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How Do I Get Rid of Toenail Fungus?

As unsightly as it is, the infection is usually manageable — but only with the right treatment. Here’s how to kick it. Although some drugstores devote entire aisles to over-the-counter fungus salves, Dr. Elewski said that the best a nonprescription treatment or home remedy can do is improve your nail appearance. If you want to actually kill the fungus, “a prescription antifungal is the only option,” said Dr. Antonella Tosti, a dermatologist who treats nail disorders at the University of Miami Miller School of Medicine. There are topical prescriptions, including creams, ointments or serum-like solutions; and oral antifungals, meaning pills. Prescription antifungals usually take care of the problem,…

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  Staying one step ahead of toenail fungus

Oral medications. Itraconazole (Sporanox) and terbinafine (Lamisil) eliminated the fungus in 10 months for 55% to 70% of people in the studies required for FDA approval, but for 15% to 20% of users, the fungus returned within a few months. Either of these drugs can harm the liver, so your doctor will check your liver function at the beginning of treatment and again after six weeks. Itraconazole also interacts with a number of other drugs. If you take one of these drugs you'll also need to avoid drinking alcohol and stay out of the sun. If you have diabetes, vasculitis, or another condition that could be worsened by fungus, these medications might be a good choice, but otherwise, the benefits may not be worth the risks.

Articles of Interest

Antifungal for Nail Fungus May Be Safer Than Originally Thought

The antifungal medication terbinafine has long been considered the gold standard for treating onychomycosis, a fungal infection of the nail. But many patients are hesitant to take the drug because of the potential for side effects like liver damage. Several new studies, including one from a dermatologist at Kaiser Permanente, are now challenging that concern.

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

The landscape of onychomycosis treatment encompasses a range of oral and topical therapies. When a patient seeks treatment for confirmed positive onychomycosis, a shared dialogue between the patient and the physician is imperative.

Ask Well: Remedies for Nail Fungus

One of the most effective treatments is the drug Lamisil, which is taken orally for 90 days and works for about two out of three people. But it has been associated with rare cases of liver damage and may require regular liver function tests, which can scare people away. “The ‘risk’ of oral therapy has been largely overstated,” said Dr. Bryan C. Markinson, the chief of podiatric medicine and surgery at the Mount Sinai School of Medicine. “The truth is that after tens of millions of uses worldwide, this therapy is unequivocally safe.”

FDA issues warnings about drugs used to treat fungal nail infections

The advisory also alerts physicians about rare cases of serious liver disease, including liver failure, associated with the use of itraconazole products and terbinafine tablets. It says physicians should obtain nail specimens for laboratory testing to confirm the diagnosis of fungal nail infections before prescribing either medication.

Fungal Toenails- What are your oral options?

Fungal toenail infections, or onychomycosis, are a prevalent condition affecting many individuals of varying ages. These infections can cause nails to thicken, discolour and become brittle, often leading to discomfort and self-consciousness. While topical and light therapy treatments exist, oral medications are usually more effective, especially for severe or resistant cases.

Onychomycosis Unresponsive to Antifungals: Etiology and Treatment with a New Direct Technique

Although the number of cases with dermatophyte and candida infections is limited in our study, citric acid plus mechanical cleaning of the nail bed seemed to be successful in treating onychomycosis independent of the causative agent.

Terbinafine and Itraconazole Are Most Effective for Toenail Onychomycosis

For toenail onychomycosis, continuous terbinafine (Lamisil), 250 mg, and continuous itraconazole (Sporanox), 200 mg, for 12 to 24 weeks are the preferred therapies.

Treatment of onychomycosis in an era of antifungal resistance: Role for antifungal stewardship and topical antifungal agents

Topical ciclopirox, efinaconazole and tavaborole, delivered either alone or in combination with oral antifungals, have demonstrated efficacy in vitro against susceptible and/or resistant isolates of Trichophyton species, with low potential for development of antifungal resistance. Additional real-world long-term data are needed to monitor global rates of antifungal resistance and assess the efficacy of oral and topical antifungals, alone or in combination, in counteracting antifungal resistance in the treatment of onychomycosis.