Onychomycosis(toenail fungus) is a problem that affects millions of people worldwide. Onychomycosis can be mild, causing only cosmetic concerns. For some people, however, changes in the nail structure can cause pain and even lead to a secondarybacterial infection.
This photo contains content that some people may find graphic or disturbing.See Photozlisjak / Getty Images
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
This article explores the different topical medications and procedures that can help treat onychomycosis, either on their own or with aid of oral antifungal drugs.
Diagnosing Onychomycosis
If you havetoenail fungus, it is always a good idea to see a foot specialist known as apodiatristto have your nails evaluated. This can help identify the most effectivetreatments.
The diagnosis typically involves a nail clipping or abiopsyof the nail and nail bed. The nail sample is then sent to the lab to be cultured, examined under the microscope, and/or exposed to potassium hydroxide (known as a KOH test) to determine if the cause is fungal.
One of the main reasons why nail treatments fail is treating a bacterial nail infection as a fungal one. By working with a podiatrist, you will be able to determine whether it is bacterial or fungal, and potentially identify which strain of fungus you have.
Early-Stage Toenail Fungus Symptoms and Treatment
Prescription Antifungals
One of the more frequently prescribed topical antifungals is Penlac (ciclopirox). This is a brush-on lacquer applied to the nail, usually over the course of months. Penlac is recommended for mild to moderate cases of onychomycosis in which the infection has not spread to the nail’s growth center (known as the matrix).
It is important to note that Penlac only targets certain types of fungi (including the main form known asTrichophyton rubrum). It is less effective in controlling drug-resistant fungal strains.
Research has shown that fewer than 12% of Penlac users have partial or complete clearance of symptoms.Because of this, most doctors will combine Penlac with other forms of antifungal therapy, including oral antifungals like Diflucan (fluconazole) or Lamisil (terbinafine),
Children tend to respond to topical nail treatments better than adults because their nails are thinner and more porous.
Nail Debridement
Studies have shown that debridement with a urea-based topical agent can significantly improve the symptoms of onychomycosis after one to two weeks.
While applying urea, you will need to keep the nail covered with a water-tight bandage (known as an occlusion dressing). This helps ensure that the urea penetrates the nail and doesn’t rub off.
Over-the-Counter Treatments
There are plenty of over-the-counter (OTC) topical antifungals on drugstore shelves, most of which promise more than they deliver. If you haveespecially thick nailsor advanced signs of fungal infection (such as discoloration and texture changes), these drugs are unlikely to be beneficial no matter how long you use them.
However, if you have mild onychomycosis limited to the ends of the nail, OTC products like Lamisil (terbinafine) cream may provide relief in conjunction with regular debridement. The cost of generic Lamisil cream is around $12 for a 0.46-ounce tube.
Home Remedies
Severalhome remedieshave been popularized as nail fungus cures. These include tea tree oil, coconut oil, and Vicks VapoRub. Each has antifungal properties and an oily texture, which promotes easy absorption.
Tea Tree Oil
While clinical evidence remains sparse, a small study concluded that 100%Melaleuca alternifolia(tea tree) oilwas as effective in treating nail fungus as 1%clotrimazoleantifungal ointment. Around 50% of the tea tree oil users reported improvement, although the rate of recurrence was high.
Coconut Oil
Coconut oil contains caprylic acid and capric acid which some people claim can clear all types of nail fungus. While there is little evidence to support the claims, research shown has shown that capric acid can suppressCandida albicans(the fungus linked to yeast infections) in the test tube.
Whether it can do the same with an especially hearty fungus such asTrichophyton rubrumis doubtful.
Vicks VapoRub
A small study involving Vicks VapoRub showed promising results in people with onychomycosis. After 48 weeks, 10 of the 18 participants achieved partial clearance of their symptoms, while five achieved complete clearance.
A 2016 study echoed these results in people with HIV. However, the results were typically short-lived, with most experiencing recurrence within a year.
Keep in mind that home remedies lack rigorous testing. Further trials are needed before any can be recommended.
Summary
Onychomycosis is a fungal nail infection. The infection is notoriously difficult to treat and typically requires a podiatrist to select the best treatment options. Topical medicines are one such option, particularly if you are averse to pills. However, topicals are not the best modality of treatment for onychomycosis.
They include over-the-counter topical antifungals like Lamisil, prescription topical antifungals like Jublia and Penlac, and home remedies like tea tree oil. coconut oil, and Vicks VapoRub. To aid with treatment, your doctor may recommend monthly nail debridement to thin the nail and allow for deeper penetration of the medicine.
Frequently Asked Questions
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In some cases, laser treatments can completely cure toenail fungus. Results vary, with cure rates running anywhere from 30% to 61%.It can take around four months of consistent treatment to see significant improvement or full recovery.Learn MoreHow Lasers Treat Toenail Fungus
In some cases, laser treatments can completely cure toenail fungus. Results vary, with cure rates running anywhere from 30% to 61%.It can take around four months of consistent treatment to see significant improvement or full recovery.
Learn MoreHow Lasers Treat Toenail Fungus
10 Sources
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