What can you do about toenail fungus?

Toenail fungus is quite common, particularly among older people. Unfortunately, it is a type of infection that can be hard to treat. What can you do about toenail fungus?

Toenail fungus usually is harmless if you are otherwise healthy. So, you do not have to treat it. You can let it be. But, it likely won’t go away on its own.

That said, toenail fungus could spread. And, it could infect the skin around it, especially if you have diabetes or a weakened immune system. Your nail might also become thicker, which could make it painful to walk.

Before deciding whether or how to treat your toenail, talk to your doctor. Your doctor can confirm whether you do indeed have toenail fungus. You could have psoriasis, which can look like a toenail fungus.

Treating a toenail infection: If you decide to treat toenail fungus, be patient. According to the National Institutes of Health, it usually takes several months for the treatment to work. Here are three treatment options from the NIH. Talk to your doctor before starting a treatment.

• Try an over-the-counter colorless medicated nail polish with amorolfine or ciclopirox. First cut and file down your nail as much as possible. Then apply amorolfine once or twice a week over the course of a year. Or, apply ciclopirox every other day for the first month, twice a week in the second month and once a week beginning the third month. Before applying the new layer of polish, clean off the old layer with alcohol.  They can keep the fungus from growing or kill it. But, evidence that these treatments work is limited.
• There is also a topical treatment that removes the part of the toenail that is infected. You first soak the nail in warm water for ten minutes. You then soften the toenail with a medicated urea-based cream and then scrape off the fungus. Discuss this option with your doctor. There is no good evidence that this treatment works over the long-term.
• There are oral medications designed to treat toenail fungus. They have been shown to be much more effective than nail polish or urea-based cream. But, they have side effects, including stomach and bowel problems and a small risk of liver damage.

Preventing nail fungus:

• Dry your feet carefully after showering.
• Wear shoes that are comfortable and fit well; if they are too tight, your feet can’t breathe.
• Whenever possible, don’t wear shoes.
• Wear flip flops in communal locker rooms.

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