Noah Sinclair
Toenail fungus, or onychomycosis, is a common fungal infection that causes thickened, discoloured, and brittle nails. While there are various over-the-counter treatments available, such as ointments, creams, and patches containing antifungal ingredients like tolnaftate and clotrimazole, they may not be effective in severe cases. Prescription oral and topical medications, such as fluconazole and terbinafine, are often more effective but may have side effects. For faster results, laser therapy is an option, and home remedies like vinegar soaks, tea tree oil, and apple cider vinegar may also help. Maintaining good foot hygiene and wearing appropriate footwear can also help prevent and treat toenail fungus.
| Characteristics | Values |
|---|---|
| Treatment Type | Oral, topical, laser therapy, home remedies |
| Treatment Time | Several months |
| Prescription Medicine | Oral antifungal medicines, topical medicines |
| Over-the-Counter Medicine | Antifungal creams, sprays, nail-softening agents |
| Home Remedies | Apple cider vinegar, tea tree oil, oregano oil, Listerine, baking soda, epsom salts, garlic, coconut oil |
| Preventative Measures | Wash feet with soap and water, wear shower shoes in public areas, wear breathable shoes, disinfect nail clippers, avoid nail polish |
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What You'll Learn
Prescription medicines
Oral prescription medications include fluconazole, which inhibits the growth of the yeast Candida albicans, allowing the body to eliminate the fungus. Oral antifungals are recommended for severe cases by the American Academy of Dermatology. Topical prescription treatments are also available and are applied directly to the nail and surrounding skin.
It is important to consult a doctor or podiatrist if nail fungus persists or keeps returning, as it may be caused by an underlying issue. Doctors can determine the root cause of the problem and recommend an appropriate course of treatment. Toenail fungus can be challenging to treat, especially when severe, and it is important to maintain foot hygiene and keep nails short during treatment.
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Over-the-counter treatments
While there is no single "best" over-the-counter (OTC) treatment for nail fungus, several options are available that can help improve nail appearance and manage symptoms. Here are some over-the-counter treatments to consider:
Antifungal Creams and Sprays
OTC antifungal creams and sprays can be effective in treating nail fungus. Look for products containing ingredients such as tolnaftate, clotrimazole, or undecylenic acid, which have antifungal properties. These treatments can start killing the fungus on contact, but full results may take time. Combining them with professional treatments recommended by a certified foot specialist can lead to faster results.
Nail-Softening Agents
Nail-softening agents like urea, salicylic acid, and lactic acid can help improve the nail's appearance and manage symptoms. These ingredients soften and thin the nail, making it easier to manage and reducing symptoms like thickening, discoloration, and brittleness. While they don't cure the infection, they can be helpful, especially for people with painful or brittle nails.
Home Remedies
Home remedies can be effective in improving nail fungus and may include the following:
- Soaking the affected nails in a one-part vinegar and one-part water solution may help reduce fungus over time.
- Tea tree oil, oregano oil, Listerine, baking soda, Epsom salts, garlic, or coconut oil may also help improve the condition.
Over-the-Counter Nail Patches
Nail treatment patches are available for overnight nail repair. These patches can help restore discolouration and thickness, improving the appearance of damaged nails.
It is important to note that while OTC treatments can help manage nail fungus, they may not cure severe infections. Consulting a doctor or podiatrist is advisable for persistent or severe cases, as oral medications or other professional treatments may be necessary.
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Home remedies
While medical treatments are the only known methods to effectively treat nail fungus, home remedies may help clear up symptoms. It is important to note that natural remedies may be able to relieve your symptoms, but there is no certainty that they will work, and even if they do, it will likely take longer.
Tea tree oil
Tea tree oil has natural antifungal and antiseptic properties. A study published in the Journal of Family Practice found that 100% tea tree oil applied twice daily cleared nail fungus in 18% of participants after six months, with noticeable improvement in 56% of cases. Mix a few drops of tea tree oil with a carrier oil (e.g. coconut or olive oil). Apply directly to the affected nail using a cotton swab. Repeat twice daily for several weeks.
Apple cider vinegar
Soaking affected nails in a one-part vinegar/one-part water solution may help reduce fungus over time.
Garlic
Garlic has antifungal properties and can be used as a home remedy for nail fungus.
Vicks VapoRub
Although designed for cough suppression, its active ingredients (camphor and eucalyptus oil) may help treat toenail fungus. An older 2011 study found that Vicks VapoRub had a "positive clinical effect" in treating toenail fungus. To use, apply a small amount of Vicks VapoRub to the affected area at least once a day.
Snakeroot (Ageratina pichinchensis) extract
Snakeroot extract is an antifungal made from plants in the sunflower family. An older 2008 study showed that the remedy is effective against toenail fungus as the antifungal medication ciclopirox.
It is important to note that if you have diabetes or a weakened immune system, you should not use home remedies for toenail fungus and should instead contact your doctor for advice.
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Laser therapy
Several types of laser treatments are available, which may affect how well the therapy works for an individual. These include the Nd:YAG class, which includes titanium (Ti):sapphire and erbium-based devices, and fractional CO2 lasers, which ablate the nail plate, disrupting the growth of the fungus. The Ti:sapphire laser delivers a substantial amount of energy per pulse but spares the involved tissues from excessive heating due to its high thermal conductivity. The CO2 laser therapy achieved the best overall results among several types of laser therapy, with a highly successful cure rate and a good safety profile.
In one study, researchers randomized 34 patients with onychomycosis of one or both great toes into a treatment group and a control group. The treatment group received four exposures to an 870/930-nm laser at days 1, 14, 42, and 120. At 180 days, 65% of the treated toenails showed at least 3 mm of clear linear nail growth, compared to 9% in the control group. Another study by Lim enrolled 24 patients with microscopy-confirmed onychomycosis to receive three sessions of a CO2 laser at four-week intervals, with instructions to apply topical amorolfine cream to the feet daily. The authors found that 50% of the patients achieved a "complete cure", defined as negative fungal culture with total visible clearance of infection three months after the last treatment.
While laser therapy shows promise, it is important to note that the American Academy of Dermatology Association (AAD) still considers it an unproven therapy due to a lack of research concerning its safety and effectiveness. Laser therapy can also be expensive, and insurance may not cover it. Therefore, individuals considering laser therapy should discuss the costs and success rates with the clinic before scheduling a session.
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Oral antifungals
One of the earliest oral antifungals was griseofulvin, which was introduced in 1958. Griseofulvin disrupts the cell microtubule function, impairing the synthesis of ergosterol in fungal cell membranes, which leads to the breakdown of the cell. However, griseofulvin may cause more side effects than other treatments for nail fungus.
Terbinafine is another oral antifungal. It is fungicidal, interacting with ergosterol synthesis at an earlier stage than griseofulvin, causing cell death. For people with fingernail infections, terbinafine treatment takes 6 weeks. For toenail infections, the treatment lasts 12 weeks. In all cases, the individual must take one 250-milligram tablet daily.
Itraconazole is another oral antifungal. Doctors do not recommend itraconazole to certain individuals, including those with liver disease or congestive heart failure. Treatment involves taking one 200-milligram capsule daily for 12 weeks for toenail infections.
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Frequently asked questions
Nail fungus is a common fungal infection of the toenails that often starts as a white or yellow spot under the nail bed. It is caused by fungi called dermatophytes that infect the skin beneath the nail.
Some over-the-counter nail fungus treatments include Fungi-Nail Anti-Fungal Ointment, Kerasal, and Dr. Scholl's Fungal Nail Clear & Cure Swabs.
Yes, home remedies such as apple cider vinegar, tea tree oil, oregano oil, Listerine, baking soda, epsom salts, garlic, or coconut oil may help improve nail fungus.
Yes, prescription treatments for nail fungus include oral antifungal medicines and topical medicines applied to the nail and surrounding skin.
There is no single "best" treatment for nail fungus. The best treatment depends on the severity of the infection and individual preferences. Laser therapy is one of the fastest ways to target fungal nail infections.
