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5 Nail Fungus Treatment Options: Prescription, Over-the-Counter, and Procedures

What are your options when it comes to treating a nail fungus? Learn the basics about the 5 top treatments.

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Treating a nail fungus can be tricky. Depending on the severity of the condition and what other conditions you have, you may need prescription therapies in order to fully clear the infection.

Even with prescription treatments, due to the slow-growing nature of toenails, you may need to continue the use of the medication for months to over a year until a full non-infected nail can grow in.

Below, we will cover the 5 basic treatment options when it comes to a toenail fungus. Some of these options may be appropriate for some people but not for others. With a toenail fungus, it is always a good idea to speak with a doctor in person or online about which treatment options are a good fit for your fungus severity.

1. Over-the-counter creams, solutions, and polishes

There is a wide range of antifungal medications available over the counter in the form of creams, solutions, polishes, sprays, or powders. These are normally indicated for fungal infections like ringworm, athlete’s foot, and jock itch. But, if the toenail fungus situation is mild enough, some people find relief from these over-the-counter antifungal ingredients.

  • Undecylenic Acid
  • Tolnaftate
  • Clotrimazole
  • Terbinafine

However, these over-the-counter options may lack the ability to penetrate down into the tough toenails, even if they do have antifungal abilities. If you aren’t seeing improvements after a few weeks of treatment with over-the-counter options or your toenail fungus is getting worse, it is a good idea to speak with a doctor about prescription treatments.

If you have diabetes or conditions that affect your immune system, toenail fungus can be riskier and should be addressed with a doctor right off the bat.

2. Prescription topical fungus creams and solutions

There are also topical prescription medications that may be prescribed to you in order to help clear a toenail fungus. These may contain ingredients that are not available over the counter, be compounded to contain multiple ingredients, or have additional ingredients meant to drive the medication through the tough nail to the infection site.

Prescription topical medications may include the following ingredients:

  • Ciclopirox
  • Amorolfine
  • Efinaconazole
  • Tavaborole

Compounded topical medications may include a mix of antifungal agents along with ingredients to help drive the medication under the nail.

Our topical prescription nail fungus formulation combines Ketoconazole, Terbinafine, Hydrocortisone, Biotin, and DMSO for a powerful combination nail fungus formula. You can have a free online consultation with our doctors to see if this is a good fit for you. If you are a good candidate for treatment, your prescription nail formula can be shipped to your front door with our free shipping.

These prescription topical medications are normally considered as the second step for people who have already tried the over-the-counter toenail fungus options and need something stronger, but don’t want to use or can’t use oral antifungals.

3. Prescription oral medications

Oral prescription medications are normally the first-line treatment for people with severe toenail infections who want quicker results. These medications are taken by mouth normally once daily or once a week and are typically continued for 6-12 weeks. 

  • Terbinafine
  • Itraconazole

After the treatment period is over, you may still see the toenail fungus and it may not be fully gone until the healthy nail has regrown in. This may take between 4 months for fingernails, and up to over 1 year for toenails.

However, oral antifungal medications may not be right for everyone. People with liver disease, congestive heart failure, or those on certain medications may not be able to tolerate these oral medications and may need to use other alternatives. Your doctor may ask for blood tests periodically while you are on these medications to make sure you are handling them well, and side effects like skin rashes or liver problems are possible.

4. At-home remedies like vinegar or Vaporub

Some people may want to try at-home methods for clearing their toenail fungus. And, while these treatment benefits are mainly anecdotal, if you have a mild case and you are not a high-risk toenail fungus patient like people with diabetes, some of these may be ok to try.

Vinegar and tea tree oil applications or soaks may have antifungal effects, and some may see benefits in using these on their toenail fungus.

Some people also like trying Vaporub on a toenail fungus. One small-scale study showed a positive effect on nail fungus after patients used Vaporub on the affected areas for 48 weeks.

If improvement is not seen with these methods or the fungal infection gets worse, it is likely time to speak with your doctor about prescription options. If you have diabetes or a weakened immune system, or your toenail fungus is severe, it is best to skip these at-home treatments and get professional treatment first.

5. Toenail removal procedures

The removal of the affected toenail(s) is often the last resort when it comes to toenail fungus treatment options. This is normally an in-office procedure when a doctor will numb your toe and then remove the affected nails to better access and clear the fungus underneath. 

If the nail bed is left intact, a new nail will grow out, but sometimes the nail bed is removed in order to stop the regrowth of the nail. 

Permanent nail removal may be chosen when the infection is particularly bad, extremely painful, or keeps recurring.

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