Materiały źródłowe

• #1 Nail fungus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nail-fungus/diagnosis-treatment/drc-20353300

  Treatment for toenail fungus isn’t always needed. And sometimes self-care and nonprescription products clear up the infection. Talk with your health care provider if your condition doesn’t improve. Treatment depends on the severity of your condition and the type of fungus causing it. It can take months to see results. And even if your nail condition improves, repeat infections are common. […] Your health care provider may prescribe antifungal drugs that you take by mouth (orally) or apply to the nail. […] These drugs help a new nail grow free of infection, slowly replacing the infected part. […] You typically take this type of drug daily for 6 to 12 weeks. But you won’t see the end result of treatment until the nail grows back completely. It may take four months or longer to eliminate an infection.

• #2 Fungal nail infection | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/fungal-nail-infection/

  A fungal nail infection is unlikely to get better without treatment. However, treatments can take a long time and can sometimes cause side effects. […] A pharmacist may suggest an antifungal nail medicine that you brush onto the nail. […] You’ll need to use this regularly for a few months before you start to see an improvement. […] You should keep using the treatment until you’re told to stop. Stopping too early could cause the infection to return. […] If treatments from a pharmacy don’t work, your GP may prescribe antifungal tablets. […] Before starting treatment, your GP will take a sample of your nail to test what kind of infection you have. […] You may need to take antifungal tablets for up to 6 months. […] Sometimes badly infected nails need to be removed. This is a small procedure that’s done while the area is numbed under local anaesthetic.

• #3 Nail fungus: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/nail-fungus-treatment

  Treatment usually begins with your dermatologist trimming your infected nail(s), cutting back each infected nail to the place where it attaches to your finger or toe. Your dermatologist may also scrape away debris under the nail. This helps get rid of some fungus. […] To completely get rid of the infection, most people also need one or more of the following treatments: […] Medicine you apply to the nail: If you have a mild infection, a medicine that you apply to your nails may get rid of the infection. This treatment helps keep new fungus out while the nails grow. Fingernails typically grow out in four to six months. Toenails take longer, usually takes 12 to 18 months. […] The US Food and Drug Administration (FDA) has approved the following medicines that you apply to the nail to treat nail fungus: Amorolfine, Ciclopirox, Efinaconazole, Tavaborole.

• #4

  https://bpac.org.nz/2025/fungal-nails.aspx

  Fungal nail infection (onychomycosis) is a common clinical problem, especially in older adults, and can significantly impact quality of life. Laboratory confirmation is recommended before initiating treatment. Both oral and topical antifungals are available for patients who wish to proceed with treatment; prescribing decisions are determined by severity of infection, co-morbidities, potential for medicines interactions and preference. […] Laboratory diagnosis of onychomycosis with microscopy and culture of nail clippings is recommended before starting oral or topical treatment. Microscopy results are usually available within a few days. However, culture can take up to four weeks to confirm the causative organism. […] Treatment may not be necessary for all patients and specific medicines may be inappropriate in some cases, e.g. patients with frailty, co-morbidities, taking multiple medicines or with limited mobility (to apply treatment to toenails).

• #5 Onychomycosis: Management – UpToDate

  https://www.uptodate.com/contents/onychomycosis-management

  Onychomycosis, fungal infection of the nail, can cause disfigurement of the nail, pain, and may increase risk for soft tissue bacterial infection in immunocompromised patients. Dermatophytes, particularly Trichophyton rubrum, are the most common causes of onychomycosis. Yeast (eg, Candida albicans) and nondermatophyte molds can also cause onychomycosis. […] Therapeutic options for onychomycosis include oral antifungal medications, topical antifungal medications, and physical interventions. Factors such as the causative organism, severity of nail involvement, treatment side effects, and patient preference influence treatment selection. […] Treatment of onychomycosis is not mandatory in all patients. We suggest treating onychomycosis in: Patients with a history of cellulitis of the lower extremity, especially if repeated, who have ipsilateral toenail onychomycosis.

• #6 Nail fungus: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/nail-fungus-treatment

  Treatment usually begins with your dermatologist trimming your infected nail(s), cutting back each infected nail to the place where it attaches to your finger or toe. Your dermatologist may also scrape away debris under the nail. This helps get rid of some fungus. […] To completely get rid of the infection, most people also need one or more of the following treatments: […] Medicine you apply to the nail: If you have a mild infection, a medicine that you apply to your nails may get rid of the infection. This treatment helps keep new fungus out while the nails grow. Fingernails typically grow out in four to six months. Toenails take longer, usually takes 12 to 18 months. […] The US Food and Drug Administration (FDA) has approved the following medicines that you apply to the nail to treat nail fungus: Amorolfine, Ciclopirox, Efinaconazole, Tavaborole.

• #7 Fungal nail infection | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/fungal-nail-infection/

  A fungal nail infection is unlikely to get better without treatment. However, treatments can take a long time and can sometimes cause side effects. […] A pharmacist may suggest an antifungal nail medicine that you brush onto the nail. […] You’ll need to use this regularly for a few months before you start to see an improvement. […] You should keep using the treatment until you’re told to stop. Stopping too early could cause the infection to return. […] If treatments from a pharmacy don’t work, your GP may prescribe antifungal tablets. […] Before starting treatment, your GP will take a sample of your nail to test what kind of infection you have. […] You may need to take antifungal tablets for up to 6 months. […] Sometimes badly infected nails need to be removed. This is a small procedure that’s done while the area is numbed under local anaesthetic.

• #8

  https://bpac.org.nz/2025/fungal-nails.aspx

  Antifungal treatment selection depends on the causative organism and patient factors: Oral terbinafine is first-line treatment for dermatophyte onychomycosis. Oral itraconazole is preferred for onychomycosis caused by candida infection. Topical amorolfine (funded) or ciclopirox (not funded) may be suitable for patients with superficial infection or infection confined to the distal nail plate and for those unable to take oral antifungals. […] Incomplete resolution is a common occurrence. Check adherence to the treatment regimen and consider antifungal resistance. Consider switching to a different oral antifungal, combination oral and topical treatment or discuss with a dermatologist or clinical microbiologist. […] Ensure the patient has realistic expectations regarding long-term outcomes. Successful antifungal treatment can take years and nail appearance may never completely return to normal.

• #9 Toenail Fungus: Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/hs/toenail-fungus/prevention-and-treatment/

  Treatment is available but can take several months, depending on the type of treatment. Your doctor can advise on the best options for you. […] Treatment is with topical applications or medication. Drug treatment is more effective but can lead to adverse effects and is not suitable for everyone. […] The choice will depend on: the extent and severity of the infection, your age, as oral medication is not suitable for children, the cost of treatment and if your insurance covers it, how you react to the side effects of any drugs, other health conditions you may have. […] Topical treatments may help if the infection is in only one to three nails, covers less than half of each nail, and does not affect the toenail bed. […] Clear nail polishes containing anti-growth and antifungal agents can help remove a toenail infection. They are available over the counter as well as through prescription. You can choose between polishes containing amorolfine or ciclopirox. Treatment can take up to a year.

• #10 Fungal Nail Infections — DermNet

  https://dermnetnz.org/topics/fungal-nail-infections

  Treatment aims to eliminate the offending organism and restore the nail to health and a normal appearance. Fingernail infections are usually cured more quickly and effectively than toenail infections. […] Mild infections affecting less than 50% of one or two nails may respond to topical antifungal medication, but cure usually requires an oral antifungal medication for several months. […] Topical antifungal treatment options include Ciclopirox 8% lacquer, Tavaborole 5% solution, Efinaconazole 10% solution, and Amorolfine 5% lacquer. […] With total nail involvement, medical nail avulsion using urea paste may enhance systemic antifungal efficacy. […] Oral antifungal treatment options include Terbinafine, Fluconazole, Itraconazole, and Posaconazole. […] These are widely used due to accessibility, low cost (some of them), and high efficacy; however, they may require an extended course especially for toenail involvement (3-4 months). […] Non-pharmacological treatment options include Infrared laser therapy, Photodynamic therapy, Iontophoresis, and Ultrasound. […] Treatment should be individualised, and the patient should be counselled for the estimated time to cure.

• #11

  https://bpac.org.nz/2025/fungal-nails.aspx

  The goal of treatment is to eliminate the causative organism and restore normal nail appearance, however, specific treatment options may not always be necessary or appropriate, e.g. patients with frailty, multiple co-morbidities, limited mobility or taking multiple medicines. […] Oral antifungal treatment (terbinafine, itraconazole) is typically prescribed in preference to topical treatment (amorolfine, ciclopirox) in most clinical situations as it is more effective, and treatment duration is shorter. […] Terbinafine is the first-line treatment for patients with confirmed dermatophyte onychomycosis. […] Itraconazole is preferred for treating candidal onychomycosis due to its broad antifungal activity. […] Topical treatments can be considered when onychomycosis does not involve the nail matrix (i.e. superficial white onychomycosis, early distal or lateral subungual onychomycosis) and only affects one or two nails.

• #12 Nail fungus: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/nail-fungus-treatment

  Treatment usually begins with your dermatologist trimming your infected nail(s), cutting back each infected nail to the place where it attaches to your finger or toe. Your dermatologist may also scrape away debris under the nail. This helps get rid of some fungus. […] To completely get rid of the infection, most people also need one or more of the following treatments: […] Medicine you apply to the nail: If you have a mild infection, a medicine that you apply to your nails may get rid of the infection. This treatment helps keep new fungus out while the nails grow. Fingernails typically grow out in four to six months. Toenails take longer, usually takes 12 to 18 months. […] The US Food and Drug Administration (FDA) has approved the following medicines that you apply to the nail to treat nail fungus: Amorolfine, Ciclopirox, Efinaconazole, Tavaborole.

• #13 Fungal Nail Infections — DermNet

  https://dermnetnz.org/topics/fungal-nail-infections

  Treatment aims to eliminate the offending organism and restore the nail to health and a normal appearance. Fingernail infections are usually cured more quickly and effectively than toenail infections. […] Mild infections affecting less than 50% of one or two nails may respond to topical antifungal medication, but cure usually requires an oral antifungal medication for several months. […] Topical antifungal treatment options include Ciclopirox 8% lacquer, Tavaborole 5% solution, Efinaconazole 10% solution, and Amorolfine 5% lacquer. […] With total nail involvement, medical nail avulsion using urea paste may enhance systemic antifungal efficacy. […] Oral antifungal treatment options include Terbinafine, Fluconazole, Itraconazole, and Posaconazole. […] These are widely used due to accessibility, low cost (some of them), and high efficacy; however, they may require an extended course especially for toenail involvement (3-4 months). […] Non-pharmacological treatment options include Infrared laser therapy, Photodynamic therapy, Iontophoresis, and Ultrasound. […] Treatment should be individualised, and the patient should be counselled for the estimated time to cure.

• #14 Fungal Nail Infection: Overview, Causes & Treatments

  https://www.healthline.com/health/fungal-nail-infection

  Fungal nail infections are common and are caused by fungi that live in the environment. They enter through small cracks in your nail or the nearby skin, causing infection. […] Over-the-counter products arent usually recommended to treat nail infections since they dont provide reliable results. Instead, your doctor may prescribe an oral antifungal medication, such as: terbinafine (Lamisil), itraconazole (Sporanox), fluconazole (Diflucan), griseofulvin (Gris-PEG). […] Your doctor may prescribe other antifungal treatments, such as antifungal nail lacquer or topical solutions. These treatments are brushed onto the nail in the same way that youd apply nail polish. […] Depending on the type of fungus causing the infection, as well as the extent of the infection, you may have to use these medications for several months. Topical solutions arent generally effective in curing toenail fungal infections.

• #15 Onychomycosis Treatment & Management: Medical Care, Surgical Care, Activity

  https://emedicine.medscape.com/article/1105828-treatment

  Efinaconazole is indicated for toenail onychomycosis. Its approval was based on two phase III multicenter, randomized trials (N = 1655), in which complete cure was seen in 17.8% and 15.2% of patients receiving the drug vs 3.3% and 5.5% of subjects receiving the vehicle. Mycologic cure rates were significantly greater with efinaconazole (53.4-55.2%) than with the drug vehicle. Data indicate that efinaconazole is very effective in the treatment of yellow streaks and dermathophytoma, which are often resistant to oral antifungals. […] Tavaborole, a topical oxaborole (boron-containing) antifungal, is indicated for onychomycosis of the toenails due to T rubrum or T mentagrophytes. Its approval was based on two multicenter, double-blind, randomized trials involving 1194 subjects. After 48 weeks of treatment, complete cure was found in 6.5% and 9.1% in patients receiving tavaborole compared with 0.5% and 1.5%, respectively, of patients applying the vehicle alone. Mycologic cure was obtained in 31.1% and 35.9% for active treatment vs 7.2% and 12.2% for the vehicle.

• #16 Nail fungus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nail-fungus/diagnosis-treatment/drc-20353300

  Oral antifungal drugs may cause side effects such as rash and liver damage. […] Your health care provider may prescribe an antifungal nail polish called ciclopirox (Penlac). […] You may need to use this type of nail polish daily for almost a year. […] Your health care provider may prescribe an antifungal cream, such as efinaconazole (Jublia) and tavaborole (Kerydin). […] These creams may work better if you first thin the nails. […] Your health care provider might suggest temporary removal of the nail so that the antifungal drug can be applied directly to the infection under the nail. […] The most effective but least used option is surgery to permanently remove the nail and its root.

• #17 Fungal Nail Infections and Toenail Removal Surgery

  https://www.webmd.com/skin-problems-and-treatments/fungal-nail-infection-treatment

  A fungal nail infection (known as onychomycosis) isnt pretty, but hiding it and hoping it goes away on its own wont help. Sometimes you can get rid of a nail fungus without a trip to the doctor. Heres what you need to know. […] Some treatments that you can get without a doctors prescription might work well. […] Your local drugstore has antifungal creams and lotions you can try. Theyre not expensive, but often theyre 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, youll need to try something else. […] Some research has shown that a mentholated salve can get rid of a fungal infection. Swab a small amount on the nail every day. […] Snakeroot is a natural antifungal from the sunflower family. For some people, it works about as well as a prescription antifungal cream.

• #18 How to Stop Toenail Fungal Infections

  https://www.webmd.com/skin-problems-and-treatments/treat-toenail-fungus

  Toenail fungus (the medical term is „onychomycosis”) is a very common condition. Nail fungus doesn’t go away by itself. And if you don’t treat it, there’s a chance it could get worse and cause pain when you walk. Luckily, there are a number of ways to take care of it. […] Prescription toenail fungus treatments include creams, sprays, and gels like ciclopirox (Penlac), efinaconazole (Jublia), and tavaborole (Kerydin). These are best for surface fungus, as the products don’t penetrate your nail bed. It may take a year of daily use before you see the fungus go away. Antifungal pills like itraconazole (Sporanox) and terbinafine (Lamisil) work better than creams and gels. You usually take them for 12 weeks, but the fungus may not be completely gone for 10 months or longer. […] If the infection is deep and you’ve had it for a while, your doctor may want to remove all or part of your nail. Your nail can be removed surgically or nonsurgically. For nonsurgical treatment, your doctor will put urea ointment on the infected nail surface and wrap the nail in plastic and tape. The ointment softens the nail bed. After about 10 days, the doctor can remove the infected nail from the nail bed, or just cut away the diseased part of the nail.

• #19 Nail fungus: Learn More – Nail fungus: Polish, cream or tablets? – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279546/

  Nail fungus can be very persistent. Topical treatment with nail polish may take up to one year. Tablets for treating fungal nail infections usually have to be taken for several weeks or months. They are much more effective than topical treatments, but they have more side effects. […] The treatment options for nail fungus include nail polishes and creams as well as tablets. Nail polishes and creams are available in pharmacies without a prescription. […] Treatment sets that contain two creams and a nail scraper (spatula) can also be used for the topical treatment of nail fungus: One cream has urea in it, which softens the nail so it can be removed. The other cream contains bifonazole, which has an antifungal effect. […] The combination of urea and bifonazole got rid of nail fungus in an extra 10 participants. But there was no difference between the two groups six months after treatment.

• #20 Canespro® Fungal Nail Treatment Set | Nail Fungus | Canesten

  https://www.canesten.co.uk/discover-canesten-products/canespro-fungal-nail-treatment-set

  Canespro® Fungal Nail Treatment Set from the makers of Canesten® is the shortest treatment towards healthy nails*. It is a unique over the counter treatment for fungal nail infection and works differently to other currently available fungal nail treatments. The Canespro® ointment softens the infected part of the nail to help it’s gentle and painless removal, whilst keeping the healthy part of the nail intact. The infected part of the nail can then gradually be removed with the plastic tool provided in the set. This gentle removal usually takes 2 to 3 weeks and enables you to get to the main root of the infection – as fungal nail infections can occur under the nail plate. […] After treating with Canespro®, a follow-up treatment with an anti-fungal nail cream is recommended. Speak to your pharmacist for advice.

• #21 Onychomycosis Treatment & Management: Medical Care, Surgical Care, Activity

  https://emedicine.medscape.com/article/1105828-treatment

  To decrease the adverse effects and duration of oral therapy, topical treatments and nail avulsion may be combined with oral antifungal management. […] Several laser devices have been used to treat onychomycosis, including Nd:YAG lasers and carbon dioxide lasers. Some data suggest that laser therapy may be as effective as terbinafine, with fewer adverse effects, but there remains a need for more data from large-scale randomized controlled trials. Laser treatment can be combined with topical antifungals. […] Surgical approaches to onychomycosis treatment can also include mechanical, chemical, or surgical nail avulsion. Chemical removal by using a 40-50% urea compound is painless and useful in patients with very thick nails. Removal of the nail plate should be considered an adjunctive treatment in patients undergoing oral therapy. A combination of oral, topical, and surgical therapy can increase efficacy and reduce cost.

• #22 Toenail Fungus (Onychomycosis/Tinea Unguium): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/11303-toenail-fungus

  Toenail fungus is notoriously tricky to treat. You may need to treat tinea unguium for several months to get rid of the fungus. Still, toenail fungus often comes back. […] A skin specialist (dermatologist) or foot doctor (podiatrist) can explain your treatment options. If you have a mild case that doesn’t bother you, your healthcare provider may recommend no treatment. […] Tinea unguium treatment options include: […] You can take a prescribed oral antifungal medication to treat the fungus. Options include terbinafine (Lamisil), itraconazole (Sporanox) or fluconazole (Diflucan). You’ll need to take the medication every day for several months (or longer). Your healthcare provider may use blood tests to check for potential medication side effects. These medications can affect your liver and interact with other medications, so oral antifungals aren’t for everyone.

• #23 Fungal Nail Infection: Overview, Causes & Treatments

  https://www.healthline.com/health/fungal-nail-infection

  Fungal nail infections are common and are caused by fungi that live in the environment. They enter through small cracks in your nail or the nearby skin, causing infection. […] Over-the-counter products arent usually recommended to treat nail infections since they dont provide reliable results. Instead, your doctor may prescribe an oral antifungal medication, such as: terbinafine (Lamisil), itraconazole (Sporanox), fluconazole (Diflucan), griseofulvin (Gris-PEG). […] Your doctor may prescribe other antifungal treatments, such as antifungal nail lacquer or topical solutions. These treatments are brushed onto the nail in the same way that youd apply nail polish. […] Depending on the type of fungus causing the infection, as well as the extent of the infection, you may have to use these medications for several months. Topical solutions arent generally effective in curing toenail fungal infections.

• #24 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  Published studies measuring mycologic cure (negative KOH preparation or negative cultures) and clinical cure (normal nail morphology) have demonstrated the effectiveness of all three medications. […] Terbinafine is an allylamine antifungal agent that is active against dermatophytes, which are responsible for the majority of onychomycosis cases. […] The FDA-labeled dosage of terbinafine is 250 mg per day given continuously for 12 weeks to treat toenail infections and for six weeks to treat fingernail infections. […] Studies have shown that the regimen for toenails results in a mycologic cure rate of 71 to 82 percent and a clinical cure rate of 60 to 70 percent. […] Itraconazole is a newer triazole medication with a broad antifungal spectrum that includes dermatophytes, many nondermatophytic molds and Candida species.

• #25 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Systemic therapy […] Systemic treatment is recommended if topical treatment fails or is contra-indicated. The slow growth of nails means that they do not appear normal even after effective treatment. […] If dermatophyte nail infection is confirmed: Terbinafine: Currently first-line with evidence of greater efficacy compared to itraconazole. […] Prescribe 250 mg once a day for between six weeks and three months for fingernails, and for three to six months for toenails. […] Advise the person that visible improvement may be seen after the end of two months of fingernail treatment and three months of toenail treatment. […] It is not licensed for use in children. […] There have been cases of severe idiosyncratic skin and hepatotoxic reactions. […] It interacts with rifampicin and cimetidine. […] Itraconazole: Should be offered if an alternative to terbinafine is indicated. […] Highly active against Candida spp. but much less so against dermatophytes. […] It can be given in a pulsed rather than continuous regimen. 200 mg twice a day for one week, with subsequent courses repeated after a further 21 days. […] Prescribe two pulses for fingernails and three pulses for toenails. […] It can cause hepatotoxicity and LFTs should be checked for treatment lasting longer than a month. […] It is contra-indicated in pregnancy and not licensed for use in children. […] It interacts with a wide variety of commonly used pharmaceutical agents, including warfarin, antihistamines, antipsychotics, digoxin, H2-receptor antagonists, some statins and phenytoin. […] If terbinafine and itraconazole are contra-indicated, consider using griseofulvin. […] Griseofulvin: May be used in adults and children. […] It is not expensive and there is a long experience of its use. […] It requires long duration of treatment (at least six months) and has low cure and high relapse rates. […] It interacts with warfarin, ciclosporin and the combined oral contraceptive pill (it is an hepatic enzyme inducer). […] Fluconazole is not licensed for this use and is not as effective as terbinafine or itraconazole. However, it may have a role in patients in whom other alternatives are not tolerated, have unacceptable dosage regimes or cause adverse effects.

• #26 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  Published studies measuring mycologic cure (negative KOH preparation or negative cultures) and clinical cure (normal nail morphology) have demonstrated the effectiveness of all three medications. […] Terbinafine is an allylamine antifungal agent that is active against dermatophytes, which are responsible for the majority of onychomycosis cases. […] The FDA-labeled dosage of terbinafine is 250 mg per day given continuously for 12 weeks to treat toenail infections and for six weeks to treat fingernail infections. […] Studies have shown that the regimen for toenails results in a mycologic cure rate of 71 to 82 percent and a clinical cure rate of 60 to 70 percent. […] Itraconazole is a newer triazole medication with a broad antifungal spectrum that includes dermatophytes, many nondermatophytic molds and Candida species.

• #27 Onychomycosis Treatment & Management: Medical Care, Surgical Care, Activity

  https://emedicine.medscape.com/article/1105828-treatment

  Laser treatment can be combined with topical antifungals. […] The newer generation of oral antifungal agents (itraconazole and terbinafine) has replaced older therapies in the treatment of onychomycosis. They offer shorter treatment regimens, higher cure rates, and fewer adverse effects. The efficacy of the newer antifungal agents lies in their ability to penetrate the nail plate within days of starting therapy. In the past few years, however, reports of resistance to terbinafine have been growing in number worldwide. It is therefore very important to refrain from starting oral treatment without mycologic confirmation of the diagnosis and to consider resistance when treatment is ineffective. […] Various clinical trials have demonstrated higher efficacy for terbinafine than for other antifungal treatments. A meta-analysis of 18 studies on terbinafine, six studies on pulse itraconazole, and three studies on fluconazole for onychomycosis showed mycologic cure rates of 76%, 63%, and 48% respectively.

• #28 How to Stop Toenail Fungal Infections

  https://www.webmd.com/skin-problems-and-treatments/treat-toenail-fungus

  Your doctor might prescribe an antifungal medicine that you paint on your nails. This will look like a colorless nail polish and will contain a drug like ciclopirox. You’ll get instructions on how often to use it, but usually, you paint it on the affected toenail once a day, every day. It may take 6 months or more before your nails start to look better. […] Be sure to finish any medication your doctor has prescribed for you. If you stop taking it when your toenail starts to look better, you might be allowing some hidden fungus to grow back. […] The main antifungal pills have side effects. Terbinafine can cause an itchy rash, headaches, diarrhea, nausea or a stomachache. In some cases, it can affect your liver, so your doctor will often do a blood test to make sure this is not happening.

• #29 Nail Fungus Pictures, Types, Causes, Symptoms, Best Treatment

  https://www.medicinenet.com/fungal_nails/article.htm

  Terbinafine (Lamisil): This drug is taken daily for 12 weeks for toenails and six weeks for fingernails. The drug is safe, effective, and produces few side effects. However, it must be used with caution in patients with liver disease. This medication is also affordable. […] Itraconazole (Sporanox): This is often prescribed in „pulse doses” — one week per month for two or three months. It can interact with some commonly used drugs such as the antibiotic erythromycin or certain asthma medications. It is considered the treatment of choice for onychomycosis caused by Candida yeast and non-dermatophytic molds. […] Fluconazole (Diflucan): This drug may be given once a week for several months. The dosing of this drug may need to be modified if the patient has impaired kidney function or is taking it simultaneously with certain other medications. It is not as effective as Lamisil or Sporanox and should be used cautiously in patients with liver disease.

• #30 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  Published studies measuring mycologic cure (negative KOH preparation or negative cultures) and clinical cure (normal nail morphology) have demonstrated the effectiveness of all three medications. […] Terbinafine is an allylamine antifungal agent that is active against dermatophytes, which are responsible for the majority of onychomycosis cases. […] The FDA-labeled dosage of terbinafine is 250 mg per day given continuously for 12 weeks to treat toenail infections and for six weeks to treat fingernail infections. […] Studies have shown that the regimen for toenails results in a mycologic cure rate of 71 to 82 percent and a clinical cure rate of 60 to 70 percent. […] Itraconazole is a newer triazole medication with a broad antifungal spectrum that includes dermatophytes, many nondermatophytic molds and Candida species.

• #31

  https://bpac.org.nz/2025/fungal-nails.aspx

  The goal of treatment is to eliminate the causative organism and restore normal nail appearance, however, specific treatment options may not always be necessary or appropriate, e.g. patients with frailty, multiple co-morbidities, limited mobility or taking multiple medicines. […] Oral antifungal treatment (terbinafine, itraconazole) is typically prescribed in preference to topical treatment (amorolfine, ciclopirox) in most clinical situations as it is more effective, and treatment duration is shorter. […] Terbinafine is the first-line treatment for patients with confirmed dermatophyte onychomycosis. […] Itraconazole is preferred for treating candidal onychomycosis due to its broad antifungal activity. […] Topical treatments can be considered when onychomycosis does not involve the nail matrix (i.e. superficial white onychomycosis, early distal or lateral subungual onychomycosis) and only affects one or two nails.

• #32 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  The FDA-labeled dosage of itraconazole is 200 mg once daily taken continuously for 12 weeks to treat toenail infections and for six weeks to treat fingernail infections. […] Fluconazole is not currently labeled by the FDA for the treatment of onychomycosis, but early efficacy data are promising. […] Treatment guidelines for the newer antifungal medications are provided in the text. […] In addition to oral medications, some patients benefit from other treatments. […] Surgical or chemical nail avulsion may be useful in patients with severe onycholysis, extensive nail thickening or longitudinal streaks or spikes in the nail. […] Longer courses of antifungal therapy may be useful in patients whose nails grow slowly, who have diminished blood supply to the nail bed as a result of conditions such as peripheral vascular occlusion or diabetes mellitus, or who have total or nearly total nail plate involvement.

• #33 Onychomycosis: Dermatophyte Infection of the Fingernails and Toenails

  https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/skin-soft-tissue/dermatophyte-infection-fingernail-or-toenail/

  Oral treatment: 1st choice Terbinafine 250mg every 24 hours for 6 weeks to 3 months depending on severity of infection and nail growth. […] Oral treatment: 2nd choice Itraconazole 200mg every 24 hours for Fingernail 6 weeks, Toenail 12 weeks. […] Itraconazole pulse therapy: Fingernail: 200 mg every 12 hours for one week per month, Toenail: 200 mg every 12 hours for one week per month. Fingernail: 2 months, Toenail: 3 months.

• #34 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  Onychomycosis accounts for one third of fungal skin infections. […] Newer, more effective antifungal agents have made treating onychomycosis easier. Terbinafine and itraconazole are the therapeutic agents of choice. […] Continuous oral terbinafine therapy is most effective against dermatophytes, which are responsible for the majority of onychomycosis cases. […] Intermittent pulse dosing with itraconazole is as safe and effective as short-term continuous therapy but more economical and convenient. […] With careful monitoring, patients treated with the newer antifungal agents have a good chance of achieving relief from onychomycosis and its complications. […] The U.S. Food and Drug Administration (FDA) has labeled ciclopirox (Penlac) nail lacquer for the treatment of mild to moderate onychomycosis caused by T. rubrum without involvement of the lunula.

• #35 Onychomycosis Treatment & Management: Medical Care, Surgical Care, Activity

  https://emedicine.medscape.com/article/1105828-treatment

  Laser treatment can be combined with topical antifungals. […] The newer generation of oral antifungal agents (itraconazole and terbinafine) has replaced older therapies in the treatment of onychomycosis. They offer shorter treatment regimens, higher cure rates, and fewer adverse effects. The efficacy of the newer antifungal agents lies in their ability to penetrate the nail plate within days of starting therapy. In the past few years, however, reports of resistance to terbinafine have been growing in number worldwide. It is therefore very important to refrain from starting oral treatment without mycologic confirmation of the diagnosis and to consider resistance when treatment is ineffective. […] Various clinical trials have demonstrated higher efficacy for terbinafine than for other antifungal treatments. A meta-analysis of 18 studies on terbinafine, six studies on pulse itraconazole, and three studies on fluconazole for onychomycosis showed mycologic cure rates of 76%, 63%, and 48% respectively.

• #36 Nail fungus: Learn More – Nail fungus: Polish, cream or tablets? – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279546/

  To treat fungal nail infections from inside the body, you can take tablets that inhibit the growth of fungi or kill them. They are all prescription-only. Terbinafine and itraconazole are typically used for this purpose. […] Tablets for the treatment of nail fungus have been tested in several studies. All participants had an infection on their toenails caused by a skin fungus. Overall, the study results showed that tablets are considerably more effective than nail polishes or creams. […] Treatment with breaks is thought to be about as effective as continuous treatment. But that has only been looked into in a few studies. […] The possible side effects of itraconazole include headaches, dizziness, stomach and bowel problems, and rashes. […] If the fungal nail infection is severe, tablets can be used in combination with nail polish or cream.

• #37 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Systemic therapy […] Systemic treatment is recommended if topical treatment fails or is contra-indicated. The slow growth of nails means that they do not appear normal even after effective treatment. […] If dermatophyte nail infection is confirmed: Terbinafine: Currently first-line with evidence of greater efficacy compared to itraconazole. […] Prescribe 250 mg once a day for between six weeks and three months for fingernails, and for three to six months for toenails. […] Advise the person that visible improvement may be seen after the end of two months of fingernail treatment and three months of toenail treatment. […] It is not licensed for use in children. […] There have been cases of severe idiosyncratic skin and hepatotoxic reactions. […] It interacts with rifampicin and cimetidine. […] Itraconazole: Should be offered if an alternative to terbinafine is indicated. […] Highly active against Candida spp. but much less so against dermatophytes. […] It can be given in a pulsed rather than continuous regimen. 200 mg twice a day for one week, with subsequent courses repeated after a further 21 days. […] Prescribe two pulses for fingernails and three pulses for toenails. […] It can cause hepatotoxicity and LFTs should be checked for treatment lasting longer than a month. […] It is contra-indicated in pregnancy and not licensed for use in children. […] It interacts with a wide variety of commonly used pharmaceutical agents, including warfarin, antihistamines, antipsychotics, digoxin, H2-receptor antagonists, some statins and phenytoin. […] If terbinafine and itraconazole are contra-indicated, consider using griseofulvin. […] Griseofulvin: May be used in adults and children. […] It is not expensive and there is a long experience of its use. […] It requires long duration of treatment (at least six months) and has low cure and high relapse rates. […] It interacts with warfarin, ciclosporin and the combined oral contraceptive pill (it is an hepatic enzyme inducer). […] Fluconazole is not licensed for this use and is not as effective as terbinafine or itraconazole. However, it may have a role in patients in whom other alternatives are not tolerated, have unacceptable dosage regimes or cause adverse effects.

• #38 Onychomycosis Treatment & Management: Medical Care, Surgical Care, Activity

  https://emedicine.medscape.com/article/1105828-treatment

  Laser treatment can be combined with topical antifungals. […] The newer generation of oral antifungal agents (itraconazole and terbinafine) has replaced older therapies in the treatment of onychomycosis. They offer shorter treatment regimens, higher cure rates, and fewer adverse effects. The efficacy of the newer antifungal agents lies in their ability to penetrate the nail plate within days of starting therapy. In the past few years, however, reports of resistance to terbinafine have been growing in number worldwide. It is therefore very important to refrain from starting oral treatment without mycologic confirmation of the diagnosis and to consider resistance when treatment is ineffective. […] Various clinical trials have demonstrated higher efficacy for terbinafine than for other antifungal treatments. A meta-analysis of 18 studies on terbinafine, six studies on pulse itraconazole, and three studies on fluconazole for onychomycosis showed mycologic cure rates of 76%, 63%, and 48% respectively.

• #39 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  The FDA-labeled dosage of itraconazole is 200 mg once daily taken continuously for 12 weeks to treat toenail infections and for six weeks to treat fingernail infections. […] Fluconazole is not currently labeled by the FDA for the treatment of onychomycosis, but early efficacy data are promising. […] Treatment guidelines for the newer antifungal medications are provided in the text. […] In addition to oral medications, some patients benefit from other treatments. […] Surgical or chemical nail avulsion may be useful in patients with severe onycholysis, extensive nail thickening or longitudinal streaks or spikes in the nail. […] Longer courses of antifungal therapy may be useful in patients whose nails grow slowly, who have diminished blood supply to the nail bed as a result of conditions such as peripheral vascular occlusion or diabetes mellitus, or who have total or nearly total nail plate involvement.

• #40 Toenail Fungus (Onychomycosis/Tinea Unguium): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/11303-toenail-fungus

  Toenail fungus is notoriously tricky to treat. You may need to treat tinea unguium for several months to get rid of the fungus. Still, toenail fungus often comes back. […] A skin specialist (dermatologist) or foot doctor (podiatrist) can explain your treatment options. If you have a mild case that doesn’t bother you, your healthcare provider may recommend no treatment. […] Tinea unguium treatment options include: […] You can take a prescribed oral antifungal medication to treat the fungus. Options include terbinafine (Lamisil), itraconazole (Sporanox) or fluconazole (Diflucan). You’ll need to take the medication every day for several months (or longer). Your healthcare provider may use blood tests to check for potential medication side effects. These medications can affect your liver and interact with other medications, so oral antifungals aren’t for everyone.

• #41 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Systemic therapy […] Systemic treatment is recommended if topical treatment fails or is contra-indicated. The slow growth of nails means that they do not appear normal even after effective treatment. […] If dermatophyte nail infection is confirmed: Terbinafine: Currently first-line with evidence of greater efficacy compared to itraconazole. […] Prescribe 250 mg once a day for between six weeks and three months for fingernails, and for three to six months for toenails. […] Advise the person that visible improvement may be seen after the end of two months of fingernail treatment and three months of toenail treatment. […] It is not licensed for use in children. […] There have been cases of severe idiosyncratic skin and hepatotoxic reactions. […] It interacts with rifampicin and cimetidine. […] Itraconazole: Should be offered if an alternative to terbinafine is indicated. […] Highly active against Candida spp. but much less so against dermatophytes. […] It can be given in a pulsed rather than continuous regimen. 200 mg twice a day for one week, with subsequent courses repeated after a further 21 days. […] Prescribe two pulses for fingernails and three pulses for toenails. […] It can cause hepatotoxicity and LFTs should be checked for treatment lasting longer than a month. […] It is contra-indicated in pregnancy and not licensed for use in children. […] It interacts with a wide variety of commonly used pharmaceutical agents, including warfarin, antihistamines, antipsychotics, digoxin, H2-receptor antagonists, some statins and phenytoin. […] If terbinafine and itraconazole are contra-indicated, consider using griseofulvin. […] Griseofulvin: May be used in adults and children. […] It is not expensive and there is a long experience of its use. […] It requires long duration of treatment (at least six months) and has low cure and high relapse rates. […] It interacts with warfarin, ciclosporin and the combined oral contraceptive pill (it is an hepatic enzyme inducer). […] Fluconazole is not licensed for this use and is not as effective as terbinafine or itraconazole. However, it may have a role in patients in whom other alternatives are not tolerated, have unacceptable dosage regimes or cause adverse effects.

• #42 Nail fungus – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nail-fungus/diagnosis-treatment/drc-20353300

  Oral antifungal drugs may cause side effects such as rash and liver damage. […] Your health care provider may prescribe an antifungal nail polish called ciclopirox (Penlac). […] You may need to use this type of nail polish daily for almost a year. […] Your health care provider may prescribe an antifungal cream, such as efinaconazole (Jublia) and tavaborole (Kerydin). […] These creams may work better if you first thin the nails. […] Your health care provider might suggest temporary removal of the nail so that the antifungal drug can be applied directly to the infection under the nail. […] The most effective but least used option is surgery to permanently remove the nail and its root.

• #43 Fungal nail infection | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/fungal-nail-infection/

  A fungal nail infection is unlikely to get better without treatment. However, treatments can take a long time and can sometimes cause side effects. […] A pharmacist may suggest an antifungal nail medicine that you brush onto the nail. […] You’ll need to use this regularly for a few months before you start to see an improvement. […] You should keep using the treatment until you’re told to stop. Stopping too early could cause the infection to return. […] If treatments from a pharmacy don’t work, your GP may prescribe antifungal tablets. […] Before starting treatment, your GP will take a sample of your nail to test what kind of infection you have. […] You may need to take antifungal tablets for up to 6 months. […] Sometimes badly infected nails need to be removed. This is a small procedure that’s done while the area is numbed under local anaesthetic.

• #44 Fungal nail infection

  https://www.nhs.uk/conditions/fungal-nail-infection/

  You may have a fungal nail infection if your nail is brittle, discoloured or thicker than usual. These types of infections are not serious but they can take a long time to treat. […] Speak to a pharmacist if the look of your nail bothers you or it’s painful. They may suggest trying an antifungal nail medicine that you brush onto the affected nail. These medicines: should be used daily or weekly, depending on the type; need to be used for 6 to 12 months it may take several months before you start to see an improvement; may not be suitable for you if you’re under 18, pregnant or breastfeeding. The infection is cured when you see healthy nail growing back at the base. […] A GP can prescribe antifungal tablets if you have a fungal nail infection and treatments from a pharmacy have not worked. But before they give you tablets, they should take a sample of your nail and have it tested, to find out what type of infection you have. You may also need to have a blood test before starting treatment and during treatment to check your liver is working properly. You may need to take antifungal tablets for up to 6 months. The tablets can have side effects, including: headaches; an itchy rash; stomach ache; feeling sick and diarrhoea. You cannot take antifungal tablets if you have certain conditions, such as liver or kidney disease. They may also not be suitable if you’re pregnant or breastfeeding. Badly infected nails sometimes need to be removed. It’s a small procedure done while the area is numbed (under local anaesthetic).

• #45 Toenail Fungus – APMA MAIN

  https://www.apma.org/patients-and-the-public/conditions-affecting-the-foot-and-ankle/toenail-fungus/

  In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail that has not responded to any other treatment permits the fungal infection to be cured and prevents the return of a deformed nail. […] Trying to solve the infection without the qualified help of a podiatrist can lead to more problems. With new technical advances in combination with simple preventive measures, the treatment of this lightly regarded health problem can often be successful.

• #46 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  The FDA-labeled dosage of itraconazole is 200 mg once daily taken continuously for 12 weeks to treat toenail infections and for six weeks to treat fingernail infections. […] Fluconazole is not currently labeled by the FDA for the treatment of onychomycosis, but early efficacy data are promising. […] Treatment guidelines for the newer antifungal medications are provided in the text. […] In addition to oral medications, some patients benefit from other treatments. […] Surgical or chemical nail avulsion may be useful in patients with severe onycholysis, extensive nail thickening or longitudinal streaks or spikes in the nail. […] Longer courses of antifungal therapy may be useful in patients whose nails grow slowly, who have diminished blood supply to the nail bed as a result of conditions such as peripheral vascular occlusion or diabetes mellitus, or who have total or nearly total nail plate involvement.

• #47 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Treatment failure […] Manage any comorbidities which may be hampering the effectiveness of treatment. […] Consider re-investigating the cause. […] Consider referral to a podiatrist. […] Surgery […] Nail avulsion, removal of nail plate, chemical treatments (eg, 40-50% urea solution for very thickened nails) and matrixectomy may enhance the effectiveness of oral treatment. […] Studies are reporting the successful use of laser treatment but a Cochrane review recommended further research. […] Refer where: Diagnostic uncertainty remains. […] There is no response to medical treatment. […] The patient’s choice is to have surgical intervention. […] Children are concerned – it is a rarer condition in children compared to adults and there are more limited treatment options. […] There is suspected immune deficiency – eg, mucocutaneous candidiasis. […] There is extensive disease. […] There are recurring candidal nail infections.

• #48 How to Stop Toenail Fungal Infections

  https://www.webmd.com/skin-problems-and-treatments/treat-toenail-fungus

  Toenail fungus (the medical term is „onychomycosis”) is a very common condition. Nail fungus doesn’t go away by itself. And if you don’t treat it, there’s a chance it could get worse and cause pain when you walk. Luckily, there are a number of ways to take care of it. […] Prescription toenail fungus treatments include creams, sprays, and gels like ciclopirox (Penlac), efinaconazole (Jublia), and tavaborole (Kerydin). These are best for surface fungus, as the products don’t penetrate your nail bed. It may take a year of daily use before you see the fungus go away. Antifungal pills like itraconazole (Sporanox) and terbinafine (Lamisil) work better than creams and gels. You usually take them for 12 weeks, but the fungus may not be completely gone for 10 months or longer. […] If the infection is deep and you’ve had it for a while, your doctor may want to remove all or part of your nail. Your nail can be removed surgically or nonsurgically. For nonsurgical treatment, your doctor will put urea ointment on the infected nail surface and wrap the nail in plastic and tape. The ointment softens the nail bed. After about 10 days, the doctor can remove the infected nail from the nail bed, or just cut away the diseased part of the nail.

• #49 Fungal Nail Infections and Toenail Removal Surgery

  https://www.webmd.com/skin-problems-and-treatments/fungal-nail-infection-treatment

  Your doctor may also suggest that you thin your nail first with a file or urea lotion. That can help the medicine work better, too. […] For a severe infection, your doctor can give you an antifungal pill that youll take for as long as 12 weeks. […] Studies show that drugs like itraconazole (Sporanox) and terbinafine (Lamisil) work best to help a new, healthy nail grow in to replace the infected one. […] If other treatments dont work or youre in a lot of pain, your doctor may want to remove the infected nail. […] This allows a new healthy nail to grow in, which can take more than a year. […] Once you get rid of the infection, do your best to avoid getting the nail infected again.

• #50 Onychomycosis Treatment & Management: Medical Care, Surgical Care, Activity

  https://emedicine.medscape.com/article/1105828-treatment

  To decrease the adverse effects and duration of oral therapy, topical treatments and nail avulsion may be combined with oral antifungal management. […] Several laser devices have been used to treat onychomycosis, including Nd:YAG lasers and carbon dioxide lasers. Some data suggest that laser therapy may be as effective as terbinafine, with fewer adverse effects, but there remains a need for more data from large-scale randomized controlled trials. Laser treatment can be combined with topical antifungals. […] Surgical approaches to onychomycosis treatment can also include mechanical, chemical, or surgical nail avulsion. Chemical removal by using a 40-50% urea compound is painless and useful in patients with very thick nails. Removal of the nail plate should be considered an adjunctive treatment in patients undergoing oral therapy. A combination of oral, topical, and surgical therapy can increase efficacy and reduce cost.

• #51 What Are The Best Toenail Fungus Treatments? – Scripps Health

  https://www.scripps.org/news_items/7235-which-toenail-fungus-treatment-is-best

  Toenail fungus laser treatment can temporarily improve the nail but has a lower cure rate than oral medication. […] In severe cases that do not respond to treatment, the infected nail may be surgically removed in order to treat the nail bed; a healthy nail can then grow back. A chronically infected and painful nail may be permanently removed. […] Unfortunately, toenail fungus can be stubborn the recurrence rate can be as high as 40 percent. […] If your toenail fungus keeps coming back despite taking preventive measures, see your primary care doctor or podiatrist, says Dr. Ly. Something else may be causing it, or you may need a different approach. Your doctor can get to the root of the problem and determine the best course of action.

• #52 Toenail Fungus (Onychomycosis/Tinea Unguium): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/11303-toenail-fungus

  You can regularly apply a topical medication right onto your nail. The medication treats the fungus over time. Topical medications are most effective when paired with oral medications. […] Your healthcare provider will direct a high-tech laser beam and special lights at your toenail to treat the fungus. Lasers are U.S. Food and Drug Administration (FDA) approved for temporary increase of clear nail in nail fungus, but they’re not a cure. Cure rates for laser treatment are lower than oral and topical medications. Your healthcare provider won’t typically use lasers as first-line treatments for nail fungus. […] The most effective toenail fungus treatment for you will largely depend on your symptoms and situation. Your healthcare provider will consider several factors before recommending a treatment plan. They’ll customize a treatment plan for you. […] Overall, oral antifungal medications may offer the most treatment potential. Pairing oral drugs with topical antifungal medication may make treatment more effective.

• #53 How to Stop Toenail Fungal Infections

  https://www.webmd.com/skin-problems-and-treatments/treat-toenail-fungus

  Antifungal creams, gels, sprays, and patches are available at drugstores or online without a prescription. These include clotrimazole (Lotrimin) and terbinafine (Lamisil). Over-the-counter (OTC) products are best for mild toenail fungus and may take months to work. It’s important to note that most OTC products aren’t strong enough to cure a moderate or severe case of toenail fungus. For that, you’ll need prescription drugs. […] Because of the possible side effects from pills, some people try laser treatment. There are different types of laser treatments, but in general, the laser heats up the nail layers where the fungus is and tries to destroy its genetic material. Treatments take about 30 minutes and are not covered by insurance. You usually need at least two treatments 5-6 weeks apart, and it will take about 2 months from the first treatment to see results.

• #54 How to Stop Toenail Fungal Infections

  https://www.webmd.com/skin-problems-and-treatments/treat-toenail-fungus

  Antifungal creams, gels, sprays, and patches are available at drugstores or online without a prescription. These include clotrimazole (Lotrimin) and terbinafine (Lamisil). Over-the-counter (OTC) products are best for mild toenail fungus and may take months to work. It’s important to note that most OTC products aren’t strong enough to cure a moderate or severe case of toenail fungus. For that, you’ll need prescription drugs. […] Because of the possible side effects from pills, some people try laser treatment. There are different types of laser treatments, but in general, the laser heats up the nail layers where the fungus is and tries to destroy its genetic material. Treatments take about 30 minutes and are not covered by insurance. You usually need at least two treatments 5-6 weeks apart, and it will take about 2 months from the first treatment to see results.

• #55 Fungal Nail Infections | Ausmed

  https://www.ausmed.com/learn/articles/treating-nail-infections

  Debridement of a partial or entire nail may be accomplished by chemical or surgical means. This is performed in conjunction with the use of topical and, sometimes, oral agents. […] Laser therapy may be used to destroy the fungus; however, it appears to be less effective than other methods (NHS 2021; Healthdirect 2022). […] Effective treatment of this uncomfortable and embarrassing ailment relies on increased awareness and education being provided to patients so that fungal nail infections are treated promptly. Further research is needed to develop safer, faster, economical and more effective treatments for this common condition.

• #56

• #57 What’s the Best Toenail Fungus Treatment? | Third Coast Foot and Ankle

  https://www.thirdcoastfoot.com/blog/whats-the-best-toenail-fungus-treatment.cfm

  Treatment options include: […] Prescription medication can be used to treat your fungus and its easily applied directly to your affected nails. […] Pills taken orally to treat nail fungus have a better chance of getting at the fungus from the inside out. They can also work more quickly. […] Light therapy is one of the best solutions for toenail fungus. LunulaLaser treatment is a groundbreaking approach to treating nail fungus that can be done in just minutes with each session. […] The best news is that LunaLaser treatment is incredibly effective and cures about 90% of nail fungus cases! This means its one of the most powerful solutions now available to patients. […] In order to keep your toenail fungus from spreading, its important to do a few things. […] If you suffer from toenail fungus, it can be a good idea to get rid of your present footwear and buy new shoes once your nails have been treated. […] Theres some evidence to show applying vitamin E topically to your infected toenails can help eliminate toenail fungus over time. […] Once youve treated your toenail fungus, you might consider applying a topical medication or cream to the previously infected area. This can help to keep your toenails protected and prevent regrowth. […] We can help you regain healthy feet! At Third Coast Foot and Ankle, we have the best toenail fungus treatment available for effective, painless results that last.

• #58 Nail fungus: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/nail-fungus-treatment

  Medicine you take: If you need more-aggressive treatment, your dermatologist may prescribe antifungal pills. These have a higher cure rate than medicine you apply to your nails. […] Antifungal pills also work more quickly than medicine applied to the nails. Taking antifungal pills for two months can cure an infection under the fingernails. Usually three months of treatment cures a toenail fungal infection. […] The FDA has approved the following systemic (works throughout the body) medicines to treat nail fungus: Fluconazole, Griseofulvin, Itraconazole, Terbinafine. […] Combination therapy: Sometimes, nail fungus is hard to clear. Studies show that taking antifungal pills and applying medicine to your nails can be more effective than using either treatment alone. […] Nail removal: If you have a severe infection or other treatments just dont work, your dermatologist may recommend removing the nail(s) to get rid of the infection.

• #59 Nail fungus: Learn More – Nail fungus: Polish, cream or tablets? – InformedHealth.org – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK279546/

  To treat fungal nail infections from inside the body, you can take tablets that inhibit the growth of fungi or kill them. They are all prescription-only. Terbinafine and itraconazole are typically used for this purpose. […] Tablets for the treatment of nail fungus have been tested in several studies. All participants had an infection on their toenails caused by a skin fungus. Overall, the study results showed that tablets are considerably more effective than nail polishes or creams. […] Treatment with breaks is thought to be about as effective as continuous treatment. But that has only been looked into in a few studies. […] The possible side effects of itraconazole include headaches, dizziness, stomach and bowel problems, and rashes. […] If the fungal nail infection is severe, tablets can be used in combination with nail polish or cream.

• #60

  https://bpac.org.nz/2025/fungal-nails.aspx

  Combination treatment may also be considered when antifungal-resistant dermatophyte strains or moulds are identified as the causative organism, to increase the likelihood of treatment success. […] Monitor treatment response as nail grows. Ideally review patients with fungal nail infections regularly (e.g. every three months). Treatment response can be assessed by regularly photographing the nail or making a groove with a scalpel at the proximal end of the infected area. […] Ongoing prophylaxis to reduce recurrence. Weekly or twice-weekly prophylactic application of a topical antifungal after successful treatment has been achieved can be beneficial for reducing the chances of onychomycosis recurrence in high-risk patients. […] Provide lifestyle advice to reduce recurrence. Up to one-quarter of patients treated for onychomycosis experience recurrence of infection.

• #61 Onychomycosis Treatment & Management: Medical Care, Surgical Care, Activity

  https://emedicine.medscape.com/article/1105828-treatment

  To decrease the adverse effects and duration of oral therapy, topical treatments and nail avulsion may be combined with oral antifungal management. […] Several laser devices have been used to treat onychomycosis, including Nd:YAG lasers and carbon dioxide lasers. Some data suggest that laser therapy may be as effective as terbinafine, with fewer adverse effects, but there remains a need for more data from large-scale randomized controlled trials. Laser treatment can be combined with topical antifungals. […] Surgical approaches to onychomycosis treatment can also include mechanical, chemical, or surgical nail avulsion. Chemical removal by using a 40-50% urea compound is painless and useful in patients with very thick nails. Removal of the nail plate should be considered an adjunctive treatment in patients undergoing oral therapy. A combination of oral, topical, and surgical therapy can increase efficacy and reduce cost.

• #62

  https://bpac.org.nz/2025/fungal-nails.aspx

  Combination treatment may also be considered when antifungal-resistant dermatophyte strains or moulds are identified as the causative organism, to increase the likelihood of treatment success. […] Monitor treatment response as nail grows. Ideally review patients with fungal nail infections regularly (e.g. every three months). Treatment response can be assessed by regularly photographing the nail or making a groove with a scalpel at the proximal end of the infected area. […] Ongoing prophylaxis to reduce recurrence. Weekly or twice-weekly prophylactic application of a topical antifungal after successful treatment has been achieved can be beneficial for reducing the chances of onychomycosis recurrence in high-risk patients. […] Provide lifestyle advice to reduce recurrence. Up to one-quarter of patients treated for onychomycosis experience recurrence of infection.

• #63

  https://bpac.org.nz/2025/fungal-nails.aspx

  Combination treatment may also be considered when antifungal-resistant dermatophyte strains or moulds are identified as the causative organism, to increase the likelihood of treatment success. […] Monitor treatment response as nail grows. Ideally review patients with fungal nail infections regularly (e.g. every three months). Treatment response can be assessed by regularly photographing the nail or making a groove with a scalpel at the proximal end of the infected area. […] Ongoing prophylaxis to reduce recurrence. Weekly or twice-weekly prophylactic application of a topical antifungal after successful treatment has been achieved can be beneficial for reducing the chances of onychomycosis recurrence in high-risk patients. […] Provide lifestyle advice to reduce recurrence. Up to one-quarter of patients treated for onychomycosis experience recurrence of infection.

• #64

  https://bpac.org.nz/2025/fungal-nails.aspx

  Combination treatment may also be considered when antifungal-resistant dermatophyte strains or moulds are identified as the causative organism, to increase the likelihood of treatment success. […] Monitor treatment response as nail grows. Ideally review patients with fungal nail infections regularly (e.g. every three months). Treatment response can be assessed by regularly photographing the nail or making a groove with a scalpel at the proximal end of the infected area. […] Ongoing prophylaxis to reduce recurrence. Weekly or twice-weekly prophylactic application of a topical antifungal after successful treatment has been achieved can be beneficial for reducing the chances of onychomycosis recurrence in high-risk patients. […] Provide lifestyle advice to reduce recurrence. Up to one-quarter of patients treated for onychomycosis experience recurrence of infection.

• #65 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Fungal nail infection treatment and management […] There is no need to treat if the person is not worried about the appearance, there are no symptoms and no comorbidities which could increase the risk of complications. […] Patients should be given the information to make an informed decision based on: Even after successful treatment of the fungal infection, the nail may not look completely normal. […] Cure is not achieved in 20-40% of patients. […] Even in those in whom it is successful, nails may appear abnormal for over 12 months due to their slow growth. […] Relapse occurs in about 20-25% of people. […] Oral medication is taken for six weeks for fingernail infections and for three months for toenail infections. […] Topical treatments may need to be applied for up to 12 months. […] All medication has potential side-effects. […] However, anyone who presents should probably be offered treatment, as the condition is likely to be causing significant distress if it has brought them to consult. […] If the condition progresses, it can cause significant morbidity and functional disturbance, particularly in the elderly. […] There is also a public health argument for treating it, to lessen the reservoir of fungal spores in communal bathing areas, through reduction in the number of people with the condition.

• #66 Fungal nail infection

  https://www.nhs.uk/conditions/fungal-nail-infection/

  You may have a fungal nail infection if your nail is brittle, discoloured or thicker than usual. These types of infections are not serious but they can take a long time to treat. […] Speak to a pharmacist if the look of your nail bothers you or it’s painful. They may suggest trying an antifungal nail medicine that you brush onto the affected nail. These medicines: should be used daily or weekly, depending on the type; need to be used for 6 to 12 months it may take several months before you start to see an improvement; may not be suitable for you if you’re under 18, pregnant or breastfeeding. The infection is cured when you see healthy nail growing back at the base. […] A GP can prescribe antifungal tablets if you have a fungal nail infection and treatments from a pharmacy have not worked. But before they give you tablets, they should take a sample of your nail and have it tested, to find out what type of infection you have. You may also need to have a blood test before starting treatment and during treatment to check your liver is working properly. You may need to take antifungal tablets for up to 6 months. The tablets can have side effects, including: headaches; an itchy rash; stomach ache; feeling sick and diarrhoea. You cannot take antifungal tablets if you have certain conditions, such as liver or kidney disease. They may also not be suitable if you’re pregnant or breastfeeding. Badly infected nails sometimes need to be removed. It’s a small procedure done while the area is numbed (under local anaesthetic).

• #67 Toenail Fungus (Onychomycosis/Tinea Unguium): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/11303-toenail-fungus

  Toenail fungus is notoriously tricky to treat. You may need to treat tinea unguium for several months to get rid of the fungus. Still, toenail fungus often comes back. […] A skin specialist (dermatologist) or foot doctor (podiatrist) can explain your treatment options. If you have a mild case that doesn’t bother you, your healthcare provider may recommend no treatment. […] Tinea unguium treatment options include: […] You can take a prescribed oral antifungal medication to treat the fungus. Options include terbinafine (Lamisil), itraconazole (Sporanox) or fluconazole (Diflucan). You’ll need to take the medication every day for several months (or longer). Your healthcare provider may use blood tests to check for potential medication side effects. These medications can affect your liver and interact with other medications, so oral antifungals aren’t for everyone.

• #68 What Are The Best Toenail Fungus Treatments? – Scripps Health

  https://www.scripps.org/news_items/7235-which-toenail-fungus-treatment-is-best

  Toenail fungus laser treatment can temporarily improve the nail but has a lower cure rate than oral medication. […] In severe cases that do not respond to treatment, the infected nail may be surgically removed in order to treat the nail bed; a healthy nail can then grow back. A chronically infected and painful nail may be permanently removed. […] Unfortunately, toenail fungus can be stubborn the recurrence rate can be as high as 40 percent. […] If your toenail fungus keeps coming back despite taking preventive measures, see your primary care doctor or podiatrist, says Dr. Ly. Something else may be causing it, or you may need a different approach. Your doctor can get to the root of the problem and determine the best course of action.

• #69 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Fungal nail infection treatment and management […] There is no need to treat if the person is not worried about the appearance, there are no symptoms and no comorbidities which could increase the risk of complications. […] Patients should be given the information to make an informed decision based on: Even after successful treatment of the fungal infection, the nail may not look completely normal. […] Cure is not achieved in 20-40% of patients. […] Even in those in whom it is successful, nails may appear abnormal for over 12 months due to their slow growth. […] Relapse occurs in about 20-25% of people. […] Oral medication is taken for six weeks for fingernail infections and for three months for toenail infections. […] Topical treatments may need to be applied for up to 12 months. […] All medication has potential side-effects. […] However, anyone who presents should probably be offered treatment, as the condition is likely to be causing significant distress if it has brought them to consult. […] If the condition progresses, it can cause significant morbidity and functional disturbance, particularly in the elderly. […] There is also a public health argument for treating it, to lessen the reservoir of fungal spores in communal bathing areas, through reduction in the number of people with the condition.

• #70 Fungal Nail Infection: Overview, Causes & Treatments

  https://www.healthline.com/health/fungal-nail-infection

  Treatment isnt guaranteed to completely rid your body of the fungal infection. Complications from fungal infection are also possible. […] While you may see results from over-the-counter treatments and some may vouch for home remedies, the fastest and most effective proven treatments for nail fungus are prescription strength oral antifungal medications. […] Left untreated, toenail fungus is unlikely to resolve by itself. The infection may stay in the same place on the nail, or it may spread and worsen. […] For some people, a fungal nail infection can be difficult to cure, and the first round of medication might not work. The nail infection cant be considered cured until a new nail thats free from infection has grown in. […] Although this indicates that the nail is no longer infected, its possible for the fungal infection to return. In severe cases, there may be permanent damage to your nail, and it may have to be removed.

• #71 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Side-effects […] Side-effects of systemic antifungals include headache, itching, loss of sensation of taste, gastrointestinal symptoms, rash, fatigue and abnormal liver function. […] One meta-analysis looking at safety of antifungals used to treat superficial fungal infections found a low incidence of adverse events in an immunocompetent population. […] The risk of having asymptomatic serum transaminase elevation which did not require treatment discontinuation was less than 2.0% for all treatment regimens. […] The risk of an adverse liver reaction requiring treatment to be stopped ranged from 0.1% (continuous itraconazole) to 1.2% (continuous fluconazole). […] If candidal or non-dermatophyte nail infection is confirmed […] Use itraconazole first-line, terbinafine second-line and griseofulvin third-line.

• #72

  https://bpac.org.nz/2025/fungal-nails.aspx

  Antifungal treatment selection depends on the causative organism and patient factors: Oral terbinafine is first-line treatment for dermatophyte onychomycosis. Oral itraconazole is preferred for onychomycosis caused by candida infection. Topical amorolfine (funded) or ciclopirox (not funded) may be suitable for patients with superficial infection or infection confined to the distal nail plate and for those unable to take oral antifungals. […] Incomplete resolution is a common occurrence. Check adherence to the treatment regimen and consider antifungal resistance. Consider switching to a different oral antifungal, combination oral and topical treatment or discuss with a dermatologist or clinical microbiologist. […] Ensure the patient has realistic expectations regarding long-term outcomes. Successful antifungal treatment can take years and nail appearance may never completely return to normal.

• #73 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Treatment failure […] Manage any comorbidities which may be hampering the effectiveness of treatment. […] Consider re-investigating the cause. […] Consider referral to a podiatrist. […] Surgery […] Nail avulsion, removal of nail plate, chemical treatments (eg, 40-50% urea solution for very thickened nails) and matrixectomy may enhance the effectiveness of oral treatment. […] Studies are reporting the successful use of laser treatment but a Cochrane review recommended further research. […] Refer where: Diagnostic uncertainty remains. […] There is no response to medical treatment. […] The patient’s choice is to have surgical intervention. […] Children are concerned – it is a rarer condition in children compared to adults and there are more limited treatment options. […] There is suspected immune deficiency – eg, mucocutaneous candidiasis. […] There is extensive disease. […] There are recurring candidal nail infections.

• #74 Nail fungus – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nail-fungus/symptoms-causes/syc-20353294

  Nail fungus can cause the nail to become thick, ragged and discolored. An infected nail may separate from the nail bed. […] If your nail fungus is painful and has caused thickened nails, self-care steps and medications may help. But even if treatment is successful, nail fungus often comes back. […] The following habits can help prevent nail fungus or reinfections and athlete’s foot, which can lead to nail fungus: Keep your nails clean and dry. Wash your hands and feet regularly. Wash your hands after touching an infected nail. Dry well, apply an antifungal foot powder and moisturize your nails. Consider applying a nail hardener, which might help strengthen nails and cuticles. […] If you have athlete’s foot, treat it with an antifungal product.

• #75

  https://bpac.org.nz/2025/fungal-nails.aspx

  Combination treatment may also be considered when antifungal-resistant dermatophyte strains or moulds are identified as the causative organism, to increase the likelihood of treatment success. […] Monitor treatment response as nail grows. Ideally review patients with fungal nail infections regularly (e.g. every three months). Treatment response can be assessed by regularly photographing the nail or making a groove with a scalpel at the proximal end of the infected area. […] Ongoing prophylaxis to reduce recurrence. Weekly or twice-weekly prophylactic application of a topical antifungal after successful treatment has been achieved can be beneficial for reducing the chances of onychomycosis recurrence in high-risk patients. […] Provide lifestyle advice to reduce recurrence. Up to one-quarter of patients treated for onychomycosis experience recurrence of infection.

• #76 Nail fungus – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nail-fungus/symptoms-causes/syc-20353294

  Nail fungus can cause the nail to become thick, ragged and discolored. An infected nail may separate from the nail bed. […] If your nail fungus is painful and has caused thickened nails, self-care steps and medications may help. But even if treatment is successful, nail fungus often comes back. […] The following habits can help prevent nail fungus or reinfections and athlete’s foot, which can lead to nail fungus: Keep your nails clean and dry. Wash your hands and feet regularly. Wash your hands after touching an infected nail. Dry well, apply an antifungal foot powder and moisturize your nails. Consider applying a nail hardener, which might help strengthen nails and cuticles. […] If you have athlete’s foot, treat it with an antifungal product.

• #77 Toenail infection | healthdirect

  https://www.healthdirect.gov.au/toenail-infection

  If you have paronychia, your doctor may prescribe you an antibiotic or antiviral medicine. It can help to soak your toes in warm water several times a day. […] You can help prevent getting toenail infection by: making sure your feet are clean and kept dry, keeping your toenails short, wearing clean cotton socks and changing them every day, wearing shoes that fit well and let air flow in, wearing footwear in public showers, not sharing nail scissors or shoes. […] Your pharmacist can give you advice to help you prevent or manage your toenail infections.

• #78 Nail fungal infection: Causes, treatment, and symptoms

  https://www.medicalnewstoday.com/articles/151952

  Other alternative medicines used to treat nail fungal infections include Australian tea tree oil, vinegar, listerine, and grapefruit seed extract. However, there is no scientific evidence supporting the use of these products. […] Patients with diabetes are susceptible to complications and should consult their doctor; however, fungal nail infections usually have a good prognosis if treated promptly. Although they are unpleasant or irritating, most nail fungal infections can be treated successfully without complications after treatment. The treatment can take a long time to fully cure the infection, and may require additional rounds of treatment. Complications in some extreme cases may include nail damage or permanent loss, or spread of the infection. There is also a small chance of developing cellulitis.

• #79 How to Stop Toenail Fungal Infections

  https://www.webmd.com/skin-problems-and-treatments/treat-toenail-fungus

  There’s a chance the infection can come back even if you get rid of it. So take these simple steps to help prevent that: Keep your feet clean and dry. Wear shower shoes on wet pool decks, in public bathrooms, and in locker rooms. Change your shoes and socks every day. […] Toenail fungus is a common condition and can take a long time to go away. Be patient and take the medication or cream your doctor prescribes for as long as is necessary. Home remedies are best paired with prescription medication for faster results. […] Nothing kills toenail fungus right away. It can take at least 6 months to as long as 18 months to see your nail return to normal. A prescription medication like terbinafine will work faster than a home remedy, but you’ll still need to take it for about 12 weeks. You can try OTC antifungal creams, gels, and nail polishes or home remedies like Vicks VapoRub or tea tree oil.

• #80

  https://bpac.org.nz/2025/fungal-nails.aspx

  Combination treatment may also be considered when antifungal-resistant dermatophyte strains or moulds are identified as the causative organism, to increase the likelihood of treatment success. […] Monitor treatment response as nail grows. Ideally review patients with fungal nail infections regularly (e.g. every three months). Treatment response can be assessed by regularly photographing the nail or making a groove with a scalpel at the proximal end of the infected area. […] Ongoing prophylaxis to reduce recurrence. Weekly or twice-weekly prophylactic application of a topical antifungal after successful treatment has been achieved can be beneficial for reducing the chances of onychomycosis recurrence in high-risk patients. […] Provide lifestyle advice to reduce recurrence. Up to one-quarter of patients treated for onychomycosis experience recurrence of infection.

• #81 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  Topical antifungal creams or powders may also be beneficial, especially in patients with concomitant tinea pedis. […] To improve treatment outcomes and prevent recurrence, patients should be counseled about proper foot hygiene. […] There may be a familial predisposition to some T. rubrum infections. In such instances, prophylactic treatment of family members can be considered.

• #82 Onychomycosis: Management – UpToDate

  https://www.uptodate.com/contents/onychomycosis-management

  Onychomycosis, fungal infection of the nail, can cause disfigurement of the nail, pain, and may increase risk for soft tissue bacterial infection in immunocompromised patients. Dermatophytes, particularly Trichophyton rubrum, are the most common causes of onychomycosis. Yeast (eg, Candida albicans) and nondermatophyte molds can also cause onychomycosis. […] Therapeutic options for onychomycosis include oral antifungal medications, topical antifungal medications, and physical interventions. Factors such as the causative organism, severity of nail involvement, treatment side effects, and patient preference influence treatment selection. […] Treatment of onychomycosis is not mandatory in all patients. We suggest treating onychomycosis in: Patients with a history of cellulitis of the lower extremity, especially if repeated, who have ipsilateral toenail onychomycosis.

• #83 Nail Fungus Treatment, Causes and Prevention

  https://dermatologyofct.com/what-we-do/medical-surgical-dermatology/nail-fungus-treatment-causes-and-prevention/

  Nail fungus treatment can be tricky but various remedies exist. Nail fungus medication that can be obtained without a prescription includes antifungal creams and gels found at most local pharmacies. Nail fungus treatment should begin at the first sign of infection. […] Your doctor can also prescribe an anti-fungal topical drug that goes on like nail polish or antifungal pills to treat your onychomycosis. In severe cases your doctor may opt to remove all or part of the toe nail and a new nail will grow in its place. […] If nail fungus becomes painful, it may indicate a severe infection that can permanently damage your nails. It may also lead to other serious infections that spread to other parts of you body should you have a suppressed immune system. If your nails appear to be infected and you are experiencing pain, see a doctor. Often, over the counter remedies will just not be strong enough and you’ll need a dermatologist’s care to prescribe an anti-fungal topical ointment which will help speed healing. […] Because nail fungus can lead to other complications, diabetics who suspect a fungal infection should see a doctor at the earliest sign.

• #84 Fungal nail infections | Healthify

  https://healthify.nz/health-a-z/f/fungal-nail-infections/

  Fungal nail infections are common and usually affect toenails more often than fingernails. […] Treatment for fungal nail infections is difficult and recurrence is very common. Options include antifungal nail paints that you apply to the nail or antifungal tablets or capsules. […] Most mild fungal nail infections are only a cosmetic issue, not medically serious and can safely be left untreated. […] See your pharmacist or doctor for treatment if: the nail/s are painful or they bother you; you are at risk of complications (such as cellulitis) from the infection, eg, if you have diabetes, peripheral vascular disease or connective tissue disorders. […] Fungal nail infections can be difficult to cure. The decision to treat usually depends only on how much it bothers you. If left untreated it probably wont go away, but it usually wont cause medical problems. Your doctor or pharmacist can talk to you about your treatment options. Treatment includes applying medication to the nail such as an antifungal paint or taking antifungal tablets or capsules.

• #85 Best Ways to Treat a Nail Fungus | University of Utah Health

  https://healthcare.utah.edu/the-scope/health-library/all/2020/08/best-ways-treat-nail-fungus

  The oral medications are more effective than topical treatments. […] The good news though is that the safety of most of these oral medications is very good. […] The primary concern is liver toxicity, because these medications are metabolized by the liver. […] I still will recommend appropriate monitoring. […] A lot of people use vinegar, tea tree oil. […] The hard part with any of these topical medicines is they don’t penetrate the nail unit very well. […] I think doing debridement at home is, actually, helpful. […] I use both medications, and sometimes I use them in combination. […] So it’s common. You can get the nail clear, and then people are just exposed to the fungus in their environment, in their shoes and so forth, and they can get reinfected easily. […] For some people, there could be other medical reasons to treat it. […] Right, yeah. Somebody with, you know, for example, diabetes who’s at risk of ulcerations on the feet, cellulitis infections, they are people that may be . . . they may be more proactive about treating to help reduce their risk of infections. […] That’s true.

• #86 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  The FDA-labeled dosage of itraconazole is 200 mg once daily taken continuously for 12 weeks to treat toenail infections and for six weeks to treat fingernail infections. […] Fluconazole is not currently labeled by the FDA for the treatment of onychomycosis, but early efficacy data are promising. […] Treatment guidelines for the newer antifungal medications are provided in the text. […] In addition to oral medications, some patients benefit from other treatments. […] Surgical or chemical nail avulsion may be useful in patients with severe onycholysis, extensive nail thickening or longitudinal streaks or spikes in the nail. […] Longer courses of antifungal therapy may be useful in patients whose nails grow slowly, who have diminished blood supply to the nail bed as a result of conditions such as peripheral vascular occlusion or diabetes mellitus, or who have total or nearly total nail plate involvement.

• #87 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Systemic therapy […] Systemic treatment is recommended if topical treatment fails or is contra-indicated. The slow growth of nails means that they do not appear normal even after effective treatment. […] If dermatophyte nail infection is confirmed: Terbinafine: Currently first-line with evidence of greater efficacy compared to itraconazole. […] Prescribe 250 mg once a day for between six weeks and three months for fingernails, and for three to six months for toenails. […] Advise the person that visible improvement may be seen after the end of two months of fingernail treatment and three months of toenail treatment. […] It is not licensed for use in children. […] There have been cases of severe idiosyncratic skin and hepatotoxic reactions. […] It interacts with rifampicin and cimetidine. […] Itraconazole: Should be offered if an alternative to terbinafine is indicated. […] Highly active against Candida spp. but much less so against dermatophytes. […] It can be given in a pulsed rather than continuous regimen. 200 mg twice a day for one week, with subsequent courses repeated after a further 21 days. […] Prescribe two pulses for fingernails and three pulses for toenails. […] It can cause hepatotoxicity and LFTs should be checked for treatment lasting longer than a month. […] It is contra-indicated in pregnancy and not licensed for use in children. […] It interacts with a wide variety of commonly used pharmaceutical agents, including warfarin, antihistamines, antipsychotics, digoxin, H2-receptor antagonists, some statins and phenytoin. […] If terbinafine and itraconazole are contra-indicated, consider using griseofulvin. […] Griseofulvin: May be used in adults and children. […] It is not expensive and there is a long experience of its use. […] It requires long duration of treatment (at least six months) and has low cure and high relapse rates. […] It interacts with warfarin, ciclosporin and the combined oral contraceptive pill (it is an hepatic enzyme inducer). […] Fluconazole is not licensed for this use and is not as effective as terbinafine or itraconazole. However, it may have a role in patients in whom other alternatives are not tolerated, have unacceptable dosage regimes or cause adverse effects.

• #88 Onychomycosis: Dermatophyte Infection of the Fingernails and Toenails

  https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/skin-soft-tissue/dermatophyte-infection-fingernail-or-toenail/

  Nail samples should be taken and treatment started if infection confirmed. […] For children seek specialist opinion. […] Topical treatments are limited to those specifically licensed for treatment of nail disease, other topical antifungals (e.g. creams) are not suitable as they do not penetrate the nail. […] Oral antifungal therapy is considered the gold standard for treatment of onychomycosis, however in cases where there are contraindications for systemic treatment, potential for drug-drug interactions or patient preference, then topical treatment may be considered. […] Topical treatment should only be used when less than 50% of the nail is affected and the infection has not spread to the nail matrix and/or lunula. […] 5% amorolfine nail lacquer: Apply once weekly. Fingernails: 6 months. Toenails: 9-12 months (review at 3 monthly intervals).

• #89 Who’s At Risk of Fungal Nail Infections in Children?

  https://www.footankleaz.com/blog/child/fungal-nail-infection-in-children/

  Toenail fungus in kids may not seem like a big deal at first. A little discoloration, maybe some thickening, but then it gets worse. The nail starts crumbling. Your child complains about discomfort. You wonder if it will spread. The good news? Early treatment can stop fungal nail infection in children. The bad news? Without care, it wont just go away. […] The sooner you catch it, the easier it is to apply nail fungus treatment in Mesa. […] Fungal nail infection in children can be stubborn, but the best nail fungus treatment in Gilbert works when used correctly. Here is a breakdown of the best approaches: […] Topical Antifungal Medications are usually the first choice and work for mild cases. They include creams, lotions, or medicated nail polish (like ciclopirox) which kill surface fungus. They are best for early infections before the nail thickens.

• #90 Who’s At Risk of Fungal Nail Infections in Children?

  https://www.footankleaz.com/blog/child/fungal-nail-infection-in-children/

  Oral Antifungal Medications like Terbinafine (Lamisil), Fluconazole (Diflucan) are for severe cases and when topicals dont work or fungus is deep under the nail. Consuming them requires doctor supervision due to possible side effects. […] Laser Therapy which is painless and effective. It kills fungus without medication and is quick, painless, and safe for kids. It is especially best for kids who cant take oral meds or dont respond to creams. […] Natural Home Remedies commonly support treatment. They include: […] Nail Removal is rare but necessary in severe cases. Doctors may remove part or all of the nail if the infection is painful or wont heal. It allows direct treatment of the nail bed. It is applied in extreme cases where nothing else works. […] Fungal nail infection in children is common but completely treatable with the right approach. Early detection makes treatment easier, so dont ignore changes in your childs nails. Keeping your childs feet clean, dry, and protected helps stop fungal infections before they start. Simple habits go a long way in keeping little feet healthy. If you notice discoloration, thickening, or brittleness in your childs nails, dont wait.

• #91 10 Home Remedies for Toenail Fungus

  https://www.healthline.com/health/home-remedies-for-toenail-fungus

  In most cases, toenail fungus is considered a cosmetic problem. Still, it may cause serious complications for some people. […] You shouldnt use home remedies for toenail fungus if you have diabetes or a weakened immune system. Contact your doctor for the appropriate course of action. […] Prescription oral antifungals, such as terbinafine (Lamisil) or fluconazole (Diflucan), are traditionally used to treat toenail fungus and will usually resolve it faster and more effectively. […] If you want to get rid of a toenail fungus quickly, you will likely need to see a doctor for prescription medication such as fluconazole (Diflucan). […] Home remedies may be more effective than prescription medications in treating mild-to-moderate toenail fungus. […] Home remedies may take longer to wipe out toenail fungus than topical prescription medications or oral systemic antifungals. […] Severe cases of toenail fungus may cause pain and irreversible toenail damage. If you try home remedies to treat the infection that doesnt work or causes side effects, consult your doctor.

• #92 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  In recent years, treatment outcomes in patients with onychomycosis have improved substantially, primarily because of the introduction of more effective oral antifungal medications. […] Current evidence supports the use of these newer agents as part of individualized treatment plans that consider patient profiles, nail characteristics, infecting organism(s), potential drug toxicities and interactions, and adjuvant treatments. […] Triazole and allylamine antifungal drugs have largely replaced griseofulvin and ketoconazole as first-line medications in the treatment of onychomycosis. […] Of the newer drugs, terbinafine (Lamisil) and itraconazole (Sporanox) are the most widely used, with fluconazole (Diflucan) rapidly gaining acceptance. […] These medications share characteristics that enhance their effectiveness: prompt penetration of the nail and nail bed, persistence in the nail for months after discontinuation of therapy and generally good safety profiles.

• #93

  https://bpac.org.nz/2025/fungal-nails.aspx

  Fungal nail infection (onychomycosis) is a common clinical problem, especially in older adults, and can significantly impact quality of life. Laboratory confirmation is recommended before initiating treatment. Both oral and topical antifungals are available for patients who wish to proceed with treatment; prescribing decisions are determined by severity of infection, co-morbidities, potential for medicines interactions and preference. […] Laboratory diagnosis of onychomycosis with microscopy and culture of nail clippings is recommended before starting oral or topical treatment. Microscopy results are usually available within a few days. However, culture can take up to four weeks to confirm the causative organism. […] Treatment may not be necessary for all patients and specific medicines may be inappropriate in some cases, e.g. patients with frailty, co-morbidities, taking multiple medicines or with limited mobility (to apply treatment to toenails).

• #94

  https://bpac.org.nz/2025/fungal-nails.aspx

  Antifungal treatment selection depends on the causative organism and patient factors: Oral terbinafine is first-line treatment for dermatophyte onychomycosis. Oral itraconazole is preferred for onychomycosis caused by candida infection. Topical amorolfine (funded) or ciclopirox (not funded) may be suitable for patients with superficial infection or infection confined to the distal nail plate and for those unable to take oral antifungals. […] Incomplete resolution is a common occurrence. Check adherence to the treatment regimen and consider antifungal resistance. Consider switching to a different oral antifungal, combination oral and topical treatment or discuss with a dermatologist or clinical microbiologist. […] Ensure the patient has realistic expectations regarding long-term outcomes. Successful antifungal treatment can take years and nail appearance may never completely return to normal.

• #95 Fungal Nail Infections: Causes and Treatment | Doctor

  https://patient.info/doctor/fungal-nail-infections-pro

  Fungal nail infection treatment and management […] There is no need to treat if the person is not worried about the appearance, there are no symptoms and no comorbidities which could increase the risk of complications. […] Patients should be given the information to make an informed decision based on: Even after successful treatment of the fungal infection, the nail may not look completely normal. […] Cure is not achieved in 20-40% of patients. […] Even in those in whom it is successful, nails may appear abnormal for over 12 months due to their slow growth. […] Relapse occurs in about 20-25% of people. […] Oral medication is taken for six weeks for fingernail infections and for three months for toenail infections. […] Topical treatments may need to be applied for up to 12 months. […] All medication has potential side-effects. […] However, anyone who presents should probably be offered treatment, as the condition is likely to be causing significant distress if it has brought them to consult. […] If the condition progresses, it can cause significant morbidity and functional disturbance, particularly in the elderly. […] There is also a public health argument for treating it, to lessen the reservoir of fungal spores in communal bathing areas, through reduction in the number of people with the condition.

• #96 Nail fungus: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/nail-fungus-treatment

  While there are many treatment options, none is ideal. Medicine applied to the nails has a low cure rate. Antifungal pills can cause side effects. Nail removal requires wound care. […] With treatment, many people can get rid of nail fungus. Even when the fungus clears, your nail(s) may look unhealthy until the infected nail grows out. […] To clear the fungus, its important to: Use the treatment exactly as prescribed, Apply (or take) the medicine for as long as prescribed, Keep all follow-up appointments with your dermatologist. […] Nail fungus can be stubborn. If you had a severe infection, its possible to clear the infection. A healthy looking nail, however, may be unrealistic, but you can expect the nail to look better and feel more comfortable.

• #97 Fungal nail infections | Healthify

  https://healthify.nz/health-a-z/f/fungal-nail-infections/

  Treatment with antifungals tablets or capsules is only successful for about 75% of people, and the use of antifungal paints is less effective. […] Even after successful treatment of the fungal infection, the nail may never look completely normal. […] There is a 1 in 4 chance that the fungal infection will come back. […] Treatment is often needed for several months. It can take up to 12 months to confirm successful treatment, due to the slow growth of the nail unit. […] Treatment is more likely to work with good hygiene practices. […] Antifungal tablets or capsules are more effective than paints, especially if the entire nail is infected or if the nail is thickened. […] Antifungal medicine is taken for 6 weeks for fungal infections of the fingernail and for 3 months for fungal infections of the toenail. […] When nails are very thick it can be difficult to cut them and this can cause pain with walking. Reducing the thickness can help with these symptoms. […] Laser treatment is less effective than the paints and oral medications.

• #98 Treating Onychomycosis | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0215/p663.html

  Onychomycosis accounts for one third of fungal skin infections. […] Newer, more effective antifungal agents have made treating onychomycosis easier. Terbinafine and itraconazole are the therapeutic agents of choice. […] Continuous oral terbinafine therapy is most effective against dermatophytes, which are responsible for the majority of onychomycosis cases. […] Intermittent pulse dosing with itraconazole is as safe and effective as short-term continuous therapy but more economical and convenient. […] With careful monitoring, patients treated with the newer antifungal agents have a good chance of achieving relief from onychomycosis and its complications. […] The U.S. Food and Drug Administration (FDA) has labeled ciclopirox (Penlac) nail lacquer for the treatment of mild to moderate onychomycosis caused by T. rubrum without involvement of the lunula.

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