Top Treatments for Toenail Fungus

Medically Reviewed By William C. Lloyd III, MD, FACS
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  • Toenail fungus, medically called onychomycosis, is a common problem that causes thickened, yellow toenails. It is contagious, which means you can give the fungus to someone else. You may have caught it by walking barefoot in the same area someone with the infection walked just before you, or from someone in your home. Common places to catch the fungal infection are pool decks, locker rooms, and gym showers. Infections like this should be treated promptly, especially if you have an underlying medical problem, like diabetes. Learn about some common toenail fungus treatments, including prescriptions, and home remedies.

  • 1
    Over-the-Counter Treatments
    medicine aisle

    There are several over-the-counter (OTC) treatments that claim to help cure fungal toenail infections, particularly in the early stages. If you follow the instructions, they may be worth a try before seeing a doctor, but they only help the top layer of the nail as they don’t penetrate below. The most common topical antifungals include clotrimazole (Lotrimin AF) and terbinafine (Lamisil AT). If you try these products but still see the doctor, be sure to mention that you have used them and if you noticed any changes.

  • 2
    Oral Medications
    Mature woman sitting on bed reading information on pill bottle

    Doctors often choose to prescribe oral medications before other types of treatments because they tend to work more quickly. Oral toenail fungus medications are antifungals such as terbinafine, itraconazole, fluconazole and terbinafine. They must be taken regularly for between 6 and 12 weeks. 

    The medications can have serious side effects, including liver damage. Regular blood tests to monitor your liver are usually needed. Also, it’s important to understand that even if the medications work to eliminate the fungus, you won’t see quick visible results because it takes a while for healthy nails to grow in.

  • 3
    Topical Nail Creams
    prescription medical cream coming out of tube

    Less invasive and toxic than oral medications, medicated topical nail creams may help fight your toenail fungus. Your doctor may prescribe amorolfine, ciclopirox, efinaconazole, or tavaborole ointments or creams. Some doctors feel that the creams are more effective if you soak the nail before applying the cream. For the cream to be effective, you must consistently apply the cream for the full duration of the prescription. Side effects, if any, are usually mild. Most common side effects are a burning or stinging sensation on the skin around the toe, swelling, and possible ingrown toenails. Treatment can take from 9 to 12 months.

  • 4
    Medicated Nail Polish
    Unseen Caucasian man's feet getting pedicure

    You may have seen an antifungal nail polish called ciclopirox, brand name Penlac. This medicated nail polish is applied daily for a week. After seven days, the accumulated polish is removed with rubbing alcohol and you start the process over again. The polish should be applied at least 8 hours before your nails may get wet, either bathing or in a pool, for example. It can take up to 12 months for this treatment to be effective. Consistency is important so you shouldn’t miss any day’s application.

  • 5
    Combination Treatment
    doctor examining patient's foot with nurse

    If you seem to have a particularly difficult case of toenail fungus, your doctor may recommend combination treatment, using both oral antifungal medications and topical nail creams or medicated nail polish. Keeping track of both—taking the medications and applying the topical treatments regularly as prescribed—is important. One is not more important than the other. Unfortunately, using both treatments won’t necessarily shorten the amount of time you need treatment, but they do increase the chances of the fungus going away completely.

  • 6
    Removing the Affected Nail
    Doctor or technician performing foot procedure

    If you tried the recommended antifungal toenail treatments, your doctor may recommend that the toenail be removed. This can be done surgically or nonsurgically. For nonsurgical removal, your doctor will protect the skin around your nail with a bandage or tape. An ointment with urea is then applied to the nail and covered with plastic and tape. After 7 to 10 days, the nail should be soft enough for your doctor to lift it away from your toe.

  • 7
    Surgical Nail Removal
    doctor examining patient's foot

    If your doctor suggests surgical removal of your nail, you will receive an injection in your toe to numb the area. The nail is then slowly loosened from the skin fold that holds it in place and the nail is cut away. If only part of your nail is affected, the doctor may only remove that part. The toe will be sensitive after the procedure because the nail bed will be exposed. It’s important to keep the nail bed covered and clean. You will likely be instructed to apply an antibiotic ointment to the area to prevent infection.

  • 8
    Laser Treatment
    doctor holding laser physical therapy wand

    Some podiatrists and dermatologists advertise that they can cure fungal toenail infections with laser therapy. The evidence that laser treatment is effective is not yet solid enough for this treatment to be officially recommended. Practitioners who use laser therapy claim that the laser penetrates the nail plate and destroys the fungus, often within a few treatments. It is painless, but pricey. Most insurances don’t cover this treatment yet. And the long-term safety and results are not yet known.

  • 9
    Home Remedies
    high angle of baking soda and measuring spoon

    Home remedies are likely not effective in killing the fungal infection, but some people prefer to try them before seeing a doctor. The most common home remedies for toenail fungus include tea tree oil, a paste of baking soda and water, coconut oil, snakeroot extract, and olive leaf extract. These are all meant to be applied directly to your toenail, not to be taken internally.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Sep 8
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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