Fungal Nails (cont.)
Allison Harvey, MD, FACEP
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
How is nail fungus treated?
Keeping nails trimmed and filed can help to reduce that amount of fungus in the nails and is highly recommended. A podiatrist or dermatologist may shave the top layer of the nail off or even remove part of the nail.
Creams and other topical medications have traditionally been less effective against nail fungus that oral medications. This is because nails are too hard for external applications to penetrate. A medicated nail lacquer, ciclopirox (Penlac) topical solution 8%, has been approved to treat finger or toenail fungus that does not involve the white portion of the nail (lunula) in people with normal immune systems. It only works about 7% of the time. There is some evidence that using an antifungal nail lacquer containing amorlfine can prevent reinfection after a cure, with a success rate of about 70%.
Efinaconazole (Jublia) is a medication approved in 2014. It is a topical (applied to the skin) antifungal used for the local treatment of fungal infections of the toenails. Daily application is required for 48 weeks.
Tavaborole (Kerydin) is another new medication that is indicated for onychomycosis of the toenails due to Trichophyton rubrum or Trichophyton mentagrophytes. Daily use for 48 weeks is also required.
Oral antifungal therapy works about 50% of the time. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back about 20%-50% of the time.
Oral medications that are effective against nail fungus include:
There are several innovative treatments that are still being tested:
Vinegar is a commonly recommended home remedy. Its effectiveness is highly doubtful. Some people apply various oils and other tonics to their nails as well.
Medically Reviewed by a Doctor on 3/16/2015
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