The 6 Best Toenail Fungus Treatments

Toenail fungus is a common fungal condition that often starts after a rash on the foot spreads to the nails. When mild, it looks like white and yellow spots growing under the nail beds. If left untreated, the fungus can grow severely by hardening the nails and spreading to other toes. The fungus often begins in the form of athlete’s foot between the toes or on the soles of the feet. Treating it early is best, as later stages of toenail fungus can be hard to mitigate with over-the-counter treatments.

We researched dozens of toenail fungus treatments and evaluated them based on the following attributes: medication forms, ingredients, and treatment areas. We also had a medical dermatologist from our Medical Expert Board review the contents of this article for medical accuracy regarding how toenail fungus progresses and what to know about how to treat it.

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Ingredients to Look for in Toenail Fungus Treatments

• Undecylenic acid: This is an FDA-approved ingredient to treat toenail fungus. It’s a fatty acid that prevents fungus from growing and is also helpful for fungal infections on the skin, such as jock itch.
• Zinc undecylenate: Another FDA-approved ingredient, zinc has antifungal properties that reduce itching and irritation. Like undecylenic acid, it can help fungal infections on the skin like athlete’s foot and jock itch.
• Azole: If you seek help from a dermatologist, they will likely prescribe medications in the “azole” family. According to Shari Lipner, MD, a board-certified dermatologist at New York-Presbyterian Hospital/Weill Cornell Medicine, azoles interfere with fungal cell membrane production, killing the fungus. A common medication in the “azole” family used to treat toenail fungus is Jublia (efinaconazole). Other medications often prescribed include the active ingredient terbinafine, which is usually prescribed as oral or topical Lamisil.
• Tea tree oil: This ingredient has antifungal and antibacterial properties that may help reduce toenail fungus when used topically.

Types of Toenail Fungus Treatments

• Oral: Michelle Henry, MD, founder of Skin & Aesthetics Surgery of Manhattan, says oral medications are very effective and great for multiple nails that need stronger treatment. However, some underlying conditions that make people susceptible to toe fungus can also make you susceptible to negative side effects. Speak with your doctor to ensure you can safely take an oral antifungal.
• Topical: Topical treatments (like amorolfine and ciclopirox) can help with minor toenail fungus. They cause fewer and less serious side effects. However, it’s difficult for them to penetrate the nail plate. Orit Markowitz, MD, founder and CEO of OptiSkin treatment center in New York City, says that they can be very effective when used properly. Still, treatment times are generally longer and thus more costly.
• Natural/homeopathic: Garlic has antifungal properties, and when used in a footbath, it can relieve pain. Henry suggests tea tree oil and white vinegar soaks as well. Proper treatment can take as long as 18 months, which is why Markowitz doesn’t often recommend this path. Natural preventative measures can be effective, but once fungus sets in, your best bet is a research-backed and FDA-approved oral antifungal.

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