If you seriously dread flip-flop season—as in you’d rather do your taxes twice than expose your toes to the world—you’re in good company. An estimated 13 percent of Americans, or roughly 35 million people, have toenail fungus, says James Christina, DPM, director of scientific affairs at the American Podiatric Medical Association.  Toenail fungus causes your nails to turn yellow or white, thicken, and become brittle. It’s not only embarrassing, but it can cause complications for people with diabetes or immune disorders. Plus, it’s really hard to treat. Over-the-counter antifungal nail creams and ointments aren’t very effective, and repeat infections are common. Prescription oral meds like Lamisil and Sporanox work 60 to 80 percent of the time, says Dr. Christina, but usually need to be taken for months to work, and like any oral med, come with the risk of side effects. 

But there’s good news: The FDA recently approved the use of lasers to help treat nail fungus. And so far, the results are promising. According to one recent study, toenail fungus improved in about 85 percent of patients treated with the laser after six months, according to the Journal of the American Podiatric Medical Association. And while there aren’t a lot of studies yet on how effective lasers are long-term, says Dr. Christina, they may turn out to be as effective as taking oral medications—without the side effects.  The lasers are being used in doctors’ offices to treat toenail fungus, and now treatment centers are opening up across the country, such as NovoNail Nail Restorations Centers in Charlottesville and Boston.  The best way to deal with toenail fungus is, of course, to avoid getting it in the first place. Something easier said than done. “Fungus is everywhere—in the carpet, in your shoes, in locker room showers,” says Chris Stewart, DPM, a podiatric surgeon in Charlottesville, Virginia and founder of NovoNail. And while you may not be able to steer clear of fungus altogether, there are steps you can take to prevent it from infecting your nails.  Check out these five tips from Dr. Stewart to help keep your toes fungus-free:

  1. Know the warning signs. More often than not, infections start at the tip of the nail and work their way under the nail bed, causing white, yellow or brown streaks, and thickening the nail. “The nail ends up being a shield to allow the fungus to grow," says Dr. Stewart. But when caught early, infections are easier to treat. See a podiatrist if you notice any changing color or texture of your nails.
  2. Protect your nails from trauma. No one stubs their toe on purpose, but things like the size of your sneakers can cut your nail bed and give fungus an opening. “The second toe is usually the longest on the foot and most susceptible to trauma,” says Dr. Stewart. “If you’re a runner, go up half a shoe size and make sure you’re able to wiggle your toes inside your sneaker to help prevent friction.” If you scrub your feet with a brush, make sure the bristles aren’t so rough as to damage your nail beds. 
  3. Strengthen your immune system. “A weakened immune system makes you more susceptible to fungus infections because your body can’t fight off foreign invaders as well,” says Dr. Stewart. Make an effort to reduce your stress, get plenty of sleep, and load up on antioxidant-rich fruits and veggies.  Surprising Signs Your Immune System Needs a Boost
  4. Keep those tootsies dry. Mold and fungus thrive in dark, wet places. Use antibacterial foot powder and change your socks right after you exercise. Also remember to dry between your toes with a clean towel after you shower. 
  5. Practice safe pedicures. Pedicures can keep your feet looking clean and pretty, but highly trafficked salons can be a hotbed for fungus. Consider bringing your own pedicure tools and polish to avoid the spread of fungus from others’ feet. And opt out of getting your cuticles cut. “The cuticle forms a protective layer between your nail and the bed, and removing parts of it can make it easier for fungus to get underneath, increasing the risk of an infection,” says Dr. Stewart. Also see: 10 Biggest Walking Pains—Solved, Ingrown Toenail Rx, Amazing Kitchen Cures