
Unfortunately, scientific evidence doesn’t show that home remedies like foot soaks work well to treat toenail fungus.
Thick, yellow, crumbling nails aren’t what you want to see when you look at your feet.
At best, toenail fungus is embarrassing. At worst, it can create entry points for worse infections leading to hospitalization or sores that heal poorly in diabetic skin. Many people who experience fungal nail infection want to know if it’s harmful and what can be done to prevent and treat it.
Fungus is all around us
“The fungi and environmental molds that infect nails are literally everywhere we walk,” said Dr. Erik Stratman, a Marshfield Clinic dermatologist. “They are in floors, carpets, showers, pools, soils and our footwear. It is impossible to avoid.”
Because fungus rarely causes symptoms and doesn’t kill the host, it can survive and even thrive under the nails.
Big toenails are the most commonly affected nails. You’ll notice yellowish-white thickening of the nail plate with crumbly, chalky-to-pasty debris under the end of the nail. The nail often is lifted off the skin underneath.
The older a person gets, the more likely he or she is to have toenail fungus. By age 80, there is an 80 percent chance that patient has nail fungus.
Toenail fungus usually starts with athlete’s foot
“Most patients begin with athlete’s foot, which is often an asymptomatic scaling on the bottoms of the feet and between the toes,” Stratman said. “If left untreated, the athlete’s foot infection can spread to affect under the nails.”
Treating athlete’s foot with antifungal powders, creams and sprays can hinder the fungus from affecting toenails. Once nails are infected, treating the athlete’s foot infection later can be temporary. The much more stubborn nail infection will reinfect the skin of the feet, especially between the toes.
Avoiding small, repetitive traumas to the toenails can prevent the nail plate from lifting and allowing fungus to move under the nails.
Prescription medication is the best treatment
Some people swear by the curing ability of Vicks VapoRub or hope that home remedies like vinegar soaks or applying essential oils or cooking oils to the nails will rid their feet of fungus. Unfortunately, scientific evidence doesn’t show that home remedies reliably work.
Medicated over-the-counter powders, creams and sprays don’t work much better. They do a lousy job of penetrating the nail plate and killing fungus, Stratman said. Even new topical prescriptions like medicated nail polish can be expensive and only cure nail fungus 50 percent of the time or less.
If you desire treatment for your toenail fungus, a 12-week course of oral terbinafine often is effective. It remains the mainstay of therapy for fungal infections.
“Previous concerns about risks of serious liver injury from terbinafine have been debunked,” Stratman said. “The true risk is minuscule. Terbinafine has very low rates of dangerous side effects, to the point that blood work monitoring isn’t needed for asymptomatic, otherwise healthy individuals.”
You may be able to regrow a healthy nail if fungal infection is caught and treated early. You must prepare to be patient, though. Even if the medicine works to kill your fungus, it will take the average toenail about 12 months to grow out and look normal again.
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What your nails reveal about your health
I took oral medication for my toenail fungus without any luck. On it for 6 months. No side effects either it just seemed to do nothing. Now I've been clipping the nail as short as possible and applying iodine but I'm not sure what else to try. It doesn't go away. Had it since I was 20 and I'm 26 now.
Can you change the spelling of miniscule to minuscule in the discussion of risk? Other than that, an important article. Thanks.
Hello Carol,
Thank you for letting us know about the spelling error. We have corrected it and are glad you enjoyed the article.
Thanks for reading Shine365!
Jake
I have tried 2 perscription pills that both started to work within a 2 week period. I have tried everything else out there and nothing has worked on this severe infection. The problem is I got hives very quickly from the pills. Is there anything I can do to take them and keep and keep allergic reactions to a minimal?
Hi, Anne. I think this question is best for your doctor who is familiar with your medical history, current medications and any other allergies you might have.
Or, you can request an appointment with our dermatology team: https://marshfieldclinic.org/Specialties/dermatology
Best wishes. -Kirstie
I'm at a loss.I've had my nails tested for fungus by an md and each time the tests came back negative and I couldn't get any thing prescribed due to negatve test results. The md advised it is what it is and to get pedicures. Most of my toenails have what i thought was a fungus and now its out of control. I don't what to do at this point and now one nail is getting painful. Any advise would be very appreciated.
Does the Terbinafine cause headaches or other side effects?
Hi, Brenda. There can be side effects of taking Terbinafine. Consult with your doctor or pharmacist for specifics.
Thank you for reading Shine365. -Kirstie
My toenails have been thickening over the years (I'm now 75). I've tried the prescription for fungus. Is there another cause for thickening of the toenails? If so, what can be done for them……other than trying to file them down from the top?
Hi, Darlene. This post may answer both of your questions: https://shine365.marshfieldclinic.org/wellness/what-your-nails-reveal-about-your-health/
You might also consider consulting a dermatologist: https://marshfieldclinic.org/Specialties/dermatology
I hope that helps. Please let me know if you have additional questions, and thank you for reading Shine365. -Kirstie
I was treated for this about 10 years ago with terbinafine. Can I be treated again?
Hi, Mary. We cannot provide individualized medical advice on this forum. It's best to bring this question to your provider who is familiar with your care history.
Thank you for reading Shine365. -Kirstie
Do I need a prescription to get this product?
Hi, Rosalie. Thank you for reading Shine365. Yes, oral terbinafine is prescription medication. -Kirstie
Thank you.
My pleasure, Rosalie. -Kirstie