How Do You Treat Fungus on Your Toe? 6 Treatment Options

1. Prescription oral antifungals
   • Generally prescribed for 6 to 12 weeks
   • Examples include:
     • Lamisil (terbinafine)
     • Diflucan (fluconazole)
     • Sporanox (itraconazole)
     • Effective but may cause side effects, ranging from upset stomach and dizziness to severe skin problems and jaundice
     • Must be only taken as and when prescribed by a qualified medical professional
2. Topical medications
   • Most effective when paired with oral medications
   • The FDA has approved the following medicines to be applied to the nail to treat nail fungus:
     • Amorolfine
     • Ciclopirox
     • Efinaconazole
     • Tavaborole
   • Possible side effects include redness and swelling, an ingrown toenail, and stinging or burning when the medicine is applied
3. Nonprescription options
   • Certain antifungal creams, gels, and nail polish are available without a prescription.
   • Though studies report mixed results, home remedies such as a menthol rub, tea tree oil, or snakeroot extract, may be beneficial.
4. Medicated nail polish
   • Your doctor may prescribe an antifungal nail polish called Penlac (ciclopirox)
   • Infected nails and surrounding skin should be painted once a day for almost a year
5. Laser treatment
   • A high-tech laser beam is directed at the affected toenail to treat the fungus
   • Cure rates for laser treatment are lower than for oral and topical medications
6. Nail removal
   • In cases of severe infection or if other treatments do not seem to work, your dermatologist may recommend removing the nail to get rid of the infection.
   • Nail removal can be surgical or nonsurgical (chemical is applied to the nail)

Fungal nail infections usually affect toenails but can affect fingernails as well

Toenail fungus occurs when fungi infect the space between the toenail and toenail bed (tissue underneath the toenail) through a crack or cut in the toe. Fungal toenail infection or tinea unguium can change the appearance of the nails, making them look:

• Thick
• Brittle
• White, yellow, or brown
• Chalky or cloudy in some spots
• Cracks or breaks in one or more spots

Toenail fungus can spread to:

• Other toenails
• The skin between the toes (athlete’s foot)
• Groin area (jock itch)
• Scalp

Tinea unguium or onychomycosis is a type of infection that primarily targets the toenails and is caused by a dermatophyte, a type of mold. Dermatophytes are responsible for 90% of all toenail fungal infections.

Dermatophytes are microorganisms that need a protein called keratin to grow and thrive. Keratin is the predominant structural material of nails that makes them hard. 

Different types of toenail fungus are contagious. You can get it from someone else through direct contact or by touching an infected surface. You can get toenail fungus by:

• Walking around the swimming pools
• Using a public locker room or shower
• Walking barefoot in a public area

The fungi usually infect a nail by getting into one of the following:

• Small cuts in the skin surrounding the nail
• Crack in the nail
• Space between the nail and toe

Although toenail fungus can affect anyone, certain risk factors can increase the chances of developing the condition:

• Older age, especially older than 60 years
• Family history of nail infections
• Tinea pedis (athlete’s foot)
• Nail injury
• Diabetes
• Hyperhidrosis (a disorder characterized by increased sweating)
• Psoriasis
• Poor blood circulation due to peripheral vascular disease
• History of receiving an organ transplant
• Weakened immune system, such as from an autoimmune disorder or HIV

Your doctor will examine the affected toenail to evaluate your symptoms and detect the presence of toenail fungus. To confirm a diagnosis, they may order certain tests:

• Tissue samples may be taken from underneath the nail to visualize the cells under a microscope
• Scraping can be sent to see if the fungus grows out of the culture to identify the type of fungus

Fungal nail infections develop when the feet are constantly warm and damp. Steps you can take to help prevent toenail fungus include the following:

• Keep your feet clean and dry
• Wear clean socks every day
• Avoid wearing shoes that make your feet hot and sweaty
• Avoid going barefoot in communal areas, such as public showers, locker rooms, and swimming pools
• Do not tear or rip your toenails
• Soak your toenails in warm water before cutting them to avoid trauma due to accidental or aggressive clipping
• Clean your nail trimmer before using it
• Do not share towels, shoes, nail clippers or scissors
• If you have diabetes, follow all foot care recommendations from your doctor
• Treat the athlete's foot as soon as possible to stop it from spreading to the nails