So many of us are struggling with embarrassing crusty, yellow toenails. This is the surprising habit that often triggers the problem – and exactly how to fix it: DR PHILIPPA KAYE

The sun is out; This means your feet are out too.

Winter’s heavy boots and thick socks gave way to sandals and flip-flops, and toenails suddenly appeared.

And for many of my patients, this is a problem. They look down, feel ashamed, ask what can be done for their thickened, crusted, yellowed nails, and come to my surgery.

If this is you, you are not alone. About one in ten people have a fungal toenail infection, and by age 70 this accounts for roughly half of all adults.

The culprit is often a family of fungi called dermatophytes; are the same insects on the back of athlete’s foot. They invade the nail and the skin underneath, and if left untreated, the nail becomes thickened, discolored (mostly yellow, white, or brown), brittle, and in some cases painful.

So why do most of us understand this? Nail fungal infections become more common with age as nails grow more slowly.

You’re also more at risk if you have a weakened immune system, poor circulation (possibly due to diabetes), or have a damaged nail in the past. Walking barefoot in public areas such as gym locker rooms and swimming pools primarily increases your exposure to fungi.

But here’s the surprising part: It’s usually your shoes that trigger the problem.

Fungi thrive in warm, dark and moist environments; This makes the inside of your shoe a perfect breeding ground.

Synthetic sneakers, rubber-soled boots and tight shoes without ventilation when worn for hours trap the heat and sweat that fungi love. That’s why Crocs — plastic sandals — or other sandals are some of the best anti-fungal shoes because they have holes that circulate air and evaporate sweat so moisture doesn’t accumulate.

Your socks are important too. Synthetic sports fibers or merino wool remove sweat from the skin and allow it to evaporate.

On the other hand, cotton acts like a sponge, absorbing moisture and clinging to it, ensuring that your feet remain constantly moist.

Change your socks every day (and no, this is not public advice) and try rotating your shoes so each pair takes 24 hours to dry completely.

However, this advice only helps people who have not yet contracted the infection. So what do you do when your nails are crusty and yellow?

The good news is that antifungal nail polishes like amorolfine are available over the counter. But this is where most people go wrong, and I see the same mistakes over and over again.

Take my patient Lucy. She noticed athlete’s foot, a scaly, itchy rash between her toes, a few months ago and did not treat it. After some time, her pharmacist diagnosed her toenail fungal infection and recommended an antifungal polish. He used it for a month then came to see me and complained that he was wasting his money because it didn’t work.

Do you have any of these conditions?

The problem is that a month is not enough time for the polish to be effective.

This is the most common reason why these treatments ‘fail’: people haven’t given them long enough.

The reason it takes so long to work is because toenails grow slowly, very slowly in fact.

Depending on the condition of the nail, it may take 12 to 18 months for it to grow completely.

Amorolphine needs to be administered once or twice a week for at least nine to 12 months. The infected part of the nail may never look better; Instead, more importantly, if a new, healthy nail grows from the base, the treatment has worked.

There is a second error I see. Patients cannot file their nails first.

The varnish must penetrate the nail to reach the underlying fungus, and if the infection has thickened your nail, the medication cannot penetrate.

That’s why the packages come with disposable nail files. Patients need to file the nail each time before applying the polish, otherwise the treatment is much less likely to work.

The third mistake is Lucy’s first mistake: ignoring the athlete’s foot. If you have a fungal infection on your foot skin, both problems may be caused by the same fungi.

If you treat the nail without treating the skin, you will re-infect yourself. Athlete foot creams are also available over-the-counter and should be used alongside nail treatment.

If you’ve done all this properly for long enough and it still doesn’t work, see your doctor.

We can send nail clippings to the laboratory to identify the fungus and prescribe strong terbinafine tablets if appropriate.

These are more effective and work faster, but they can cause side effects on the liver, require monitoring, and are not suitable for everyone.

Laser therapy to burn off the fungus is also recommended by some specialty podiatrists, but it can be expensive and produce mixed results.

There are also alternative and potentially effective treatments that many patients may not have heard of.

There is some evidence that tea tree oil applied undiluted to the affected nail after filing twice a day may be helpful, especially if the infection is caught early.

Again, it takes time and, although it can be used with antifungal nail polish, it is less likely to work on a long-term or severe infection.

General physician, author and publisher Dr. Philippa Kaye advises patients to act quickly when they notice a fungal toenail

Apple cider vinegar, on the other hand, is often promoted as a cure for toenail fungus, but there is no good evidence to support this; save it for your salad.

What I would advise you not to do is reach for nail polish. I understand the temptation to paint over the problem, but varnish traps moisture, prevents antifungal treatments from penetrating the nail, and hides what’s going on underneath; This could cause things to get worse.

Instead, keep it simple. After washing your feet, dry them thoroughly, including between the toes. Try to cut your toenails straight across. Do not share towels, nail clippers, or shoes as this can spread the infection.

If you notice athlete’s foot, treat it immediately with an over-the-counter cream before it spreads to the nails.

But what if you just noticed a fungal toenail? Start treatment immediately. The honest truth is that you probably won’t see results this summer; but if you follow these steps, you may well be able to do it when next year’s heatwaves arrive.