How is toenail fungus treated?

Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)
Toenail fungus is treated with oral antifungal medicines, which help a new nail to grow, replacing the infected one. You may need to take this medication for six to 12 weeks, depending on how severe the infection is. Oral antifungal medicines may not be safe for people who have liver problems or congestive heart failure, so let your doctor know if you have either of these conditions. Topical treatments, such as creams and polishes that you apply to the toenail, do not usually cure fungal infections on their own.

Talk with your doctor about treatments for toenail fungus.
Hillary B. Brenner, DPM
Podiatric Medicine

Fungal nails are one of the most commonly diagnosed foot problems that podiatrists treat. There is an increased risk for people between the ages of 40-60. The best way to start treating fungal nails is to visit with a podiatric physician who can take a culture of the nail and determine the cause which can be fungal, yeast or bacteria. Treatment for fungal nails may include topical or oral medications, and debridement (cutting and filing) of the infected nail. I recommend my patients start with a topical anti-fungal and debridement of their nails every two months. If this doesn't work oral medications can be prescribed. A liver function test is taken before starting the medication. The oral medications can harm the liver so it is important that the patient is healthy and does not drink alcohol while taking the medication.

  In some cases, surgical treatment may be required. For instance, temporary or permanent removal of the chronic painful nail plate is performed. For people who don't want to take pills or have surgery, laser treatment for fungal nails is effective. It should be noted that insurance does not cover laser treatment for fungal nails and the cost can be up to 1200 dollars.

  If you have a busy schedule and can't see a doctor there are home remedies which have helped others. For instance, tea tree oil, Vicks vapor rub or anti-fungal nail polishes. It is also important to soak your feet 2-3 times a week in Epsom salt (take one cup of Epsom salt and a gallon of luke warm water in a bucket) for 10-15 min., use a straight edge nail nipper and cut your nails straight across, wear flip flops in public showers, avoid pedicures, and wear shoes that fit well and are made of materials that can breathe.

James P. Ioli, DPM
Podiatric Medicine
Treatments for toenail fungus have improved. If you have a mild infection (white spots or a small, defined stain), apply topical over-the-counter antifungal agents to suppress the infection. Be aware, however, that these topical medications do not always penetrate the nail to reach the underlying infection. This is why oral medications have long been the mainstay of treatment for fungal nails. If the stain does not disappear, and certainly if it spreads or starts to smell, seek medical attention.

Your doctor may send tissue samples scraped from the nail to a laboratory in order to determine whether you have a fungal infection, and if so, how advanced it is. He or she may also remove the infected part of the nail through debridement (a gentle scraping of the nail surface). Depending on the extent of infection, your doctor may prescribe a topical or oral medication.

Advances have greatly improved treatment of fungal nails. For mild to moderate nail fungus, try a liquid form of ciclopirox (Penlac Nail Lacquer), which is the first topical medication specifically intended for fungal nails. This medication is applied daily, much like a nail polish, and complete treatment takes almost a year. During treatment, trim toenails yourself weekly and have a foot care professional trim them monthly.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.