Fungal nail infection is something near and dear to my heart, or at least to my left foot. I picked up what physicians call onychomycosis at some point in my life, possibly from my husband, who is an athlete’s foot sufferer; from my world travels; or from sporadic periods of working out at the gym, where I didn’t always practice caution by wearing flip-flops when using showers. At any rate, for a number of years I’ve been fighting a fungal infection in my little toenail along with an athlete’s foot skin itch that waxes and wanes. My situation is not uncommon. Although toenail funguses and athlete’s foot are separate conditions, they can be caused by the same fungus and are quite happy to coexist.

The good news is that I now live in a very dry climate—the high desert of New Mexico—and because funguses thrive best in moist environments, I’ve had fewer symptoms here than as a resident of the humid California coast. But I still get flare-ups, and when I do, one of my favorite treatments is the wonderful-smelling and soothing tea tree oil, which takes away the itch. Tea tree oil has many medicinal qualities; it’s an anti-fungal, anti-viral, and antiseptic. It doesn’t cure my condition but calms it. I apply the oil every evening to my foot and toenails before bed.

What exactly does a fungal nail infection look like? It’s easy to spot a nail that is infected. It’s brittle, discolored (often yellowish), thick, dull, misshapen, and often crumbles, loosens, and traps debris underneath. If you’re in doubt, go to your doctor for a nail scraping that will also determine the type of fungus you have.

Fungal nail infections can attack the fingers as well as the toes, although they’re more common in toenails. Why? Feet are often encased in tight shoes and socks and when they’re uncovered they come into contact with funguses at public swimming pools, in gyms, and in showers. If you perspire a lot, you’re at higher risk for developing a fungal nail infection.

What can you do to prevent fungal nail infections or keep them under control? Most important, make sure your skin is dry and clean, and wash your hands after you touch the infected area. Manicure your nails straight across and keep them short. Any thickened areas should be filed down. Wearing synthetic socks will keep your feet dryer than cotton or wool socks. Make sure those socks are clean, and give your feet regular airings by taking your shoes off periodically or wearing open-toed shoes. There are also antifungal sprays and powders that can be applied to your feet and your shoes. It goes without saying that you should never go barefoot in public areas. Even though it looks unsightly, don’t cover up the infected nail with polish or artificial nails because that will only make a bad situation worse.

Home remedies besides my favorite, tea tree oil, include vinegar diluted in twice as much water and applied to the feet for 20 minutes. Antifungal natural oils used by aromatherapists are eucalyptus, patchouli, myrrh and lavender. Herbalists recommend marigold, echinacea and myrrh in tincture form, dabbed on the affected areas. Another antifungal treatment is plain yogurt applied to the skin and nails daily. The presence of fungal infections may indicate that your immune system is not up to snuff, so you might consider adding more vitamin C and zinc to your diet, as well as acidophilus tablets to restore natural bacteria.

Your doctor can prescribe an oral antifungal medication that can eventually eliminate the infection, but it will return unless you practice good nail and skin hygiene. There is also a special nail polish, ciclopirox, but it only works in about 10% of cases.

The reality is that fungal nail infections are persistent and difficult to get rid of. Relapses are common because funguses tend to lurk unless totally obliterated and can migrate to other parts of the body. You’re probably wasting your money if you buy over-the-counter topical lotions or creams, and even oral prescription medications only work about half the time and may have nasty side effects like liver damage. In extreme cases, when there is pain, redness or pus, you can have your doctor remove the nail so that it can grow back normally, but that will take as long as a year. When it comes to treatment of fungal nail infections, patience is definitely a virtue.