Toenail fungus is an infection whose treatment often represents a challenge. Although there are different drugs, topical formulas, and natural remedies that help promote relief, restoring the healthy appearance of the nail takes time. When you’re searching for how one can eliminate toenail fungus, stick around and discover—in additional detail—six available options and what effects to expect.
Fungal infections of the toenails are also often called onychomycosis or ringworm of the nail. Under normal conditions, nails have a shiny pink hue and a smooth surface, without marks or grooves. Nonetheless, once they’re infected, you could see changes of their appearance, similar to yellowish or whitish discoloration, thickening, and breakage.
More often than not, these symptoms are seen within the nail of the massive toe, which becomes infected 10 times more ceaselessly than the remaining of the nails. Even so, fungal infections can compromise other nails or several at the identical time. In actual fact, sometimes they occur as a complication of tinea pedis (fungus on the feet), which, when effective treatment is lacking, can spread to the nail area.
Fungi called dermatophytes — especially Trichophyton spp. — are liable for as much as 80% of cases of this infection. The remaining cases are related to yeasts and molds (similar to Aspergillus, Scopulariopsis, and Fusarium). The humid and warm environments of swimming pools, public showers, changing rooms, and closed footwear are related to the expansion of those microorganisms.
Treatment options to eliminate toenail fungus
1. Oral antifungal medications
The primary line of treatment to eliminate toenail fungus is oral antifungals. These are preferred because their healing rate is higher and, subsequently, they require shorter periods to realize their effect compared to topically applied products. Essentially the most beneficial are the next:
- Terbinafine (Lamisil): Preferred because it provides higher results in lightening the nail. It’s effective for each dermatophytic and non-dermatophytic fungi. The suggested dose to combat toenail fungus is generally 125 milligrams per day, for 12 weeks.
- Itraconazole (Sporanox): Its cure rate for fungal infections reaches 80 – 85% and has a relapse rate of 10%. It helps fight dermatophytes, candida, and pityriasis. The administration schedule is generally suggested at intervals to cut back the chance of uncomfortable side effects. For onychomycosis within the feet, the dose is generally 200 milligrams every 12 hours, one week a month, for 3 months.
- Fluconazole (Diflucan): Its cure rate is 90 to 95%. Its administration regimen is pulsatile, with suggested doses of 150 milligrams weekly for at the least 6 months. It’s often beneficial if the patient doesn’t tolerate terbinafine or itraconazole.
Oral antifungal therapy isn’t freed from antagonistic reactions and risks. As a safety measure, your doctor may suggest blood tests periodically during treatment to detect possible abnormalities.
Because these drugs may cause liver and kidney damage and interactions with certain medications, they aren’t beneficial in all cases. Hence the importance of using them only under skilled supervision.
2. Topical antifungals
When you’re not a candidate for oral antifungals, or if the infection is mild or simply starting, the suggested treatment to eliminate toenail fungus is topical antifungals.
They’re classified because the “alternative to first-line treatment” and, although less effective, their use is more common given their low risk of antagonistic effects and interactions with other medications.
Their application period is a minimum of 48 weeks for onychomycosis of the feet. As a way to increase the possibilities of success, the doctor, dermatologist, or podiatrist intervenes with a preparation of the affected nail or nails. To do that, they cut, file, and, if possible, scrape the stays under the nail.
What’s sought through this approach is to cut back the thickness of the nail in order that the drug reaches the fungus more easily. For this same purpose, over-the-counter lotions containing urea are sometimes used. Once this is finished, you’ll be able to proceed with the applying of the medication. The choices will be as follows:
- Medicated nail lacquers or polishes: These transungual delivery systems are preferred over creams or ointments as they supply more optimal penetration of the drug into the nail. Essentially the most used ones contain amorolfine orciclopirox. Each have exhibited good antifungal potential although they’ve different mechanisms of motion.
- Creams or ointments: Options similar to efinaconazole and tavaborole are beneficial. Reducing the thickness of the nail is decisive to realize higher results with its application.
The possible uncomfortable side effects of those medications are mild; they might include redness, burning, or stinging of the nail.
3. Photodynamic therapy to eliminate toenail fungus
Considered one of the emerging treatments for onychomycosis is photodynamic therapy (PDT). It consists of the applying of photosensitizing substances that manage to build up in fungal cells. Then, after exposing the affected nail to light of a selected wavelength, they generate reactive oxygen species that inhibit cell replication and result in the death of the fungus.
In keeping with the outcomes of some research, this treatment has several benefits over conventional therapeutic options:
- The spectrum of motion is broader.
- It fights antimicrobial resistance.
- There’s a minimal risk of uncomfortable side effects.
- They will be combined with antifungal medications.
- They supply the potential for activating the photosensitizing substance with low-cost lights.
- There are formulations available that allow the particular release of the photosensitizer to the realm.
It’s vital to think about that this treatment option needs to be applied only by a dermatology skilled. Between 4 and eight sessions are required to realize satisfactory results.
4. Combined therapy
The protective structure of the nail makes it difficult to completely eliminate fungus with only one variety of treatment. Because of this, today, doctors recommend combined therapy as a simpler modality. Evidence suggests that each combination antifungal therapy and the simultaneous use of antifungals and photodynamic therapy give good results.
By utilizing drugs and therapies with different mechanisms of motion, the fungal eradication rate increases. As well as, response time decreases and a more significant improvement in symptoms is clear.
5. Chemical or surgical removal of the nail
When medical treatment fails or nail ringworm could be very severe, the doctor may suggest chemical or surgical removal of the nails. These are interventions through which a partial or total removal of the affected nail is carried out in an effort to enable a more direct application of the antifungal medication on the fungus and in addition to eliminate infected nail tissue.
- In chemical extraction, a keratolytic agent is used for several weeks to progressively weaken the nail structure and thus perform the removal.
- During a surgical removal (reserved for essentially the most serious cases), the doctor applies a neighborhood anesthetic and proceeds with the removal.
6. Natural remedies
In various systems of holistic medicine, a series of natural remedies are beneficial as an choice to treat and eliminate toenail fungus. Reported data suggest that they’re useful in providing temporary relief of symptoms and, sometimes, in improving the looks of the nails. Nonetheless, there are not any rigorous scientific studies to support their effectiveness.
Their application is commonly suggested as a complement to the aforementioned medical treatments. Like other topical solutions, their effects take months before becoming noticeable. If onychomycosis is severe, they might have little or no effect. If that’s the case, it’s best to go to the dermatologist or podiatrist.
Amongst essentially the most used, the next stand out:
- Tea tree oil: Evidence suggests that this ingredient has antifungal properties which might be useful against the fungi that cause onychomycosis. To make use of it, dilute three to 5 drops of tea tree essential oil in 10 milliliters of carrier oil (coconut, olive, almond). Then, apply it on to the affected nail.
- Thyme oil: This oil has antifungal potential that’s related to its fundamental lively compound, thymol. As within the previous case, dilute the thyme essential oil in a carrier oil (proportion of 5 drops per 10 milliliters), before applying it to your nails.
- Vinegar: Anecdotal data suggests that vinegar (50:50 with water) may also help combat each toenail fungus and athlete’s foot. Nonetheless, there’s no evidence of its effectiveness. It has been suggested that its simultaneous use with topical antifungals may lead to improvements in onychomycosis.
- Vicks VapoRub Ointment: The lively ingredients on this menthol ointment —eucalyptus oil, menthol, and camphor—help fight toenail fungus. You must only apply a small amount to the affected area, at the least once a day.
- Baking soda: Some evidence suggests that baking soda has antifungal properties that help stop fungal growth. Nonetheless, studies remain limited. Its use as a treatment to combat onychomycosis is essentially supported by anecdotal evidence. To do that, pour 100 grams of baking soda right into a bowl of water and immerse your nails in it for quarter-hour.
What’s essentially the most effective approach to eliminate toenail fungus?
As you’ve just seen, there are multiple treatment options on the subject of combating toenail fungus. Nonetheless, it’s difficult to determine which is the best or simplest option. Usually, this depends upon the severity of the infection, the variety of nails affected, and other aspects.
Evidence suggests that oral antifungal drugs—that are the primary line of treatment—offer a better cure rate than topical antifungals. Nonetheless, given their high risk of antagonistic effects, not everyone seems to be a candidate for using them.
Combination therapies, in accordance with recent findings, have the potential to extend treatment success, reduce the applying period, and, normally, minimize antagonistic effects. Other more modern methods, similar to photodynamic therapy, have been generating interest from patients and professionals, given their rapid results with minimal risks.
Potential treatments similar to patches, varnishes, gels, and a few naturally derived ingredients are still being investigated. Preliminary studies suggest that they might assist in cases of mild onychomycosis; although preferably together with medications.
Are there ways to forestall toenail fungus?
There’s no method that guarantees absolutely the prevention of toenail fungus infections. In actual fact, it’s possible to suffer from these infections again after successfully completing any of the aforementioned treatments. In any case, there are specific precautions that help reduce the chance of contracting them. Take note and put them into practice!
- Make certain to maintain your feet clean and dry. When you finish showering, dry your feet well, especially the spaces between your toes. Don’t forget that fungus can proliferate if moisture stays on the feet.
- Avoid walking barefoot in wet public places: Especially in gyms, swimming pools, showers, or locker rooms. Have sandals or water shoes available.
- Keep nails short and clean: The longer the nails, the more room the fungus has to thrive. This gets worse in the event that they accumulate dirt.
- Select appropriate footwear: Make certain socks and shoes are breathable and that their materials don’t increase foot sweating. If possible, alternate between multiple pairs of shoes in order that they can dry well between wears.
- Wear cotton socks: Synthetic materials retain moisture and increase the chance of fungus. After a sporting activity or after sweating for one more reason, you should definitely change your socks for clean ones.
- Avoid sharing items meant for private use: Reminiscent of nail clippers, files, socks, and shoes. Fungi spread easily through these.
- Limit using nail polish or artificial nails: Excessive use creates a great environment for the expansion of microorganisms.
When to seek the advice of the doctor
Cases of mild onychomycosis may improve with home treatment, either with over-the-counter topical medications or with frequent use of natural remedies. Nonetheless, when the symptoms don’t improve—and quite the opposite turn out to be chronic—it’s best to go to the doctor or dermatologist to study other therapeutic options.
Depending on how affected the nail is, in addition to the fungi involved within the infection, the skilled will determine if oral therapy, topical drugs, or any of the nail removal methods are crucial (severe cases).
Remember!
The presence of toenail fungus can turn out to be a persistent discomfort if intervention isn’t done in a timely and appropriate manner. Although they don’t often cause symptoms beyond changes in the looks of the nail (discoloration and thickening), toenail infections are contagious and might spread to a couple of nail.
Treatment options have gotten broader, but their success rates vary depending on the variety of fungus, the severity of the infection, and the person response to the medication or product.
Usually, it takes several months of management before seeing results. Even so, it doesn’t all the time work or the fungus reappears. It’s vital to judge along with your doctor the professionals and cons of every therapeutic option and select the one which most accurately fits the case.
Finally, it’s vital to bear in mind that hygiene and day by day care of the feet are essential to forestall fungi from proliferating and generating infection within the nails. That is much more vital if you have got any associated risk aspects, similar to athlete’s foot, diabetes, nail dystrophy, or circulatory problems.
