Fungal nail infection - Treatment 

Treating a fungal nail infection 

Look after your feet

Your feet take the weight of your whole body, so foot problems can quickly lead to knee, hip and back pain. In this video, a podiatrist talks about the importance of caring for your feet and explains some of the most common foot problems and treatments.

Media last reviewed: 22/11/2013

Next review due: 22/11/2015

Treatment may not be necessary in mild cases of fungal nail infection.

But if you don't treat the infection, there's a chance it will spread to other nails.

Using simple self-care methods may be effective in some cases. For example, not wearing footwear that makes your feet hot, keeping your nails short and maintaining a high level of foot hygiene can help prevent fungal nail infections.

Medication

Medication may be recommended if your fungal nail infection is more severe. Antifungal medicines, such as tablets and nail paints, are the two main treatments.

Your GP and pharmacist will be able to advise you about whether you need treatment and, if so, recommend the type you need.

Your nail's appearance may not return to normal after the infection has cleared. However, a sample of your nail should be tested if it still looks infected.

Antifungal tablets

Taking antifungal medication in the form of tablets means that the treatment reaches your nail through your bloodstream.

Terbinafine and itraconazole are the two medicines most commonly prescribed for fungal nail infections and they can be very effective.

However, you may have to take the tablets for several months to ensure that the infection has completely cleared up. If you stop taking the medication too early, the infection may return.

An advantage of using antifungal tablets is that they'll also clear up any associated fungal skin infections, such as athlete's foot, at the same time.

However, side effects of antifungal tablets can include: 

Antifungal nail paint

If you prefer not to take antifungal tablets, your GP may suggest you try antifungal nail paint instead.

Nail paint isn't considered to be as effective as tablets because it's painted onto the infected nail and has to work its way through to the infection. It can often be difficult to reach all of the infection.

A fingernail may need around six months of treatment, and a toenail may take up to 12 months.

Chemical nail removal

The abnormal infected nail plates can be removed using a paste containing 40% urea (a chemical that occurs naturally in the body which can also be manufactured). The paste is available over the counter from pharmacies.

You carefully apply the paste to the affected nails, which are covered and left overnight. You then wash the paste off in the morning and repeat the process each night after filing down the nail as instructed. It usually takes about two weeks to dissolve the nail plates.

Chemical nail removal is a painless treatment that gradually removes the abnormal nail plate and the fungus. It allows you to avoid taking tablets for several months and avoid surgery, which can be painful.

Once the nail plates have been dissolved, antifungal nail paint should be applied to the nails twice a week to prevent the nails being reinfected as the new nail forms.

Surgery and laser treatment

Surgery to remove the infected nail may be recommended if your infection is very severe or painful and other treatments have proved ineffective.

If your nail is surgically removed, a new nail should eventually grow back in its place. However, it could take a year or more for the nail to grow back completely.

Laser treatment is another possible option if you have a fungal nail infection that's particularly stubborn. The laser emits high doses of light energy, which are used to destroy the fungus.

Research shows that laser treatment is a safe and effective procedure, with some studies reporting a success rate of up to 90% at three months.

However, there's currently little evidence to show that laser treatment provides a long-term cure, as most studies only follow patients up for a period of three months.

To achieve these high success rates, you need to be treated every three months for up to a year. As laser treatment is only available privately, this could prove expensive.

Foot care during treatment

During your treatment, you should see a new healthy nail start to grow from the base of your nailbed. This is a sign that the treatment is working. The old infected nail should begin to grow out and can be clipped away over the course of a few months.

Speak to your GP if a new nail doesn't start to grow after two to three weeks of treatment. Keep using the treatment until your GP says you can stop. Stopping too early could result in the infection returning.

Foot care tips

There are some things you can do to help keep the infection at bay during and after treatment. These are listed below.

  • keep your feet cool and dry, and wear shoes and socks that allow your feet to breathe
  • wear clean cotton socks and avoid wearing trainers
  • treat athlete's foot with antifungal medicine as soon as possible to avoid the infection spreading to your nails
  • clip your nails to keep them short
  • use a separate pair of clippers or scissors to cut the infected nail to avoid spreading the infection to other nails
  • wear well-fitting shoes without high heels or narrow toes
  • maintain good foot hygiene
  • wear clean shower shoes when using a communal shower
  • consider seeking treatment from a podiatrist if thickened toenails cause discomfort when walking
  • consider replacing old footwear as it could be contaminated with fungal spores

Read more about how to keep your feet healthy.

Page last reviewed: 10/01/2014

Next review due: 10/01/2016

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Comments

The 17 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Bruce123 said on 21 October 2014

I started by trying lacquer and it seemed to be working on the big toe nails, albeit very slowly so I decided to try the 40% Urea paste (by Caneston) to physically remove the infected nails.

After two weeks it worked (the paste softens the infected part of the nail allowing you to scrape it away) on the two big toe nails.

After a few weeks, the nails started to grow back all new and uninfected, but at about 1/2 - 2/3rd length the ends became re-infected. So I am now using the lacquer again (but once per day as recommended by my doctor). I am hoping that this will hold off the infection until it grows out.

The moral? There is no point in removing the nail alone as it will very likely get reinfected. You need to throw your old footwear, wash socks at 60C and keep spraying things your feet come in contact with, with anti-fungal spray. Worth it in the long run.


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WackyJ said on 28 August 2014

There's an interesting article regarding the success of Vapour rub (contains the same active ingredient found in thyme oil, which is also recommended as a natural treatment) at;
http://www.jabfm.org/content/24/1/69.full

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Gingerhaze said on 22 August 2014

Have been using Vick vapour rub for a couple of months - using a separate cotton bud for each of three affected toes and spreading over and under each nail once or twice a day. Large toe nails are much improved but not yet clear; third toe was completely cured after three weeks.

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st just said on 07 May 2014

hi people i have been treating my fungel nials with vicks rub every day for a few weeks now and its working well i also soak my feet in vinigar and water daily try it bood luck st just

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VaPiano said on 02 April 2014

Hi all,

I have had an infection in one of my feet for around 6 years: I had tried most topical treatments (lacquers), both otc and prescribed by an NHS Doctor. None were effective in the slightest.

I saw on GroupOn that a few clinics have started to offer the laser treatments, which work by penetrating the nail with heat. I gave in and bought a voucher for one session @ £79 for a clinic in West London.

The good:
The clinician was friendly and optimistic about the effectiveness of the laser against my 5 infected nails. The treatment was fast (30 mins) and relatively painless (uncomfortable when nail was very hot).

The bad:
As expected, at the outset I was recommended to take a further 6 monthly sessions of the same treatment, at a reduced price of £300. I agreed to this, as I'm sure I'd do just about anything right now to get rid of it. If it's effective, it will have been £300 well spent.

I'll post my results, and how this goes to help others make an informed choice. Laser treatment of this sort seems to be in its infancy.

The other things that the clinician recommended were - bathing the affected nails in apple cider vinegar three times a week, adding freshly squeezes lemon juice to the vinegar, and using the squeezed-out lemon after this to clean the nails. As these are both acidic, it should also help to fight the infection and it will help to improve the appearance of the nail too. She also gave me particular warning to hygiene - using a separate towel to dry the affected foot after showers and baths, and also making sure to allow my foot to breathe (I.e. taking shoes and / or socks off whereever possible). Fungi like moist, hot, dark places to grow, so don't give it a refuge.

I hope this helps you all to fight your own infections - and I'll try to let you know how I get on with the treatments.

P

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jillcantor said on 17 February 2014

I have had a fungal infection in one fingernail for about four years - I have tried almost everything, including terbenafine for 6 months (useless) and various different paint-on treatments. Last year I paid a clinic in Harley Street nearly £500 for four sessions of cold laser treatment which, if anything, made it worse. When I told them, they offered me another two treatments for £200 extra but I didn't want to waste any more money. At the moment I have just started to use a Scholl paint-on preparation but it's too early to tell if it is working. The main problem seems to be that new nail grows up from the base, but the fungus grows back downwards.

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Fred Bloggs4 said on 04 January 2014

I have had a fungal nail infection for about 3 years now. Docort didn't want to prescribe tablets as they can cause problems with liver function. She prescribed Loceryl for 12 months. Seemed to be working as new nail started to grow but infortunately the nail stopped growing altogether. Had to stop using the Loceryl and doctor suggested applying T tree oil regularly. Used it weekly, it didn't improve the problem but kept it at bay for a while. Now the nail problem is getting worse.

Decided to apply it daily now to see if it will improve.

You would think that there would be a cure for this problem by now. Surely it's not incurable in this day & age. All that's happening is that companies selling supposed cures are making a bomb!

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mayka said on 02 December 2013

my 15 months daughter has fungal symptoms and I rub in into nail fresh GARLIC, I have read that trick in very old health encyclopedia, (not much people try natural classic methods this present days) in that book was to mash fresh garlic put it on the nails and keep it under plaster for 15 minutes, twice daily, that long as all fungal gone. also is good to eat garlic everyday as you know it is antibacterial, antifungus, antivirus. My old friend tried that way few years ago and it helped very quickly. Hope it will help to someone.

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mahalo said on 13 September 2013

Having tried so many well branded and recommended, expensive products to solve my nail fungus...only by chance did i use something which is very cheap compared to the other products..but has turned out to work reasonably quickly...' Hydrogen Peroxide '.
After having a shower/bath, use a nailfile to scrape between the nail and toe, then using a cotton bud dab in the peroxide and around the sides and top of the nail, do that regularly and you will see that as the nail is clipped the healthy part is following right behind the fungal area...' Hey Presto '..

Keep smiling...Mahalo

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Pat Dean said on 20 May 2013

I have fungal nail infection in all my toenails and after having a chiropodist sanding my nails, my two index nails started to grow upwards instead of outwards.

What is this vapor rub people are using and do you just rub it into and under your nails. I use vinegar for cleaning but can only find cheap malt vinegar in my local area. I would smell like the fish n chip shop.

I have heard of lazer treatment in the US but it costs about a thousand dollars a treatment and it had not been approved by the FDA. To pay that amount I would have to have cast iron guarantees on it's effectiveness.

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Boriz said on 26 March 2013

I am a diabetic type 2. I got a fungal nail infection in one of my big toenails about 3 years ago. It spread to my other big toenail and one of my smaller nails - covering most of the nail. I started using vapo-rub (just a cheap brand) about a year ago. One of the big nails and the small one grew back normal (took about 7 months for the large nail). The second nail was growing back well - but I had read that once it is more than 50% grown back you can leave it and it will grow out. This advice is not correct: once I stopped using the vaporub the infection spread right back. I am back on track now, but I advise to keep treating until discolouration has gone.
Also, when I took this to a doctor they took a cutting and told me that it was not a fungal infection. The websites were showing pictures almost identical to my nail though, so I decided to treat as a fungal infection regardless. Seems to be the correct decision.

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Quali T said on 27 August 2012

I'm about to try The Vinegar Method...

My Mum has this great book about Vinegar & it's 1000's of uses, 1 purpose it can be used for is treating fungal nail infections, My Mum has recently tried this method & after a few weeks her nails had improved dramaticly! having read the comments on long medical treatments & how they can be non effective i thought i'd try this faily inexpensive method first. I will try to post my results...

The method for killing fungal infections with vinegar is similar to the method for using hydrogen peroxide. Both substances are mildly acidic. For feet and hands, add 1/4 to 1/2 cup of vinegar to 1 gallon of water for soaking. You can also use a cotton bud to apply vinegar (undiluted) directly to the nails. Some people find the odor offensive, but it can be washed off after a few minutes. Reapply two to three times a day for as long as needed roughly 2-3 weeks & things should have at least started to clear up if this method will work for you.

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Emmak789 said on 14 August 2012

Hi all, my husband has a fungal nail infection which he has been taking tablets for over a year and it has gotten better but not completely gone. He tried the creams and antifungal powder in his shoes as well as lavender oil neat. The lavender oil helps control the fungus and the nail looks better when its used regularly but it doesnt go away altogether. After reading about vicks I'm going to get my husband to try it.

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carohi said on 10 May 2011

I have been using Vicks Vaporub twice a day for about 6 months as I caught a fungal nail infection whilst pregnant (when you're more susceptible apparently). I'm breastfeeding so can't take tablets or use laquer. In my case the Vicks does not seem to have been any difference. I have the infection on the largest and smallest nails of one foot but even the smallest nail hasn't improved which I would have expected by 6 months. I don't know if the treatment has stopped the infection from spreading or from getting any worse but it certainly has not made any improvement. I only continued to use it as I have no other options as you can't even use Tea Tree oil when breastfeeding. When I stop breastfeeding I intend to go to the doctors and ask for their advice. Good luck to anyone else trying to treat this tenacious infection - it seems that there is a lot of advice out there about natural remedies but nobody who has tried them seems to take the time to let anyone know whether any of them actually work!

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annunderhill said on 15 March 2011

I have fungal nail infection , i went to the doctors, showed him my nails and he gave me a perscription for Loceryl Nail Lacguer, decided to read up on it and found i can't use it , it says tobe painted onto nail / no contact with skin , but already i've lost 6 nails and both my thumb nails are coming off now so theres no point in useing it. I would of thought my doctor would of known this. I feel i'm back to square 1 now. :-(
Can the person who is trying vics vapour rub tell me how they are getting on with it / is there any improvement , please.

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ahd said on 20 September 2010

There is a new treatmetn now available in the UK at 4 centres, two in London one in Sheffield and one in Newcastle upon Tyne. They are currently only available as private treatments admittedly it seems costly but they treat the nails with special lasers killing the infection in the toes without any oral medication. So no harmful side effects at all. for most infections only one lase treatment is needed. It is hightly effective (in mild to moderate cases @80% effective) serious infections might take a couple of treatments but even then it is @70% effective. As foe the paint on stuff, you use it for ages and it only works in mild cases maybe 12% of the time. Old wives remedies... not a chance.

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upkar said on 23 August 2010

I have had fungal nail infection on 3 toe nails for 10 yr +. I was given cream then lacquer and then was put on tablets but nothing worked. with tablets only 1 nail cleared. I have tried tea tree oil too but nothing works. today I have read about using vicks vapourub to clear fungal infection. I am going to try this now. Will come back after few months to say if this worked. but for people reading this article if the lacquer doesnt work then try vicks vapourub before you try the tablets. Good luck!!

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Find out about antifungal medicines, which are used to treat fungal infections such as thrush and athlete's foot

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