The best treatment for fungal nail infections depends on the severity of the infection and the underlying cause. Your healthcare provider will consider several factors and then recommend 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. Some treatment options include:
Medications: Your health care provider may prescribe antifungal drugs that you take by mouth (orally) or apply to the nail.
- Oral antifungal drugs. These medications are taken by mouth and are typically reserved for more severe cases of fungal nail infections. One option is itraconazole (Sporanox). 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. Treatment success rates with these drugs appear to be lower in adults over age 65. Oral antifungal drugs may cause side effects such as rash and liver damage. Or they may interfere with other prescription drugs. You may need occasional blood tests to check on how you’re doing with these types of drugs. Health care providers may not recommend oral antifungal drugs for people with liver disease or congestive heart failure or those taking certain medications.
Topical antifungal medications: These medications are applied directly to the affected nail and surrounding skin. They may be available in the form of creams, ointments, or nail lacquers.
- Medicated nail polish. Your health care provider may prescribe an antifungal nail polish called ciclopirox (Penlac). You paint it on your infected nails and surrounding skin once a day. After seven days, you wipe the piled-on layers clean with alcohol and begin fresh applications. You may need to use this type of nail polish daily for almost a year.
- Medicated nail cream. Your health care provider may prescribe an antifungal cream, such as efinaconazole (Jublia) and tavaborole (Kerydin). You rub this product into your infected nails after soaking. These creams may work better if you first thin the nails. This helps the medication get through the hard nail surface to the underlying fungus.To thin nails, you apply a nonprescription lotion containing urea. Or your health care provider may thin the surface of the nail (debride) with a file or other tool.Antifungal nail creams may cause side effects such as rash.
Laser therapy: This treatment uses a focused laser beam to penetrate the nail and kill the fungus.
Surgical nail removal: In severe cases, a healthcare professional may recommend removing the affected nail surgically.
It is important to note that fungal nail infections can take a long time to clear up completely. It may take several months of treatment to fully eliminate the infection. In addition to treatment, it is also important to practice good foot hygiene, such as keeping your feet clean and dry, wearing clean socks and shoes, and avoiding walking barefoot in public areas.