Your Guide to Treating Toenail Fungus by an RN

Nail Fungus

Over the Counter Nail Fungus Treatments – Are There Any That Might Work?

In the world of microorganisms, fungi are a pretty hardy bunch. There are generally harder to kill than bacteria and viruses. Dermatophytes, yeasts, and molds invade nails and dig themselves deep within the nail itself. Thus an already resilient organism is even further protected by layers and layers of keratin. Because of these reasons, treating onychomycoses has been difficult, historically. Even powerful oral antimycotic medications are not 100% effective. In light of this, can any over-the-counter nail fungus treatment be effective?

Fortunately there are a number of topical over-the-counter treatments that can effectively treat nail fungus infections. One over-the-counter topical onychomycosis drug that has been shown to be effective in a few clinical trials is amorolfine. Amorolfine is available without a prescription in the United Kingdom, New Zealand, and certain other countries. It is marketed under the brand name Loceryl. Amorolfine is distributed as a nail lacquer and the effective concentration is also the way in which it is sold, namely 5%. Amorolfine nail lacquer is painted on the nail, like polish, and then dries, leaving behind the drug. The drug is able to penetrate the nail and reach the site of the fungal infection. This drug penetration takes place over a week’s time.

Amorolfine is able to kill fungus by inhibiting with the cell membrane of the fungus. It can only be used on distal (or lateral) subungual onychomycosis and is ineffective on proximal subungual onychomycosis and superficial white onychomycosis. Therefore it is important to determine the correct type of onychomycosis.

It is unclear why amorolfine is not available in the United States, especially when it is available over-the-counter in other countries. The possible side effects are infrequent and mild when used as directed. Some patients report a burning sensation when they apply the lacquer at first, which goes away. With the advent of online pharmacies, it might be possible to purchase this medication from wholesalers or retailers based in other countries, but the cost may be prohibitive. Prices quoted for a single 5 ml tube of Loceryl can range as high as $100 or more.

A Natural Solution

One promising over-the-counter treatment for nail fungus is tea tree oil (Melaleuca alternifolia). Recent, small studies have shown that 100% concentrations of the oil may be able to cure 20% of those that use it and improve nail appearance in about two-thirds of patients. A 0.05 ounce bottle of the oil costs less than ten dollars.

herbal-oil

Click Here for #1 Rated Nail Fungus Treatment

In head to head comparisons between twice daily application of 100% tea tree oil and 1% clotrimazole, tea tree oil may have been slightly more effective. Once such over-the-counter treatment that contains tea tree oil is Zetaclear.

lamisil-treatment1
While Lamisil is available as a tablet and is a reasonably good oral onychomycosis treatment, the Lamisil that is available over-the-counter is a topical ointment or cream. While the topical Lamisil may do a good job at treating some fungal infections of the skin, like athlete’s foot, it is not terribly effective at treating nail fungus.

There are various over-the-counter nail fungus treatments that have not been rigorously tested in clinical trials. Therefore it is difficult to make any strong recommendations about them. One medicine that is sold as an anti-fungal nail liquid is undecylenic acid. There have been two papers published looking at undecylenic acid in the treatment of onychomycosis, one published in 1965 and the other in 2008. The 2008 paper shows a positive effect but undecylenic acid was combined with two other ingredients cyanoacrylate and hydroquinone. It is not clear whether this topical onychomycosis drug is effective on its own.

While clotrimazole (Lotrimin) is an over-the-counter fungus treatment, it is not effective at curing onychomycosis. Studies report a cure in less than 15% of those that use it to treat nail fungus. It may lead to an improvement in nail appearance but the disease is very likely to recur after treatment is stopped. Clotrimazole is better suited to other forms of tinea like jock itch (tinea cruris), athlete’s foot (tinea pedis), and ringworm (tinea corporis).

Tolnaftate (Tinactin) is another over-the-counter antifungal that is better suited to treat skin fungus. It is not effective in nail fungus treatment. Miconazole is sometimes found in over-the-counter fungal treatments but also suffers from being ineffective against nail fungus infections.

The statements made about these topical products assume that the affected nail has not been subjected to any surgical intervention. It is possible that surgical, mechanical, or chemical removal of the nail prior to over-the-counter nail fungus treatment may improve the effectiveness of the topical agent used. If you are considering surgery for onychomycosis treatment, ask your surgeon about nail fungus aftercare treatment options.

If you are not considering surgery for onychomycosis but are serious about getting rid of the nail fungus, the highest chance of success is through the use of oral antifungal agents. These nail fungus treatments are currently only available with a prescription.

References
Hammer KA, Carson CF, Riley TV. In vitro activity of Melaleuca alternifolia (tea tree) oil against dermatophytes and other filamentous fungi. J Antimicrob Chemother 2002;50:195-199.
Hart R, Bell-Syer SE, Crawford F, Torgerson DJ, Young P, Russell I. Systematic review of topical treatments for fungal infections of the skin and nails of the feet. BMJ 1999;319:79-82.
Rodgers P, Bassler M. Treating onychomycosis. Am Fam Physician 2001;63:663-668.
Turchetti B, Pinelli P, Buzzini P et al. In vitro antimycotic activity of some plant extracts towards yeast and yeast-like strains. Phytother Res 2005;19:44-49.

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60 Comments

  1. Stephen McIntosh says:

    My doctor told me that Vicks Vapor Rub is effective in treating toenail
    fungus. I have been using it for approximately 3 weeks, but I cannot say
    for sure that it is having any effect. What have others said about its
    use for toenail fungus?

  2. Dan says:

    Your doctor is a nut.

  3. Jason says:

    I agree, your doctor is a real quack!

  4. contempted says:

    Your doctor is indeed a quack.My doctor told me the same thing and beleive me
    beleive me it doesn’t work AT ALL.I’m right back where I started.
    It really seems as if theres no hope.

  5. Tom says:

    How long did you all try the Vicks?

  6. Mia says:

    Acutally, the Mayo Clinic website recommends Vicks vapor rub as a home remedy.

  7. RACH says:

    I WORK IN A PHARMACY IN A HOSPITAL AND WE EITHER USE LAMISIL OR VICKS VAPOR RUB.

  8. Steph says:

    I have beentold that Listerine(the original bottle with the brown label) is very effective in treating the fungus.

  9. Cindy says:

    For Vick’s to work you must use it everyday, it can take up to six months.
    Use a toothbrush to apply, making sure that you get into all the little crevices.

  10. Greg says:

    The doctor is right. It is the camphor in Vicks or other products that kills the
    fungus. But it takes work and time. Apply the Vicks to a nail that has been
    roughed up with a coarse emory board. Apply the Vicks with a q-tip and then put
    a band-aid over it otherwise it is soon rubbed off. Depending on the severity
    this will take several months of constant daily application of replacing the
    band-aid daily. I’ve done it and it worked perfectly on a nail that had been
    infected for 20+ years.

  11. Tim says:

    Greg, how long did you have to treat?

  12. Kate says:

    I heard vicks works. Serval have told me. Also heard that dr. dont like and hardly give you the oral cause of the liver damage. I just started the vicks so we will see. Mine is so painfull it hurts to walk. 1 day I noticed a thicken nail than boom in a couple months it is painfull. I laso heard that yeast infection meds work to.

  13. harry says:

    Could our eating habits have anything to do with the life and death of the fungii?
    I’m going to cut my sugar intake down and be a test bunny…see’ya latter,gang

  14. arturo says:

    Vicks vapro rub actually worked on afriend that a fringer nail fungus , he had it for 20 years .
    but now he has a good looking nail !

  15. hunter says:

    What about ‘Funginail’? Its active ingredient is undecylic acid.

  16. Sad says:

    I did Vicks for over a year — it made the nail LOOK better but did NOT get ride of the fungus. I also tried “Dr. Paul’s Piggy Paste” much more expensive, also made the nail look better but did not get ride of the fungus. I have filed the nail to think the ridges, used a bandage to keep the suff in contact with the nail and pulled off dead nail almost back to the quick to get more coverage, but nothing has worked.

  17. John says:

    I have used a combination of Lamacil applied in the PM and Nail Rx applied in the AM for about 6 months on my large toenails. It is working very, very well. All of the new toenail growth is clear and appears fungus free.
    I will keep using it until all of the old yellow nail grows out, which may take another 6-12 months. Lamacil and Nail Rx have different active ingredients, so I thought I would have a better shot using both
    Patience and regularity is the key – fungus spores are only vunerable for a short time after they “hatch”, and the spores multiply only about once a month. It can take a long time to get them all.
    Once you get it the habit of a twice a day application, it becomes just as routing as brushing your teeth.

  18. Pretty says:

    I heard many differnt things work for nail fungus but have yet to see any results. I was told vinegar works, tea tree oil, and now vicks vapor rub. With all the doctors and scientists in the world we should have a cure that works in days. I will try the vicks vapor rub and see if I get the results many have said they received.

  19. pepito potito says:

    My doctor told me to use Mayonnaise and actually works on me, I’ve been
    using it for a couple weeks and the results are fantastic, do not use
    the low fat use the regular one that contains olive oil.
    Make sure you change your socks everyday. Good luck to everybody.

  20. Kate says:

    My sister told me to soak my toenails in hot water (as hot as you can stand) with a little clorox a little clorox in it for about 10 min. and apply tea tree oil. Do this twice a day. Her sister in law who is a nurse practitioner said over the counter stuff is a waste of money and that this is the only treatment that really works. It worked for her, for my sister and for me. I still do it about 2 or 3 times a week as a precaution. I also wear flip flops or go barefoot as much as possible to keep my feet from getting damp. I walk a lot and I think damp shoes and socks is what caused my fungus. Hope this helps!

  21. Melanie Rhodes says:

    If it is camphor that is the curative factor in the Vicks, the liquid form is Camphophenique and old remedy for itching. Tea tree oil sounds like it could be effective but with all fungus treatments it is persistence that really is the key

  22. Julia says:

    As far as I can tell from my readings on the Internet and my own personal experiences, you all need to find a way of getting amorolfine solution over there on your side of the Atlantic. I’ve been using it for a couple of months now and I’ve already seen a vast improvement. And it only cost me ten pounds for a three month supply. The best part is that I only have to apply it once a week, then I can forget all about it for the rest of the time.
    I couldn’t imagine having to try so many labour intensive he remedies. Tell your FDA (I think that’s who is in charge), to stop pandering to whichever andecylenic acid merchants that have paid them off.
    Good luck!

  23. NM says:

    ZetaClear takes fungus away super quick, and you get a free trial.

  24. Scott says:

    I’ve finally cured my toe fungus that I’ve had for years. My wife recommended I tell someone about my success in hopes of helping someone else. I tried many things until I hit on the right combination. It is: soak the toe in hydrogen peroxide with 8 or so drops of tea tree oil in the liquid 45 minutes a day. After this coat the nail in Undecylenic Acid (FungiCure) and file the face of nail down until it is as thin as possible. Also, it doesn’t hurt to ingest a tablespoon of apple cider vinegar (the good stuff with the “Mother”) with purified water once a day. Keep filing the nail and soaking the toe until you remove all the infected nail. It should take about 8 weeks.

  25. Cheryl says:

    1:1 ratio tea tree oil to emu oil. Mix one drop each, apply with finger. The emu oil is a transdermal carrier oil, helping the antifungal tea tree oil penetrate the thick nail. It worked in just 5 days for my 2 year old’s fingernail fungus! Had previously tried Listerine/vinegar soaks, Lamisil cream, and tea tree oil alone with no success.

  26. Cheryl says:

    Oops, forgot to add: apply 3x per day.

  27. Alun says:

    I have tried vicks, tee tree oil, lamisil, tinacide, bleach, peroxide. Several months to a year for most. I finally bought Nonyx gel and my nails were better in a short time. None of the growing loose keratin under the nail and irregular surface gone. Finally I can go to the beach or wear sandals again.

  28. charlotte says:

    My big toenail had fungus and I got over the counter (tineacide Antifungal cream) ) I used it for aprox for 10 days It looked like it was helping but suddenly I saw that my toenail was
    was lifting and I dont know what to do I cant take it off It is connected on one
    side I saw somone said peroxide treament and I never knew to file the nail down
    I am going to try this and hope it works Thanks to Scott

  29. charlotte says:

    Thank you Scott

  30. Mary says:

    The toenail fungus is just a symptom of a greater fungus problem. Yes, diet has
    everything to do with it. Fungus feeds on sugar, as does cancer. Do you crave
    sweets, pasta, or bread? If you do, your body may just have a fungal condition.
    The only way to truly kill the fungus is cut out carbs, refined sugar, and foods
    susceptible to mold, ie. corn, peanuts, pistachios. Stop with the antibiotics
    because they kill everything and break down your natural immunities to fight
    sickness and disease. Anti-fungals kill fungal infections. Anti-biotics kill
    bacterial infections.

  31. Chelsea says:

    i had this toenail fungus back when i was in Jersey. that was about 3 months ago.
    i tried vicks vapor rub for 3 months now, i’m applying it everyday but still
    nothing worked. are there any other effective options?i wouldn’t want
    oral medications as my doctor prescribed. i heard it could cause some liver
    damage and i think schizophrenia. are there topical creams you could
    recommend? is zerofungus a good one?or maybe that zetaclear or something?thanks.

  32. Jackie says:

    I had used peroxide to treat minor toenail fungus on 1/4 corner of my big toe and it had seemed to work, my nail grew back and I had my nails done with polish at salon. However about 3 months later I took polish off to repaint and I was in shock that the fungus came back with a vengence and had now taken over 3/4 of my big toenail. I had decided to visit the doctor instead of doing peroxide again as I was afraid perhaps I was making things worse. My doctor instructed me to trim down part of infected nail, and that he believed the healthy part of my nail would grow and push out the fungus as long as I kept trimming my nails and that it should take about 6 months. That all sounds great, but I am concerned that if that is all I do that it will spread to my other nails or spread further taking over to take over the entire nail. I have not seen any posts with people getting rid of minor fungus by merely trimming, if I have success I will post. However, I am keeping close eye and if fungus starts to further spread I may try the peroxide or bleach remidies suggested above.

  33. jessica says:

    4 years I have fungus under the big toenail.. I’ve been cutting it ll the way down and putting fake toe nail on it.. I’m tired of doing that… I haven’t tried anything ,I have been so scared to tell my doctor but I have to asap ..

  34. Warren says:

    I had a nail fungus on my right big toe that started causing
    me some throbbing pain. Nothing I used worked so
    I finally took some nail clippers and cut away all of the
    infected nail parts along the front edge and down the left side.
    It sounds worse than it was but I just clipped everything from
    the front edge AND there was an area down the left side of that
    nail that had become so involved that it was no longer attached,
    so I carefully clipped all of it away. I used some tweezers and
    scrapped as much of any flaky stuff as I could. I then started
    applying this over the counter product containing 25% Undecylenic acid.
    I applied it several times a day especially after I showered and
    the fungus was gone in about as long as it took for the nail
    to grow out. I use it about 3 times a week now hoping that will
    keep it away from now on. So far so good.

    A friend of mine tried the same thing as me and it was completely
    ineffective for him so far. He’s been doing it for weeks
    with no improvement. His was much worse than mine though.
    Maybe the treatment is effective depending on other factors like
    the persons immune system or maybe there are different species of
    fungus that are effected by different anti-fungus agents…I don’t know.

    I think what made the difference for me was clipping all the infected
    parts off. My friend didn’t do that.

  35. marisela says:

    hi few years ago i experienced my left toe w fungus, it was horrible. It started to turn yellow and then it got darker. I got worried and i went to the doctor because it was dark wasn’t going away with the water w bleach that i tried for 2 months. so i went again and she put me an a oral prescription. she said it may cause liver damaged, but i told her i didn’t care. Thank God nothing happened to me and he protected me and best of all the oral medication worked! i was very happy.

  36. erica says:

    i have nail fungus on both feet all nails i have tried everything and when i say everything
    i mean everything i have used all creams vics bleach ammonia u name is i
    tryed it its driving me nuts there is no doctor that takes medical card around where i live
    so now im stuck paying 900.00 dollars to get lazier treatment on them i hope it works but i cant take iit nemore its sad when your nail itches and u cant even scratch it my husband and i fiht about it all the time can some one give me a great idea for this so i dont have to spend 900.00 dollars i dont have

  37. Roger Milam says:

    Available at Podiatrists offices only, a product called Formula 3, at $40 per bottle worked wonders for me, destroying the fungus completely before the original bottle was fully used. It does leave the top of the nails rough and unsightly, but I have been told there is a new product called Piggy Paste, for about $30 per “bottle” or “tube”. It is supposed to clean up the tops of the nails so they can be covered with nail polish should that be desired.
    Formula 3 absolutely works. I want to try the Piggy Paste a soon as I can find a source.
    RM

  38. Marc Bressler says:

    According to their ad in this week’s PARADE magazine, Piggy Paste is available at Walgreen’s. However, if it is $30 a tube I may have to think hard about spending that. But Lamasil works only for a period of time; my DO recommend laser treatments.

  39. sue says:

    @craig – can’t tell if you were being serious or not, but in case you were – toenail fungus and yeast infections in women are totally different micro-organisms.

  40. jane says:

    Nonyx – takes time and persistence but it works the best .

  41. Ken says:

    What about thumbnails? Do any of the meds work on fingernails? I have it both in my big toes – and both thumbs. BTW, all of it began shortly after I finished chemotherapy 4.5 years ago. The good news is that I beat the cancer – and the chemo (simultaneously) made my plaque psoriasis disappear from my elbows. Now, I have battled the fungus / yellowing of my toes & thumbs for the past 4.5 years! I have tried all of the items recommended (but not Piggy Paste). I am more concerned about my thumbs. Anybody?

  42. DON says:

    AFTER WATCHING MY PODIATRIST THIN BIG TOENAIL AND SELL ME FORMULA 3 ANTI FUNGAL, I USED MY PEDI PAWS GRINDER, WHICH IS VERY GENTLE, AND REMOVED ALMOST ALL THE BIG TOE NAIL. EASY TO DO.FORMULA 3 SEEMS TO WORK, BUT SLOWLY. WALMARTS’ EQUATE ANTI-FUNGAL LIQID SEEMS TO WORK ABOUT AS WELL AT A QUARTER OF THE COST.

  43. MARGARET says:

    I have had great success with Animal Strength Absorbine. It is purchased in the drug store and is safe for humans. Larger quantities can usually be purchased at the race track. It takes daily soaks at first and then every two days as a soaking treatment of several cap fulls of absorbine preparation. Then dry the feet thoroughly. Clean socks should be worn daily and shoes need to be replaced and if this is not possible then they need to be sprayed with lysol spray. Soak the interior and remove the insoles and spray both sides of the insole and the inside of the shoe. Let them dry thoroughly before wearing. Alternate shoes and remove the insoles and spray the inside of the shoe and both sides of the insole after every wear. Have a container of cotton balls or pads and wipe the nails with full strength absorbine morning and night. Absorbine hasiodine in it and it can stain fabric so place an old towel or rug or a piece of plastic under your feet oand the foot bath to prevent damage to carpets and floors. You can also after the first two weeks. Start by soaking your feet in the solution for half an hour. After this first soaking trim your nails short and square. File the corner edges off slightly and run the file across the end to be sure it is smooth. Now take an emery board and buff the surface of the nail down. I like to use a glass file or a metal file the want to re-contaminate the nail. Once the nail grows out and looks normal then the emery board may be used over again but it is considered a personal item and never shared… Usually the nail becomes thick and white and it is important to thin down the diseased nail. You do not have to do too much this first time but do use the emery board to file down the surface of your nail til you reach a normal thickness. Depending on a persons nail growth the nails new growth will be normal and after 3-6 months the whole of the nail is normal. I did not mention but it is important to take a nail file or an orange stick and remove the excess dead cells under the nail after each soaking. THe first time you will be shocked at what comes out from under. Be careful not to damage the skin. It all does not need to be removed the first time . You can also use a nail brush to scrub your feet and nails while you are soaking them. Be sure to re-soak the feet after trimming and removal of dead cells. get Dr. Scholl’s cream for removing dead skin (exfolliating) at almost ant drug department. After soaking your feet and triming and cleaning under the nail. Takes a small amount of the cream and rub it around your nails, between your toes and then over the entire foot incluging the heels. Continue to rub the cream until the deadskin on the surface starts to roll off. Rub until you think they are done coming off and then wash your feet in warm soapy water. Dry your feet thoroughly and put on dry clean soaks. Before you start this Take all of your socks and wash them. Pre-soak the white ones in bleach and the colored ones in an antifungal solution such as lysol. Be sure to treat all of your shoes as well. Never walk in bare feet. Not inside or out of your home. Don’t wear open shoes without socks until your feet are completely fungus free. It is normal for us to have fungus on our feet but if we injure ourselves or take antibiotics or happen to get dry cracked skin, fungus can enter the skin and cause a major infection.. Remember to disinfect in bleach or lysol all the nail tool and basin tools at the end of each soaking. THe results are amazing and the new growth will show you your success quickly. Be sure to stick to the soaking and daily wiping with the ANIMAL STRENGTH ABSORBINE until there is no sign of fungal nail. If the time is not taken to complete the removal then it will quickly return… believe me it is work the work. If you miss a day get back on track right away. You may find ealy morning or evening best for you set up a routing that will work and stick to it…

  44. MARGARET says:

    Hey! Sorry for the typos above but the set up did not let me see what I was typing all of the time and some areas I could not see had errors.. This does work miracles. I worked with the elderly and we made some miraculous recoveries..no failures as we actually had scheduled foot baths.

  45. steven says:

    the trick is getting the nail itself out of the picture. If you coat the nail with Salicylic acid ( prefer the gel version) , the Keratin in the nail itself will break down. if you keep it coated for about a week, you will be able to remove all of the impacted nail, as it will detach from the nail bed. remarkably, the healthy part of the nail tends to stay attached. you can use this technique to completely remove the nail if need be. it takes about a week to fully break down the Keratin, after which removing of the nail is totally painless using a nail cutter and nail scissor and does not break the underlying skin or bleed. you will be left with a rough nail bed that still has fungal growth but is now fully exposed to the air, which fungus doesn’t like.

    next, you use a standard OTC topical medication on the nail bed. take the cream, completely cover the nail bed and wrap in a layer of gauze with tape to keep it intact.

    depending on the type of fungus, you will see the rough fungal patches die off within a week or two. your job is to brush off the dead skin, keratin and fungus remains. you can use additional Salicylic acid treatments to help remove the tough spots. keep the process of topical coating with anti-fungal going until you have a nice, clean nail bed and you see your new nail growing in clean.

    the antifungal you use will be dependent upon the type of fungus. I always start with the type that is most effective when I have athlete’s foot on the assumption that the toenail fungus is likely the same. It is also possible to cycle through the top 3 antifungals, as they are all generic now.

    it is critical that you do not break the skin! feet are dirty and you don’t want an infection. if you are having trouble getting the nail off, keep using more of the acid treatment. The Gel type is particularly good in that it dries as a solid in less than a minute and stays on for days.

  46. Randy says:

    My doc suggested colorless iodine mixed with DSMO. Any one have any experience or thoughts about this choice?

  47. misty says:

    I have tried everything for my nail fungus, I have seen several doctors and dermatologist and have tried otc products vinegar,tea tree oil, candida cleanse, lemongrass ess. oil rosemary, neem oil,dmso, lamisil, prescription and otc creams, thymol zeta clear you name it I have tried it it’s been 10 years, they Listerine and the vicks have thymol in them and that does work for some people, the thymol that I used was a clear liquid and the dermatologist prescriped me and it smells just like Listerine only it doesn’t leave the sticky feeling like the Listerine did, I used 10% thymol it wass $11…
    now I am trying the Pythium oligandrum vampire fungus…I hope that this works

  48. Merry Cocke says:

    I am seeing results. However, I am trying to order another tube of the paste and I don’ seem to be able it with my credit card. I do not wish to order thru PayPal. So guess I wont be ordering any by email I have ordered before just using my credit card. So, thanks but no thanks,

  49. josanne says:

    laser treatments people….it can cure the most stubborn nail fungus.

  50. DANMD says:

    A patient showed me this link and asked for my thoughts, so I thought I would post my opinion.
    Home remedy’s are great, Vicks, Vinegar, Tea Tree and cost effective. The down side is compliance such as soaking, odor and sometimes messy.
    One has to realize if home remedy’s work and so often used, I believe that simple good foot hygiene is the best prevention. Wash feet with a foot cleanser that kills germs, dry between toes and most important use clean socks and rotate shoes. By doing this you may never need a home remedy.
    As far as other products I base my recommendations on clinical studies. Keep in mind we are dealing with an infection in the nail bed, so I have always questioned tropical products. The most published is Lamisil – terbinafine an oral pill that has good results provided the patient has a positive test for fungi. More resent studies by Lamisil has shown increased results with debridement (filing) of the nail.
    The studies I have seen for a topical product is Penlac Nail Lacquer (Loceryl) and Clearzal BAC. Published success rates for Penlac ran around 10% and for Clearzal around 35%.
    One product was shown to me at a recent conference was Formula 3. They have a 100% guarantee for the product and would sell to me for $18 and I would sell for $40. 100% guarantee, I should have ran, Lamisil the most published 100’s of millions of dollars works good, but not 100%. That seemed high for a product that a few years back was sold in salons for $15. I asked about the science of the product and the rep could not even pronounce common medical terms. I asked why a brush was used for application. Any medical professional is aware of cross contamination in using an apparatus on an infection over and over (like reusing a bandage). It made my stomach turn that they would ask a doctor to sell something like this that is a salon product.
    What do I do:
    Combination therapy appears to work best. Using clinical based papers.
    Use generic Lamisil (very inexpensive now) for patients that have multiple nails infected and can tolerate the medication.
    I then dispense Clearzal topical (which is published) for a twice a day application for $18. It is broad spectrum and kills fungus and bacteria, which compliments Lamisil. For less severe cases I start with Clearzal.
    In all cases I trim the nails and file down any build up.
    I also dispense a foot cleanser – like Fungi Soap or now the Clearzal Cleanser and have patients use once a day.
    Tell the patient to always dry between toes, use fresh socks and rotate shoes.
    This does not work 100% as nothing does, but I can say all patients who have complied showed improvement of the nail.
    As far as Laser, I have not made the investment, die to the fact that once again there are now good studies to justify the $900 I would have to charge patients, and I am not comfortable with that as it is not covered by insurance (even if it was I would still be uncomfortable charging that much without clinical evidence).
    Hope this helps from my small world. All the best.

  51. Scott says:

    Based on hundreds of comments on this site, it’s clear that there are a variety of remedies. What works for one person is completely ineffective for another, and the difference is explained by the variety of infections.

    But that isn’t really the problem. The problem is getting the medicine to the affected area.

    Unless you are willing to go with an oral solution with it’s potential health risks, you must remove the nail, because it keeps the medicine from reaching the affected area.

    I found that prescription ciclopirox laquer not only costs 10x other topicals, but didn’t seem to penetrate the nail. No effect at all, except on my wallet.

    In frustration, I purchased 2 bottles of cicliopirox from eBay, $22 on eBay, which is 1/10 the price per unit of the prescription stuff and is water-based. I cut the nail and all dead material, very carefully, once a week, and for a year, applied the topicals as close as possible to the affected area. Problem solved.

    One guy in his comments on another page of this site suggested using a dremel tool, which would have been eaiser than nail clippers, but takes some guts.

    Steve, in this same thread, suggested on 08 Jan 2012) to use Salicylic acid to remove the nail. That seems a good idea.

    So, here is the best solution to the problem:

    1. Remove the nail to expose the infected area. See Steve from 08 Jan 2012 above for details.

    2. Apply home or over-the-counter remedy, and i it fails, try another & another. See DANMD from 17 Feb 2012 above for a list.

    3. Once problem is gone, do a weekly soak in vingear or over-the-counter remedy to reduce the likelihood of re-infection.

    Also, I find that wearing mostly cotton socks rather than those of various plastic threads (polyester, etc.) means my feet can breathe and the socks will soak up any sweat. That prevents excessive stink, and reduces fungus.

  52. Randy says:

    I am using Vick’s rub and I got rid of the fungus on one big toe and the other three I have seen a big change in the sign of the fungus under the nail. It does work but it may take 6 months or more. I will keep it justntomkeep control ofbthenfungus from growing

  53. terry says:

    No Short Cuts Exist! It helps if you are OCD, Anal Retentive, or just plain Self-Disciplined. 3 months, every day TWICE. All thru Europe & US Tour. Drag the applicator brush across the end of the nail where it meets the nail bed (skin). Then cover nail liberally.. Wear sandals, go barefooted when possible. I even tried putting a condom over the freshly medicated toe, my wife objected. The longer the twice a day application remains undisturbed the better. I do not have the “courage” to Dremel my own toe, but saturation of nail to nail bed is important, hence, twice a day routine. I used “Fungi-Cure” I’m cured, and still OCD, Anal Retentive, & Self Disciplined..Be well. “cured” .

  54. Dr Christine says:

    I have tried lots and lots of over the counter products for years and years. The money I spent on Loceryl! then I started using stuff from the web, When my nails looked good and had grown out, after a month the rotten fungus would be starting to creep back again. Used a manuka cream with an “accelerator”. Held it in check a bit but big problemo… the fungus kept spreading to other fingers and toes. One toe or finger would start looking better and another one would suddenly get it. It was driving me mad. Now trying the pythium oilgandrum. So far so good. One more application to go with it. Will keep you posted. I had a really tough fungus.

  55. James says:

    Dr Christine-

    “Now trying the pythium oilgandrum. So far so good. One more application to go with it. Will keep you posted. I had a really tough fungus.”

    How is this working? I have tinea versicolor, spots around my waist and abdomen.. was wondering if this would be affective cure?

    Thanks!

  56. L.spangler says:

    I tried Piggy Paste for several months with hardly any improvement. I went to a podiatrist and he gave me a bottle of FFN r/x. after one week, I am truly amazed at the improvement. I am to see him in 8 weeks and I suspect the fungus will be completely gone by then.

  57. HoJo says:

    Vicks worked for me. Trouble is t will come back. Now taking FFN-RX. My dermatologist told me about Vicks and she was spot on.

  58. HoJo says:

    My dermatologist told me about Vicks and it worked. She said for whatever reason
    Fungus does not like Vicks. Only problem is it comes back. Now on
    FFN-RX which is going great.

  59. Jackie says:

    What is FFN-rx and Where do you get it? Do you need a perscription?

  60. Chan says:

    My doc gave me Spora…for 3 months, then switched to Lami… (actually Lami… should be the first line, don’t know y he gave me Spora) and using Loce..topical for the whole seven months. Culture found trichophyton species. 7 months getting only worse. When first discover, I used undecylenic 10% for 2 weeks, then apply Scho… lacquer. Microbiologist told me that there’s an antifungal can try called Voriconazole but very costly. I surf on the net saying that the success rate is lower than Spora and Lami. Now try soaking my foot in baking soda and epsom salt, rub chlorhexidine gluconate cream, taking antifungal supplement don’t know if all that works? anyone can share any success stories with home remedies?

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