Nail fungus is a persistent problem that can take up to a year for the affected nail to grow healthy again. But first, a diagnosis needs to be made: Other conditions, such as psoriasis and injuries, can mimic the symptoms of a fungal nail infection.
A doctor can test a nail sample in a lab for confirmation. Effective prescription treatments include topical polishes and tablets.
The most common nail treatment involves the daily application of a prescription-strength antifungal topical cream to the infected nails. This helps reduce the infection but does not fully cure it.
The best topical fungus medication is ciclopirox (Penlac). It is more effective than other over-the-counter treatments. It is also less expensive than many oral medications.
Other prescription topical treatments that are more effective than over-the-counter ones include efinaconazole (Jublia) and tavaborole (Kerydin). Both are clear solutions, not lacquers. They must be applied to the nails daily, and it can take up to 18 months to completely clear the infection.
Several home remedies are claimed to work as nail fungus cures, but these have yet to be rigorously tested. There are anecdotal reports that tea tree oil and Vicks VapoRub may help, but more research is needed. Other home remedies for preventing fungal nail infections include:
- Wear shoes that fit well.
- Using foot powder.
- Washing feet regularly with antifungal soap.
- Disinfecting nail clippers and files.
If topical treatments don’t work, your doctor may prescribe oral medication. These medications are taken as pills and can help eliminate the infection. They also have a higher cure rate than the medicine you apply to your nails. They are typically taken daily for 12 weeks or longer. Because they can affect the liver, your doctor will do blood tests before you start nail treatment and periodically throughout your treatment to check for problems.
Oral medications include terbinafine (Lamisil) and itraconazole. They’re also available in combination with urea cream to treat thick nails. A recent study found that this combo is more effective than a single urea cream. The fungus isn’t always removed entirely, though, and the fungus can return. Also, oral medications can cause upset stomachs and other side effects. Some people cannot take them because of other medical conditions or drugs they’re taking. This is why seeing a dermatologist for a diagnosis and treatment plan is essential.
Laser treatment can be used to effectively clear the fungus from the nails. The light penetrates the nail and soft tissue to kill the fungus and stimulate new nail growth.
This method is much safer than topical treatments or oral medications, which can have side effects and interactions with other medicines. It also removes thickened nails and alleviates the pain associated with onychomycosis.
A study published in Lasers in Medical Science found that nail fungus laser treatments had better cure rates than over-the-counter and prescription antifungal creams. Patients were able to achieve healthy nail growth after just one treatment session.
You should see your primary care physician or podiatrist for diagnosis and treatment if you have a fungal nail infection. Be aware that the fungus can return even with clearing, and you may need further nail treatment. To help prevent a recurrence, wear shoes that let your feet breathe, remove your socks after a workout, use an antifungal foot powder, wash your hands with antifungal soap, and avoid moist environments such as public showers or pools.
Infected nails can take two months or longer to clear up with over-the-counter medications, and they may not eliminate the infection. If the fungus returns, you must see your dermatologist, who can make an accurate diagnosis and develop a nail fungus treatment plan.
A dermatologist will examine the affected nail and surrounding skin. They may also remove a bit of the nail or scrape the nail bed and send it to a lab for testing to determine what fungus is present.
While many options exist for treating a fungal nail infection, there are better options. However, some treatments show promise and more research is needed. In the meantime, patients can try to prevent infections by wearing flip-flops in public showers and locker rooms and clipping their nails carefully instead of excessively. The fungus can be spread through contact with a person who already has an infection, so it’s also recommended that patients avoid barefoot walking in public areas and use disinfectants to clean their nail clippers regularly.