The diagnosis and treatment of toenail fungus should involve specialists including internists, podiatrists, and others.
Tinea pedis (athlete's foot) is the most common superficial fungal infection encountered. This is contagious and use from fungal spores shed by infected individuals onto the floors of public swimming pools, locker rooms, etc. This usually occurs with tinea cruris, which is a superficial fungal infection of the hands, nails, or groins. Tinea pedis is very itching and sometimes painful with red lesions between the toes and on the soles. For tinea infections, topical antifungals that can be found over the counter can suffice, but, if refractory, oral antifungals can be helpful. However, oral antifungals can have side effects and drug interactions. Given that you may have involvement of your nails, oral therapy may be indicated for you. You should also be evaluated for secondary bacterial infections which may require the use of oral antibiotics. In addition to medication, additional therapies such as foot powder to prevent maceration, avoidance of tight fitting shoes, and treating your shoes with an antifungal powder will help.
It is not possible to come to a diagnosis without examining the patient. The strong recommendation is to see an internist
or get a referral to a podiatrist
and get evaluated in person.