Caleb Foster
Toenail fungus, or onychomycosis, is a common but challenging condition. While treatments are available, they can take a long time to work and the infection may return. Toenail fungus treatments include antifungal pills, creams, gels, sprays, patches, and nail lacquers. Oral medication is considered more effective than laser treatment, which can only temporarily improve the nail. In some cases, the infected nail may need to be surgically or non-surgically removed.
| Characteristics | Values |
|---|---|
| Treatment Time | Fingernails typically grow out in 4 to 6 months, while toenails take 12 to 18 months. Antifungal pills can cure a fingernail infection in 2 months and a toenail infection in 3 months. |
| Treatment Options | Antifungal pills, creams, gels, sprays, patches, nail lacquers, and oral medications are available. Laser treatment is also an option but has a lower cure rate. |
| Side Effects | Antifungal pills can cause side effects, and require monthly blood tests to check for problems. Topical treatments may cause redness, swelling, ingrown toenail, and stinging or burning. |
| Home Remedies | Vinegar, baking soda, tea tree oil, eucalyptus oil, ozonized sunflower oil, and Vicks VapoRub have all been suggested as home remedies, with varying degrees of success. |
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Antifungal pills
Oral treatments are usually taken for two to three months, and they can take up to six months to cure a toenail fungal infection. However, the fungus may not be completely gone for 10 months or longer. Doctors may prescribe these pills for a shorter period of time, usually 12 weeks, but patients should be aware that side effects can occur. These side effects include nausea, vomiting, headaches, dizziness, stomach and bowel problems, and rashes. In addition, oral treatments can affect the liver, so liver function tests may be required while taking the medication.
It is important to note that antifungal pills can interact with other medications. For example, itraconazole can negatively interact with cholesterol-reducing and blood-sugar-lowering medications, certain sleeping pills, and drugs like Pepcid AC and Prilosec. Therefore, patients should inform their doctor of any other medications they are taking before starting treatment. Itraconazole is also not suitable for people with heart failure or for women who are pregnant or breastfeeding.
Due to the possible side effects of antifungal pills, some people opt for laser treatment or home remedies. However, these treatments may not be as effective as oral treatments.
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Topical treatments
Topical antifungal creams are a common treatment option. These creams are applied directly to the affected nail and can be used to treat mild toenail or fingernail fungus. Over-the-counter antifungal creams, such as clotrimazole (Lotrimin), are available without a prescription and may take months to work. However, it is important to note that over-the-counter products may not be strong enough for moderate to severe cases, and prescription drugs may be necessary.
Another topical treatment option is a combination of two creams and a nail scraper (spatula). One cream contains urea, which softens the nail, and the other contains bifonazole, an antifungal agent. This treatment is carried out over 14 days, followed by four weeks of treating the skin beneath the nail with bifonazole cream.
Topical nail polishes and lacquers are also used to treat nail fungus. These products contain antifungal ingredients such as amorolfine or ciclopirox. Treatment with ciclopirox has shown positive results in clinical studies, with about 30 out of 100 people no longer having a detectable fungal nail infection after one year. However, it is important to note that even when the fungus is cleared, the cosmetic results may not always be satisfying.
In addition to these treatments, home remedies such as tea tree oil, eucalyptus oil, vinegar, and baking soda have been recommended for treating nail fungus. However, there is limited scientific evidence to support the effectiveness of these remedies.
While topical treatments can be effective for mild nail fungus infections, it is important to consult a healthcare professional for proper diagnosis and treatment recommendations, especially for more severe or persistent infections. Additionally, it is crucial to follow the directions provided with the chosen treatment option to ensure optimal results.
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Natural remedies
Vicks VapoRub
Vicks VapoRub is a topical ointment containing camphor, eucalyptus oil, and menthol, which have antifungal properties. A small 2011 study found that long-term use of VapoRub can help treat nail fungus. To use, apply a small amount to the affected area at least once a day or three to four times a week.
Tea Tree Oil
Tea tree oil has been used traditionally as an antiseptic and for treating skin conditions. It is believed to have antimicrobial and antifungal effects. In one study, applying tea tree oil to the affected nail twice a day for six months showed similar cure rates to using clotrimazole cream. However, another study lasting only eight weeks showed no improvement.
Oregano Oil
Oregano oil can be applied to the affected nail twice daily with a cotton swab. It is potent and may cause irritation or allergic reactions. Some people use oregano oil together with tea tree oil, but combining them may increase the risk of side effects.
Listerine Mouthwash
Listerine mouthwash contains menthol, thymol, and eucalyptus, which have antibacterial and antifungal properties. To use, soak the affected foot in a basin of Listerine for 30 minutes daily.
Baking Soda
Baking soda has been found to prevent fungal growth in 79% of specimens tested. It can be applied as a paste directly to the affected nail and left for at least 10 minutes before rinsing. Alternatively, you can make a foot soak with baking soda or sprinkle it on your feet to absorb moisture.
Cloves
A 2012 review suggested placing chopped cloves in socks overnight or crushing and applying them directly to the infected nail for 30 minutes. A homemade cream can also be made by combining fresh chopped garlic cloves with coconut oil and olive oil, which can be applied daily.
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Laser treatment
Toenail fungus, or onychomycosis, is a stubborn condition that can be difficult to treat. Laser treatment is a newer, promising option that uses concentrated light to kill the nail fungus and prevent its growth. The laser radiation restricts the growth of the fungus by selective photothermolysis, which causes a rapid temperature increase, resulting in fungal cell death.
The length of time it takes to repair nail fungus with laser treatment depends on several factors, including the severity of the infection, the type of laser used, and the individual's health condition. Some people may see results in as little as 12 weeks, while others may need multiple treatments over several months. It is important to note that laser treatment may not be suitable for all types of fungal infections, and a podiatrist should be consulted for a proper evaluation and recommendation.
There are several types of lasers used for nail fungus treatment, including:
- Fractional carbon dioxide (CO2) laser: This type of laser ablates the nail plate, disrupting the growth of the fungus. It has been shown to have promising results, with some studies reporting a complete cure in 50% of patients.
- Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser: This laser operates at a wavelength of 1064 nm and has been shown to have a highly successful cure rate and a good safety profile.
- Titanium (Ti): sapphire laser: This laser delivers a substantial amount of energy per pulse while sparing the surrounding tissue from excessive heating due to its high thermal conductivity.
- Non-thermal cold laser: This type of laser, such as the Lunula Laser by Erchonia, uses a low-level laser wavelength to eliminate discomfort and searing heat during treatment.
The choice of laser depends on the patient's condition, the severity of the infection, and the availability of the technology. It is important to consult with a qualified healthcare professional to determine the most suitable treatment option.
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Nail removal
In some cases of severe nail fungus infection, or when other treatments have failed, a doctor or dermatologist may recommend removing the nail to get rid of the infection. This can be done surgically or nonsurgically.
Nonsurgical nail removal
Nonsurgical nail removal involves applying a strong chemical to the nail to remove it. This procedure can be performed in a doctor's office or clinic and does not require hospitalisation.
Surgical nail removal
For surgical nail removal, a doctor will first administer a local anaesthetic to numb the area. They will then use a special tool to loosen the skin around the nail before removing it. This type of procedure is rarely performed.
Aftercare
Following nail removal, it is important to care for the wound. A new nail will typically grow back within a year, but it may take longer, depending on whether it is a fingernail or toenail. To prevent re-infection, it is recommended to keep the area clean and dry and to avoid walking barefoot, especially in public places.
Alternative treatments
Before resorting to nail removal, there are several alternative treatments available for nail fungus. These include:
- Antifungal pills and topical medications, such as creams, gels, sprays, and patches
- Laser treatment, which uses high doses of light to destroy the fungus
- Natural remedies, such as tea tree oil, baking soda, mentholated salve, and snakeroot extract
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Frequently asked questions
Antifungal pills can be taken for two to three months to cure a fingernail fungal infection, while a toenail fungal infection may take up to six months.
Topical treatments such as antifungal nail medicines, creams, gels, sprays, and patches may take months to work, with fingernails typically growing out in four to six months and toenails taking up to 12 to 18 months.
While laser treatment can temporarily improve the appearance of the nail, it is not as effective as oral medication. There is currently no definitive timeline for how long it takes to repair nail fungus with laser treatment.
