Complications associated with fungal toenails. Toenail fungus can infect skin and cause athlete’s foot or tineapedis. Ingrown toenails can occur as a result of the presence of toenail fungus due to increased pressure between the thickened nail plate and the surrounding skin. Cellulitis or soft tissue infection can occur also due to toenail fungus. Individuals who have diabetes and a fungal toenail infection have a higher incidence of foot ulceration and foot gangrene than those without toenail fungus. A toenail fungus does not always require treatment. In fact, if there are no pain or complications as a result of the presence of toenail fungus, it may be left untreated. There are several over the counter treatment options, including creams, ointments, and solutions, which may be tried. Trimming and thinning of the nail plates prior to application can help the over-the-counter medications reach the deeper levels of the nail plate. There are both oral and topical prescription medications for the treatment of toenail fungus. Depending on coexisting medical conditions, baseline lab work, fungal nail cultures, and discussion of treatment goals with your provider topical treatment oral treatment, or a combination of both may be used in the treatment of nail fungus.