Top 7 nail fungus treatments in 2023 (2023)

Toenail fungus is a common fungal disease that often begins after a foot rash has spread to the nails. When mild, it looks like white and yellow patches that grow under the nail bed. If left untreated, the fungus can harden the nail and spread to other fingers.

"The more severe the toenail fungus, the thicker the toenail, and the more toenails affected, the more difficult it is to treat the toenails even with effective therapies," says Dr. Shari Lipner, board-certified dermatologist at New York-Presbyterian Hospital. /Weill Cornell Medicine Mushroom often starts in a moldhealthy footbetween the toes or on the soles of the feet. At this stage, the fungal infection is easier to treat with over-the-counter medications, which include onychomycosis medications. In addition to understanding the stage and severity of onychomycosis when purchasing medications, you should carefully evaluate the ingredients and type of onychomycosis treatment based on its location.

We've researched dozens of toenail fungus treatments and rated them based on the following attributes: price, drug form, ingredients, and treatment area. We also had a dermatologist from oursCouncil of medical expertsreview the content of this article for medical accuracy regarding the progression of onychomycosis and what you need to know about how to treat it.

What to look for in the treatment of nail fungus

Seriousness

Onychomycosis, if left untreated, can become a difficult problem to treat and will greatly affect what medication you will need. In fact, it's best not to wait until the problem becomes serious before starting treatment, especially if you hope to stick with OTC products.

"Onychomycosis is very difficult to treat, and even under the supervision of a dermatologist, it is not always possible to get rid of it," says Californian dermatologist Caren Campbell, MD. "Given how difficult treatment is, it's best to see a dermatologist as soon as possible to avoid getting worse."

Moreover, the fungus can spread to other nails and other areas of the body, adds Dr. Campbell, which is another reason why early treatment is ideal. If you notice that the fungus is spreading or your toenails have become thick and yellow, you may need a prescription product or seek help from a certified dermatologist.

Place

dr. Lipner says onychomycosis begins like athlete's foot: "It starts with a rash on the foot and spreads to the nails," she says.

Since athlete's foot treatment is different from nail fungus treatment, attention should be paid to where on the foot the problem occurs. Athlete's foot can be treated with over-the-counter anti-fungal ointments, sprays, and powders, but if the fungus has made its way under the nail or surrounding skin, says Dr. Campbell, treatment should focus on topical creams, ointments, and pastes. , ororal medications.

Ingredients

Zinc undecylenate and undecylenic acid are FDA-approved ingredients for the treatment of onychomycosis.Also, if you seek help from a dermatologist, they will likely prescribe medications in the "azole" family. "The compound interferes with the synthesis of the fungus cell membrane," says Dr. Lipner, which essentially kills the fungus.

One common azole medication used to treat onychomycosis is Jublia (efinaconazole). Other commonly prescribed medications include the active ingredient terbinafine, which is usually prescribed as oral or topical lamisil.

Tip

Treatment of onychomycosis can take many forms, but oral, topical and homeopathic remedies are the most common.

Oral medications

Oral medications have been shown to be effective, but take time to work.

"Lamisil also has the lowest side effect profile of the oral antifungals and acts as a fungicide that destroys the fungus by blocking its ability to 'breathe' or produce the oxygen molecules it needs to survive," says Orit Markowitz, MD, founder and director of OptiSkin Treatment Center in New York.

But there are a few conditions that can make people ineligible for oral antifungals. The same comorbidities, including chronic kidney failure (with dialysis) and kidney transplantation, immunodeficiency, diabetes, cancer, and peripheral arterial disease that make someone more susceptible to toenail fungus also increase the risk of adverse drug reactions . Talk to your doctor to make sure you can safely take oral antifungal medications.

However, if you qualify for oral medications, you can take a multi-pronged approach: "I prefer oral and topical medications if patients really want a chance of recovery because onychomycosis is so difficult to treat," she says. Doctor Campbell.

You can also opt for oral medication if more than one nail is affected.

"[You] can use [Lamisil] if multiple nails are involved," says Michelle Henry, MD, founder of Skin & Aesthetics Surgery in Manhattan, "because oral treatment is much more effective at removing the fungus."

Local medicines

Topical treatments(such as amorolfine and ciclopirox) can help treat minor onychomycosis. They cause fewer and less serious side effects. However, it is difficult for them to penetrate the nail plate, which makes the treatment longer and the effectiveness low.

"Azole antifungals, such as Jublia, inhibit fungal elements involved in the biosynthesis of key fungal elements, such as fungal cell membranes," says Dr. Markowitz. He adds that "topical therapies can be effective, but require lengthy and costly regimens with no established method of predicting outcomes." This could mean daily topical treatment for 52 weeks.

Natural/homeopathic remedies

Natural preventive measures can be effective, but when fungus occurs, a research-backed, FDA-approved oral antifungal is the best choice. Garlic has antifungal properties, and when used in a foot bath, it can bring relief.

"Given that prescription topical medications require at least a year of daily use to work in only two-thirds of mild to moderate cases, it's hard to recommend a natural over-the-counter treatment," says Dr. Markowitz.

You can also try tea tree oil in combination with other, more traditional treatments, says Dr. Henry, and even with white vinegar: "I often recommend a white vinegar soak: patients [put] a quarter cup of white vinegar in a bowl and soak the nail. Once or twice a day."

Full recovery may take up to 18 months; while you wait, Dr. Campbell suggests washing your socks in hot water to prevent reinfection and using anti-fungal powders such as Zeosorb in your shoes. Keep in mind that 20 to 25 percent of treated patients do not recover from fungal nail infections.

"I always advise patients that even oral medications work [only] about 60% of the time, so it's often a chronic condition," Dr. Campbell says.

Below you will find the best nail fungus remedies available on the market today.

as we chose

To find the best cure for toenail fungus, we asked four dermatologists to tell us what to look for when choosing a product - and how to know when you need to step up your game and go for something heavy with a prescription. The experts we spoke to include:

• Shari Lipner, MD, certificirani dermatolog w New York-Presbyterian Hospital/Weill Cornell Medicine
• Orita Markowitz, MD, founder and CEO of OptiSkin Treatment Center in New York City
• Michael Henry, MD, founder of Skin & Aesthetics Surgery in Manhattan
• Caren Campbell, MD, a California dermatologist

They suggested a combination of oral and topical medications, especially those containing antifungal ingredients such as zinc undecylenate, terbinafine, and efinaconazole.

Armed with this information, we scoured the Internet for the highest-rated OTC drugs that make it easier to fight nail fungus (since it can takebloodtime, so you need something comfortable!). We also looked for products that hit the fungus hard at the source, such as creams and polishes, as well as soothing ones, such as healing soaks and scrubs, to keep the rest of your feet healthy while you work to revitalize your nails.

What the experts say

“The most common manifestation of toenail fungus is a white-yellow discoloration of the nail, which is thick and filled with yellow-white keratin debris. The more severe the toenail fungus, the thicker the nail and the more affected nails, the more difficult it is to treat the toenails even with effective therapies.”— Dr. Orit Markowitz MD, founder and CEO of OptiSkin Treatment Center in New York

Why you should trust Verywell Health

As an experienced health writer,Danielle Zoellnerknows how important it is to find the right product for your medical needs. Throughout her career, Danielle has interviewed various medical and health experts, reviewing dozens of products. Her experience and field knowledge combine to help readers like you find the best products for your everyday life.

Additional accounts of the story were written by Jennifer Nied and Sarah Bradley

over 10 years,Jennifer Niedhas reviewed products, interviewed experts, analyzed ingredients and studied scientific research, and claims to help readers like you understand what works under certain conditions. Each product in this section has been selected based on physician recommendations, published research, and real customer reviews.

Sarah Bradleyhas been writing health content since 2017, from product reviews and disease FAQs to nutrition explanations and food trends. She knows the importance of getting sound, expert-approved advice on over-the-counter products that deal with everyday health issues, from gastrointestinal issues and allergies to chronic headaches and joint pain.