungus digests the keratin protein that makes up the surface of the nail, causing the nail to become brittle and discolored. As the infection worsens, the nail may separate from the skin underneath and give off a repugnant smell.
Risk Factors for Toenail Fungal Infections
You may be more prone to developing a fungal toenail infection if:
- You wear tight-fitting or closed shoes frequently
- Your feet sweat excessively
- Your socks retain moisture
- You walk barefoot in damp public areas like pools, showers, or locker rooms
- You have a minor injury to your nail that allows fungi entry
- You have a suppressed immune system
- You have diabetes, cancer, or an overactive thyroid
- You are over age 60
Taking steps to minimize these risk factors can help prevent fungal toenail infections and smelly nails.
Home Treatments for Smelly Toenails
Mild cases of smelly toenails caused by fungus, bacteria, or poor hygiene may be treated at home using these methods:
- Soak feet in white vinegar – The acidic vinegar can help kill fungus and bacteria. Mix 1 part vinegar with 2 parts warm water and soak feet for 15 minutes daily.
- Apply tea tree oil – Tea tree oil is a natural antifungal. Apply it directly to clean nails twice daily.
- Use an antifungal powder – Sprinkle an over-the-counter powder containing clotrimazole or tolnaftate on feet and shoes daily.
- Soak in epsom salts – The magnesium in epsom salts has antifungal properties. Dissolve 1/2 cup in warm water and soak feet for 20 minutes.
- Scrub with baking soda – Make a paste with 3 parts baking soda to 1 part water. Gently scrub under and around nails daily.
- Dry thoroughly after bathing – Use a blow dryer on a cool setting to ensure feet and nails are completely dry.
- Disinfect footwear and socks – Spray the inside of shoes with an antifungal spray and wash socks in hot water with fungicidal soap.
- Trim nails properly – Cut nails straight across to avoid ingrown nails. File down thickened nails.
- Apply Vicks VapoRub – The menthol and camphor have mild antifungal action. Apply a thin layer before bedtime.
Perform home treatments daily for several weeks to see improvement in smelly toenails. Schedule a doctor’s appointment if no improvement after 2-3 months.
Medical Treatments for Smelly Toenails
Podiatrists and dermatologists can provide prescription medications and in-office procedures to treat stubborn toenail fungus and odor, including:
- Oral antifungal medication – Prescription pills like terbinafine or itraconazole are highly effective against fungal infections. Treatment lasts 6-12 weeks.
- Topical antifungal lacquer – Medicated nail polish like ciclopirox or amorolfine applied weekly for up to one year.
- Laser therapy – Laser beams target and kill fungal infections in the nail and nail bed in a series of painless office visits.
- Photodynamic therapy – A topical photosensitizing agent and special light source combine to destroy nail fungus.
- Surgical nail removal – For severe infections, the nail can be partially or fully removed to provide access to treat the nail bed.
In some cases, smelly toenails are caused by an underlying health condition that must be addressed to fully eliminate odor:
- Diabetes – High blood sugar can increase susceptibility to infections. Proper glucose control is key.
- Poor circulation – Reduced blood flow to the extremities allows infections to thrive. Management of cardiovascular health can help.
- Overactive thyroid – Excess thyroid hormone increases sweating. Medication helps regulate thyroid function.
- Damaged nails – Ingrown or injured nails may require trimming or removal of part of the nail to prevent recurrence of infection.
Tips for Preventing Smelly Toenails
You can help prevent smelly toenails by following these foot care tips:
- Wash feet daily with antibacterial soap and dry thoroughly, especially between the toes.
- Apply foot powder to help absorb moisture and reduce friction inside shoes.
- Wear moisture-wicking socks made of natural fibers like cotton or wool.
- Choose shoes with open toe boxes and breathable materials.
- Alternate pairs of shoes to allow them to fully air out and dry.
- Disinfect shower floors and avoid damp public areas barefoot.
- Trim nails straight across to avoid ingrown nails.
- Treat athlete’s foot promptly as it can spread to the nails.
- Get periodic pedicures to remove debris and thickened parts of nails.
- See a podiatrist at the first sign of nail discoloration or odor.
When to See a Doctor for Smelly Toenails
Schedule an appointment with your doctor if you experience:
- Persistent foul toenail odor lasting more than 2 weeks
- Discolored, thickened, or distorted nails
- Detached or loose nails
- Pus or discharge around the nails
- Redness, swelling, or pain in the toes
- Bleeding around or under nails
- Ingrown toenails
- Diabetes, thyroid issues, or circulatory conditions
- Weakened immune system from illness or medication
- Nail fungus that recurs despite home treatment
A podiatrist can determine the underlying cause of smelly toenails and provide appropriate treatment. Leaving fungal or bacterial infections untreated allows them to worsen and spread to other nails.
Diagnosis of Smelly Toenails
To diagnose the cause of smelly toenails, the doctor will:
- Ask about symptoms and medical history
- Examine the nails and surrounding skin
- Take nail clippings for laboratory testing to identify fungi or bacteria
- Order blood tests to check for diabetes, thyroid problems, or other conditions
- Possibly do a culture of any drainage from around the nail
- Perform a biopsy to analyze a small piece of nail removed under local anesthesia
Identifying the exact cause determines the most suitable treatments to eliminate odor and prevent recurrence.
Conclusion
Smelly toenails can be unpleasant and embarrassing, but are rarely a sign of a serious underlying problem. With proper foot hygiene and prompt treatment of any infections, most causes of toenail odor can be successfully managed. See your doctor if home remedies don’t improve the smell within 2-3 months for prescription medications or procedures to safely eradicate stubborn fungal and bacterial nail infections.
| Cause | Signs | Treatments |
|---|---|---|
| Toenail fungus | Thickened, discolored nails with debris underneath, detached from nail bed | Topical antifungal creams, oral medications, laser therapy, photodynamic therapy, nail removal |
| Bacterial infection | Redness, swelling, pus, foul odor | Oral antibiotics, antiseptic soaks, keep nails short |
| Poor hygiene | Visible debris under nails, sweaty feet, damp socks and shoes | Wash feet daily, dry thoroughly, use antifungal powder, rotate shoes, disinfect footwear |
| Underlying conditions | Diabetes, thyroid disorder, circulatory problems | Treat underlying condition, optimize glucose levels, regulate thyroid, improve cardiovascular health |
| Injury | Ingrown, bruised, or damaged nails | Proper nail trimming technique, keep nails short, treat injuries promptly |
