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What's the Treatment for a Fungal Nail Infection?

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

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

Antifungals. Your local drugstore has antifungal creams and lotions you can try. They’re not expensive, but often they’re not strong enough to get rid of the fungus. Sometimes, an infection treated this way will clear up for a while, then come back. If that happens, you’ll need to try something else.

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

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

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

Listerine or vinegar. Some report soaking the affected nail(s) in Listerine or vinegar for 5 minutes a day to dry out the affected nails.

photo of fungal toenail infection

No. You may be able to scrape a bit off the top of or from under your nails, but that won’t cure the infection.

Anytime you think you have a fungal nail infection or any nail problem, and treating it at home doesn’t help, see your doctor or podiatrist (foot doctor). The sooner you go, the sooner your doctor can help.

Fungal nail infections can get worse over time. See your doctor ASAP if your nail has turned brown or black, if it suddenly hurts, or if it pulls away from the nail bed.

If you have diabetes and you notice that the look of your toenails has changed even a little, see your doctor right away to keep the problem from getting worse.

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

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

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

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

  • Ciclopirox (Ciclodan, Penlac, Loprox)
  • Efinaconazole (Jublia)
  • Naftifine (Naftin)
  • Tavaborole (Kerydin)
  • Terbinafine (Lamisil)

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

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

These pills are not usually given to people with liver disease or heart problems. They may interact with other medicines you’re taking, such as antidepressants and beta-blockers. 

Laser treatment. High doses of light may help destroy stubborn fungus. This treatment is fairly new. We need more studies to know how well it works. Laser treatments are also costly and usually not covered by insurance.

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

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

The best thing to do is avoid getting nail fungus in the first place. It’s worth the extra bit of time and effort to keep them fungus-free. Follow these steps:

  • Keep your hands and feet clean and dry.
  • Keep your nails trimmed short and cut your toenails straight across.
  • Don’t walk barefoot in locker rooms or on pool decks.
  • Change your socks and shoes when your feet get sweaty.
  • Have more than one pair of sneakers so your sweaty pair can dry out before you wear them again.

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