Fungal Treatment for Toenails

While toenail fungus can be an embarrassing problem, Cleveland Clinic estimates that as much as 20 percent of the population is affected by the condition. Also called onychomycosis, toenail fungus is usually characterized by yellowing of the toenails. Sometimes the toenails also thicken and have streaks of white, while other times the nails may become thin and even crumble away if the fungus is not treated. Toenail fungus can be treated with topical medications (anti-fungals), oral anti-fungals or, in some rare cases, surgical removal of the affected nail or nails.

Topical Treatments

Topical treatments may be available by prescription or over the counter. Lamisil and other over-the-counter fungicides may be used in the treatment of toenail fungus. Ciclopirox, another topical anti-fungal, is recommended by UAB Health System. Medicated nail polishes are also available to apply to the affected nail. These nail polishes usually contain Amorolfine or Ciclopirox. However, these topical treatments may be unable to effectively treat the toenail fungus because they cannot penetrate the fungus under the nail. Often, these topical products must be combined with oral anti-fungal medications and/or are passed over in favor of an oral drug.

Oral Anti-Fungals

Because it is difficult to access the fungus without removing the toenail, oral anti-fungals are often considered to be more effective than fungus creams applied directly to the nail. However, these oral medications–itraconazole, terbinafine and fluconazole–can be expensive and have dangerous side effects. Also, oral medications can take a long time to eliminate the fungus from the body. Cleveland Clinic estimates that many patients must take oral anti-fungals between three and 12 months to effectively treat toenail fungus.


Surgery may be performed to access the fungus. Because the fungus is under the nail, a podiatrist or foot surgeon may need to remove the nail in order to get to the nail bed where the fungus is growing. The doctor can remove the damaged nail matter and then apply fungicide directly to the fungus.

While toenail fungus can be an embarrassing problem