What is the treatment for fungal nails?
Keeping nails trimmed and filed can help to reduce the amount of fungus in the nails and is highly recommended. This also provides pain relief when thickened nails cause pressure-related pain.
Creams and other topical medications have traditionally been less effective against nail fungus than oral medications. This is because nails are too hard for external applications to penetrate. It is also cumbersome to adhere to topical medication regimens. Oftentimes, these medications require daily applications for a period of time up to one year to see results. One of the major advantages of topical treatment is the minimal risk for serious side effects and drug interactions compared to oral therapy.
Prescription topical medications for fungal nails include the following:
Ciclopirox (Penlac) topical solution 8% is a medical nail lacquer that 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. The medication is applied to affected nails once daily for up to one year. The lacquer must be wiped clean with alcohol once a week. There is some evidence that using an antifungal nail lacquer containing amorolfine can prevent reinfection after a cure, with a success rate of about 70%. However, this drug is currently unavailable in the United States.
Efinaconazole (Jublia) is a medication that was approved in 2014. It is a topical (applied to the skin) antifungal used for the local treatment of toenail fungus due to two most common fungal species affecting nails (Trichophyton rubrum and Trichophyton mentagrophytes). Once-daily application is required for 48 weeks. The most common side effects of Jublia are ingrown toenails and application site dermatitis and pain.
Tavaborole (Kerydin) is another new medication that is indicated for onychomycosis of the toenails. This medicine has the same indication as efinaconazole. It also requires application once daily for 48 weeks. Common side effects of Kerydin are similar to those of Jublia.