What's the Treatment for a Fungal Nail Infection?

A fungal nail infection (onychomycosis) isn’t pretty, but hiding it and hoping it goes away on its own won’t help. Sometimes you can get rid of a nail fungus without a trip to the doctor.

Non-Prescription Treatments

Some treatments that you can get without a doctor’s prescription might work well.

Over-the-counter remedies. Your local drug store has antifungal creams and lotions you can try without a prescription. They’re not expensive, but often they’re not strong enough to get rid of the fungus. Sometimes, an infection treated this way will clear up for a while, then come back. If that happens, you’ll need to try something else.

Mentholated salve. Some research has shown that a mentholated salve (like Vicks VapoRub) can get rid of a fungal infection. Swab a small amount on the nail every day.

Snakeroot extract. Snakeroot is a natural antifungal from the sunflower family. For some people, it works about as well as a prescription antifungal cream.

Tea tree oil. Because it’s a natural antiseptic, you can try applying this oil to your affected nail twice a day. Never take tea tree oil by mouth,  because it can be toxic. Still, it’s unclear how well this treatment works.

Prescription Medicines

If your fungus doesn’t clear up at home, you should check in with a dermatologist (a skin specialist) or podiatrist (a foot doctor.) They may gently scrape under your nail to get rid of some of the fungus or send it to the lab for diagnosis. They can also prescribe stronger medicines.

Topical medicines. If you have a mild infection, your doctor can give you an antifungal skin cream or solution to rub into the nail. You’ll want to trim your nail and soak the area first. This can help the drug attack the deepest layers of the fungus. (It can also lessen pain by reducing pressure on your nail.)

Your doctor may also suggest that you thin your nail first with a file or lotion. That can help the medicine work better, too.

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There are topical drugs that work to get rid of nail fungus:

  • Amorolfine
  • Ciclopirox
  • Efinaconazole
  • Tavaborole

You may have side effects like redness, swelling, or stinging and burning when you apply them.

Medicines you take by mouth. For a severe infection, your doctor can give you an antifungal pill that you’ll take for as long as 12 weeks. Studies show that drugs like terbinafine (Lamisil) and itraconazole (Sporanox) work best to help a new, healthy nail grow in to replace the infected one.

These pills are not usually given to people with liver disease or heart problems. They may interact with other medicines you’re taking, such as antidepressants and beta-blockers. If you do take an antifungal pill, you’ll need to have a blood test every month to make sure it isn’t causing any problems.

Other Treatments

Laser treatment. High doses of light may help destroy stubborn fungus. This treatment is fairly new. While results so far have been good, more studies are needed to prove that it can be safe and useful. Laser treatments are also costly and usually not covered by insurance.

Nail removal. If other treatments don’t work, or you’re in a lot of pain, your doctor may want to remove the infected nail. This allows a new healthy nail to grow in, although it could take more than a year for that to happen. Your doctor will either remove the nail by putting a strong chemical on it, or you may need surgery. Either can be done in your doctor’s office or clinic. You won’t need to stay in the hospital.

Once you get rid of the infection, do your best to avoid getting the nail infected again. Disinfect your bathroom tiles with bleach. Wear socks with your shoes. Don’t go barefoot, especially in public places. Use shower shoes instead.

WebMD Medical Reference Reviewed by Stephanie S. Gardner, MD on 2/, 016

Sources

SOURCES:

Mayo Clinic: “Nail Fungus,” “Tea Tree Oil.”

American Family Physician: “Onychomycosis.”

NHS, “Treatment for a fungal nail infection.”

Westerberg, C., American Family Physician, Dec. 1, 2013.

Botek, G., Cleveland Clinic Journal of Medicine, February 2003.

HealthLink British Columbia, “Fungal Nail Infections.”

American Podiatric Medical Association, “Toenail Fungus.”

Cleveland Clinic, “Toenail Fungus.”

American Academy of Dermatology, “Nail fungus.”

Hart, R., Bell-Syer, S., Crawford, F., et al. BMJ, July 10, 1999.

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