Toenail Fungus Treatment Options Explained

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There are many options available for the treatment of toenail fungus infections. Some focus on removing the fungus while others work to boost your immune system and encourage healthy nails to grow. Current therapies fall into four main categories: topical treatments (in the form of lacquers or nail paints, washes, oils and creams), oral prescription medications, surgery and laser treatment. We provide information on all four categories below, but you’ll find that the safest and most effective treatments for mild and moderate infections involve applying a topical antifungal nail lacquer or polish to affected nails. For a short cut to the best treatments for toenail fungus, have a look at the reviews in the side bar.

The effectiveness of different fungus toenail treatment methods will depend a great deal on the severity of your fungal infection, the part of the nail that is affected, the number of nails affected, the rate of growth of the infection as well as your ability to stick to a regular routine of application.

For prevention and mild disorders

mild-treatmentIf your focus is mainly on prevention of cross-infection to other toenails or you have a mild infection, then it may be worth ‘experimenting’ with a home remedy. But as home remedies are not designed for and have not been tested for the treatment of nail fungus we also recommend using one of the specialized topical toenail treatments. Combining the two therapies makes good sense.  So use a specialized antifungal lacquer on the affected toenail, and apply a home remedy such as tea tree oil to other toenails to prevent any cross infection. Bear in mind also that products such as apple cider vinegar may simply be bleaching the yellow discoloration on the nail, rather than removing the fungus itself.  This may give you the impression that the vinegar is eliminating the fungus when in fact all it is doing is masking one of the symptoms (the yellow discoloration).

Read our reviews of home remedies:

Read our reviews of two best-selling specialized topical treatments for toenail fungus:

Mild to moderate infections of nail fungus

moderate-treatmentFor mild or moderate infections, it’s a good idea to choose a specialized topical antifungal medication, particularly if the infection has started at the side or the tip of the toenail and is spreading towards the cuticle (a common subtype known as Distal Lateral Subungal Onychomycosis). Make sure you start treatment as early as possible and continue until a new nail has completely grown out. Toenails are slow growing so this may take many months.

There are many available options, some of which use all natural, homeopathic ingredients.  Most of the options listed below are classified as over the counter toenail fungus treatment products.  The effectiveness of topical treatments is dependent on whether the application can penetrate the nail structure and reach the fungus. In some cases, you may be advised to use these creams with an over-the-counter lotion containing urea to help speed up absorption.  Treatment times are generally long and require daily or weekly applications. Prepare yourself mentally to commit to several weeks of treatment before you can expect to be able to see visible signs of improvement. That way you wont be disappointed that results don’t come immediately and will be more likely to remain motivated and stick to a consistent application routine.

Read our reviews of the best toenail fungus treatment options for mild to moderate infections:

Severe nail fungus infections

severe-treatmentFor severe cases where the nail has become very disfigured and distorted, resistant fungal strains, or if many toenails are infected, your doctor may prescribe an oral (or systemic) anti-fungal medication – often in combination with the topical treatments listed above. Oral medications can have side effects (especially to the liver, skin and/or bone marrow).  As a result your doctor is likely to order periodic blood tests while you are undergoing treatment for toenail fungus to ensure your toxicity levels remain within acceptable limits. Your doctor will also consider any other medications you are taking.

Oral medications are usually prescribed over a 6-12 week period but you’ll only be completely free of infection once a new nail grows back in full. For toenails this may take over a year (finger nails grow faster than toe nails). Actual growth rates can vary considerably and are affected by age, exercise, diet, the seasons and genetic factors.

Toenail fungus treatment with surgery and laser therapy

Recent years have seen increasing experimentation with laser nail fungus treatment. But more clinical trials are needed and it is still too early to determine the efficacy of this treatment approach. However, early signs appear to be positive as the laser light appears to be able to penetrate through the nail layers and reach the fungus causing the infection.

Finally, surgical removal of an affected nail remains an option. This method of treatment can be successful; however it is not uncommon for the new nail that grows out to be infected with the fungus. Unless the affected nails are causing significant pain or discomfort, many sufferers consider a surgical procedure to be overly invasive. Most decide to treat the condition topically. See the reviews in the sidebar for more details.

Closing thoughts

Unfortunately toenail fungus infections rarely disappear on their own without treatment. They may go through periods of dormancy, where it appear that the infection is not spreading, but the fungus will typically start growing again in the future. Early treatment is important as the smaller the area of toenail that is infected, and the shallower the infection, the quicker you will see results. While undergoing treatment (and in order to remain fungus-free into the future) it is important to stick to healthy foot habits, including the following:

  • Read our resource article providing tips help you stick to your topical treatment routine. You’ll find useful downloads for tracking your progress.
  • Wash your feet and toenails regularly, ideally with an antifungal soap, and always dry them carefully before putting on your socks and shoes.
  • Clear up any foot fungus infections (athlete’s foot) promptly before the fungus is able to spread to infect the toenails. This normally takes 1-2 weeks of treatment, far less than for fungal infections that have spread to the nail.
  • Don’t wear the same shoes every day, but change up your pairs and shake some antifungal powder into your favorites. Avoid wearing shoes made out of plastic or other synthetic, non-ventilating materials. You want your feet and toenails to be able to breathe. The same goes for socks: stick to natural fibers such as wool or cotton and wash on the hot cycle.
  • If you are prone to sweaty feet, have a spare pair of socks on hand that you can change into. Change out of sweaty exercise shoes and socks promptly.
  • Fresh air and sunlight are great for fungal toenails, so get your feet and toes out into the open as often as possible. While fingernails can also become infected with fungus, it is far less common that toenail fungus infections due to the simple fact that fingernails spend more time out in the open and less time covered up.
  • Avoid wearing toenail polish or artificial nails as these create exactly the kind of warm, damp (the nail is not able to perspire), dark, airless and protected environments in which fungi can thrive.
  • Get rid of any tight-fitting shoes that press against your toenails. It is thought that trauma, damage or injury to the toenails can weaken the local immunity and provide an entry point for fungal invasion.
  • Always wear rubber thongs in public places where people have a tendency to walk around barefoot. Take extra care where the floor is damp, such as at the gym, spa or swimming pool.
  • Only use the services of reputable nail salons that thoroughly sterilize all nail instruments (including the foot bath) between clients. If you are unsure, bring your own equipment. It is thought that the rise of cut-price nail salons is a key factor in higher toenail fungus infection rates.

Choose your treatment approach carefully and good luck.

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