Medical treatments for nail fungus are considered here as over-the-counter or prescription substances that don’t fall into the other categories of natural treatments or home remedies. The question of whether it’s best to follow conventional medical wisdom, adopt an all-natural approach, or rummage through medicine cabinets for a home therapy is a hotly debated one, with advocates of each method loyally defending their stances. Visit a few websites devoted to the subject, and you’ll see numerous entries touting the latest FDA-approved drug or homegrown preparation. Sadly, you’ll also probably find a good deal of nail-fungus sufferers complaining that their infections have persisted for years and nothing seems to help.
This kind of wild inconsistency is maddening to anyone with a nail fungus problem. There isn’t any single perfect treatment that works for everyone, so caring for a fungal infection is more complicated than eradicating other types of infections that respond to tried-and-true techniques. The best advice is to consult a doctor if you’re unsure about which course to take. Nail fungus can go from mildly annoying to dangerously nasty if left untreated. Unless you’ve had nail fungus before and know which therapy works for you, play it safe and get professional help. Your doctor may take a sample culture to determine exactly what’s going on with your nails, and he or she can tell you if the infection is a minor or major one.
Topical medications or antifungal lacquer can be purchased over the counter or obtained through a doctor. A commonly used topical antifungal is econazole nitrate (Spectazole), and this can be combined with over-the-counter lotions containing urea to hasten the absorption of the medication. Antifungal lacquers are applied like nail polish to the affected area using a brush, and there’s an FDA-approved one called ciclopirox (Penlac). You need to reapply it over a number of days and then remove it and repeat the process. There are serious drawbacks to both of these topical approaches. They generally take many months to produce the desired effect, and estimates of their efficacy are disappointing, giving them a success rate of only ten percent of cases. They are best suited for mild to moderate infections or for use in conjunction with other methods.
Oral antifungal medications are stronger remedies that require a doctor’s prescription. These include itraconazole (Sporanox), fluconazole (Diflucan), and terbinafine (Lamisil). Oral antifungals can help damaged portions of the infected nail regenerate new, healthy nail material, but there are downsides to these medications as well. They may have to be taken anywhere from six weeks to many months, they may interact in dangerous ways with other drugs, and they pose health risks ranging from skin rashes to liver damage. People with congestive heart failure or liver disease are not good candidates for these drugs.
In combination with these non-surgical options, doctors will sometimes remove the entire nail. This is a good tactic if the infection has grossly deformed the nail or if the nail is so thickened that its pressure is causing pain. The procedure is usually performed in a doctor’s office with the administration of local anesthesia, and the strategy is to remove all traces of the infected nail so that a healthy new one can replace it. Some patients choose to have the nail permanently removed to avoid relapses, and the doctor accomplishes this by destroying the cells that attach to the bone covering at the back of the nail.
Although there’s still no magic bullet for nail fungus, medical science has given us more treatment options. Find the one that sets your feet on the right path.