Treatment for a
fungal nail infection includes using medicines, taking
steps to prevent the infection from returning, and possibly removing the
affected nail. Treatment is generally successful, but treatment does not work
for 20% to 25% of people with the condition.4
You may decide not to treat a fungal nail infection if your nail is
discolored or damaged but not painful. Antifungal medicine does not guarantee a
cure, and antifungal pills (oral medicine) can be expensive and have
dangerous side effects.
treatment, fungal nail infections tend to get worse, infecting more of the nail
or surrounding skin. Early treatment may shorten treatment time and increase
your chances of being cured.
If you have a fungal nail infection
that causes quality-of-life problems, such as discomfort, pain, or
embarrassment, you may decide to treat it.
If you have a
condition such as
diabetes that might complicate a minor foot injury or
infection, your doctor may suggest treating a fungal nail infection, even if it
does not bother you.
For more information on deciding whether to
use oral antifungal medicine, see:
Nail Infection: Should I Take Antifungal Pills?
Standard treatment for fungal nail infection includes one
or a combination of the following:
Antifungal pills (oral medicine) offer the best chance
of a cure. But they require close monitoring for
dangerous side effects and are typically reserved for
moderate-to-severe or hard-to-treat fungal nail infections. Pills include
terbinafine (Lamisil), itraconazole (Sporanox), and fluconazole (Diflucan).
Antifungal topical medicine (creams, lotions, gels,
and lacquers) are applied to the infected nail and surrounding areas of the
skin. They may be used for mild-to-moderate infections and to help prevent an
infection from returning or to prevent
athlete's foot from spreading to the nails. Topical
medicines include terbinafine (Lamisil) and ciclopirox (Penlac). Topical
medicines may not be as effective as oral medicines.
- Removal of an infected nail is used for severe or recurring
fungal nail infections. Combining nail removal with antifungal creams or pills
is likely to be more effective than using one of these treatments alone. Nail
removal is rarely needed.
nonsurgical nail removal, a urea ointment is put on
the nail, softening and dissolving it for easy removal.
surgical nail removal, the infected nail and tissue is
fully removed (avulsion) or partially removed (debridement).
A topical or oral
antibiotic is needed only when a bacterial
infection has developed along with the fungal infection.
Recurring infections and prevention
apparently successful treatment with antifungal pills, a fungal nail infection
can return, either as a new infection or as regrowth of the original fungi.
Severe toenail infections, particularly those involving a big toe, are
hard to treat and tend to recur.
After treatment, be sure to
take steps to keep a fungal nail infection from developing again.
- Before bed, thoroughly wash and dry your feet or hands and
apply a topical antifungal medicine, such as terbinafine (Lamisil) or
ciclopirox (Penlac), directly to your skin or nail. Use the topical medicine
for 1 year.5
- Keep your feet and hands dry. Dry skin and nails are less
likely to become infected. Apply powder to your dry feet or hands after you
take a shower or bath.
- Wear dry cotton socks and change them 2 or 3 times a day if
- Wear sandals or dry roomy shoes made of materials that allow
moisture to escape. Avoid tight, enclosed shoes. Injury to the tips of the toenails
because of tight shoes may be the biggest single factor that leads to
recurrence of a fungal nail infection.5
- Wear shower sandals or shower shoes when using a public pool or
shower, and let them dry between uses.
- Don't share shoes, socks, nail clippers, or nail files with
- Avoid injuring your nail. Cutting nails too short is a common
cause of nail injury. If you decide to get artificial nails or have a manicure,
go to a salon that uses sterile instruments. Nail manicure and certain nail
products can damage the nail or cuticle, making the nail more susceptible to
- Control chronic conditions such as
- Stop smoking.
What to Think About