Toe Nail Fungus Removal Options

Toe nail fungus (onychomycosis) isn’t going anywhere without treatment. Protected under the nail plate where it’s moist, has access to protein (keratin), and limited exposure to the immune system. Many times toenail fungus is primarily cosmetic, however, if left untreated it can spread to other toes and the skin or cause the nail to thicken and become painful.

Choosing the right treatment and using it long enough to eradicate the fungus and allow healthy nail to grow back is important.

Nail Fungus Treatment Breakdown

Different medications reach fungus in different areas under the nail. Antifungal creams and solutions work on fungus at the surface but have limited ability to penetrate and treat deeper infection under the nail plate. Oral antifungal medications reach all areas infected by passing through the bloodstream.

The main takeaway here is that mildly infected nails are usually treated first with topical (cream) medications and more severe infections require oral pills.

Topical Treatments (Creams/Lotions)

Topical treatments are applied directly to the nail and slowly penetrate the nail to treat the infection. These treatments come in many forms such as creams, solutions that you soak your toe in, and medicated nail polish.

Creams and prescription polishes that contain either ciclopirox or efinaconazole have been shown to be effective when used consistently and for long enough. Unfortunately, topical treatments have a difficult time penetrating into thick nails which is why they’re typically used for mild cases and early stages of fungus.

Treatment requires daily application and be used for several months. You will not see immediate results with topical treatment. Results will only be noticeable as the nail grows out which can take months.

Some habits like keeping your nails trimmed short, washing your feet regularly, and allowing them to dry properly along with disinfecting shoes will go a long way to ensuring success.

Oral Antifungal Treatment Medications

Prescription oral antifungal medications are used to treat more severe toenail fungus or fungus that has spread to multiple toenails. Terbinafine and Itraconazole are the most commonly prescribed medications for toenail fungus and work by reaching the fungus through your bloodstream.

Unlike topical medications that work on the surface of the nail these medications can reach fungus that’s buried under the nail plate.

Treatment duration is typically between a few weeks to a few months and has a higher clinical cure rate than topical treatments.

As with any medication that’s metabolized by the liver your prescribing provider will most likely check liver function before and during treatment.

Although rare most people are able to tolerate these medications. If you experience symptoms such as unusual fatigue, dark urine, or skin turning yellow, contact your provider.

Laser Treatment Removal Options

Toe nail fungus laser treatment removes fungus by heating it with a concentrated beam of light. The procedure focuses on fungal cells under the nail and kills them without damaging surrounding tissue.

Treatment only takes 10-20 minutes and there is no recovery time. Most patients require more than one treatment spaced out by several weeks.

As with other treatment options results are not immediate and you’ll have to wait until the nail grows out to see improvements.

Laser treatment is typically used for patients that cannot take oral medications. Cost is typically the downside as insurance rarely covers laser treatment.

Surgical Nail Removal

Surgical removal of either part (partial nail avulsion) or all of the nail (total nail avulsion) is typically reserved for severe cases of toenail fungus.

If the nail has become too thick or painful to wear shoes surgical removal may be recommended.

The benefit of removing the nail allows for direct treatment of the nail bed and removing the fungus “home.”

Removal of the nail matrix may also be performed during surgery to prevent future growth of the nail. (If there’s concern the fungus will come back.)

Depending on the severity of the infection and if the nail matrix was treated recovery can vary. You’ll be provided with a dressing that covers the affected area. New nail growth can take anywhere from 9–12 months.

Home Remedies for Nail Fungus

Home remedies for toenail fungus are just that… home remedies. You may see some benefit from natural remedies if the infection is very mild.

Studies have shown that vinegar can help prevent fungus however there’s no data to support that it actually kills fungus. All the tea tree oil will do is make your toes smell like tree vomit.

Truth is, natural remedies don’t work very well for nail fungus and can cause you to waste valuable time. If you don’t see results after a couple weeks, cut your losses and try something proven to work.

Determining Your Treatment Options

Treatment should be based off of how severe the infection is and how many toenails are infected.

• Topical medication: Mild infection affecting one toenail

• Oral medications: Moderate infection or multiple toenails affected

• Laser treatment: Patient can’t take oral medications

• Surgical Removal: Severely infected nails or nail causing pain.

A combination of oral medications with topical treatment directly to the nail often works best for recurring cases of toenail fungus.

Prevention & Things to Keep in Mind During Treatment

Preventing toenail fungus begins with keeping your feet as dry as possible. Wash and dry your feet thoroughly so that no moisture is left behind.

Rotate shoes so that they have enough time to air out between uses. Wear shoes that breathe and don’t go around barefoot in public places.

Scrub and disinfect your toenail clippers after use and don’t share towels or shoes with others.

Keep an eye on your toes. Because toenail fungus can come back if untreated keep monitoring your nails for recurrence. The sooner you catch it, the easier it will be to treat.

Frequently Asked Questions

Q: What is the fastest way to get rid of toenail fungus?

A: Oral antifungal medications are by far the fastest way to treat toenail fungus. Treatment can take a few weeks to several months depending on the severity of infection. Remember even with oral medication you will have to wait until the nail grows out to see visible results.

Q: Can toenail fungus spread to other parts of your body?

A: Unfortunately yes. Toenail fungus can spread to other toenails and hands. It can also spread to the skin on your feet causing athlete’s foot as well. If you have toenail fungus washing your feet and keeping them dry will help reduce the risk of spreading.

Q: Will my nail grow back normal?

A: If there is no permanent damage to the matrix of the nail. And the infection is treated properly your nail will grow back healthy. However, this can take time. Depending on severity of infection and treatment nails can take 6-12 months to fully grow back.