Podiatrist (Foot and Ankle Specialist) Questions Fungal Infections

How can I get rid of a fungal infection?

I've had a fungal infection on one toenail for a couple of years now. I've been prescribed creams, but none of them worked. Is there any other treatment?

17 Answers

There are many different treatments for fungus of the toenails. Meints include topicals, oral medications, and laser treatment.
Fungal infections are produced by molds that live within her environment. There are different types of molds that can produce this infection. Typically involving the human skin and nail these represent dermatophytes. #1 is to maintain good hygienic principles in the care of your feet to include appropriate cleansing and drying of the feet, changing of socks and shoes on a regular basis and allowing the feet to air. If there is acquired infection there are many topical antifungal creams, solutions and sprays that can be applied. Most commonly these need to be used for at least 3 to 4 weeks if it is skin involvement. Nail involvement is far more challenging as it does not readily absorb or permit for penetration of antifungal products.
Try Epsom salt soaks after bathing, then apply Lamisil cream daily. Do for at least 3 months. Severe cases require oral medication.
Yes, there are several other treatments for nail fungus, however, the first thing that needs to be done is get an accurate diagnosis as without a nail biopsy and PAS study, the chances of getting an accurate diagnosis is much less as you cannot tell by appearance alone. There are several topical nail medications that have been approved by the FDA, however, the most effective are the solutions, as the creams do not penetrate the nail as well as the newer smaller molecule solution medications. The newer oral medications that bind to skin and nail structures are very effective, however, it has to be determined you are a candidate for these medications which is done through nail biopsy and liver function tests. You must eliminate trauma to the nails, micro trauma from a small or tight shoe, as well as major trauma. You need to control the moisture around the feet changing shoes and socks if they become damp.  Maintenance medications for skin and nails are sometimes necessary to prevent reinfection.
Before you consider getting rid of a “ fungal infection” you need to seek medical care and have a biopsy so that you know exactly what the infection is from and then can be told by the doctor what treatments to do. Just giving a generic approach to fungus is medically inappropriate
Podiatrists have a number of ways from topical treatment to laser. First get a culture to make sure it is a fungal condition
Hello. There is oral antifungal therapy for 12 weeks. There are possible side effects though.
Fungal infections ate always a pesky problem. The best treatment is oral medication...lamisil, one pill daily for 90 days. The medication continues to work for an additional 6 months,  which is good since it can take up to a year to clear. Go see your podiatrist and they can give you more information. 

Dr. Siegel
Yes, there are other treatments. Oral tablets and laser are both more effective than topical medications. See your podiatrist to determine the appropriate choice for you.
Many times, toenail fungus needs oral medication to eradicate the infection.

Jonathan M. Kletz, D.P.M.
When the infection is in only 1 toenail and has been there for years it's possible that it is not an infection but could be damage to the nail root because of an injury to that toenail. This was especially be the case if the treatments have not worked. You can consider a biopsy of the nail to determine if it is actually a fungus.
I would make sure it is a fungus first since nothing has worked. You can set up a visit and get a nail biopsy. There are topical and oral medications. If it is not fungus though they won't work.
There are generally 2 main treatments for fungal toenails. Topical medication and oral medication. There are advantages and disadvantages to each. There is also laser treatment for fungal toenails. A trip to your local podiatrist would be beneficial to understand all your options.
Try Tolcylen Ointment, it's the strongest penetrating formula available.
Though toenail fungus is very difficult to get rid of in some people, and some people simply can not seem to get rid of it, there are several cures. The most effective treatment I have found in my patients is oral medication called Lamisil. Many patients and doctors are afraid of prescribing or taking Lamisil because it is processed by the liver (but so are MANY medications-including all NSAIDS). As long as the liver functions are checked and within normal limits, I have NEVER had a patient have any sort of liver problem from taking Lamisil. You can not take Lamisil or other antifungals if you are taking certain other medications. Alternatively, there are several topical treatments (you need to apply these 1-2 times per day, depending on the medication, for a minimum of 9 months, and often up to 2-3 years). Lastly, there are Laser treatments (these are not covered by insurance, are costly, and usually does not work, or the problem recurs quickly after therapy). No matter what treatment you have, they all take about 9 months to fully cure the problem (even though the oral medication is only taken for 3 months, it takes 9 months to fully clear the nail of the fungus). You should bleach your shower and spray your shoes with Lysol to kill any spores in the environment that may re-infect you.
Toe nail fungus is a difficult problem to deal with and all treatments take time. Usually any topical treatment will take about 12 months to get the final result. If the nail has significant disease, you may benefit from removal of the nail plate. I recommend you be evaluated by a foot and ankle surgeon (podiatrist) to discuss options
In my experience the best treatment of fungal toenails is an oral medication, Lamisil. You take one pill a day for 90 days, and I always get some baseline liver function enzyme labs beforehand to make sure there are no issues prior to starting therapy. Literature states over 80% clearance within 6-9 months but I have experienced closer to 95% clearance within a few short months. Call your local podiatrist and schedule an appointment to get rid of the fungus once and for all.