Week 1 – Hi my name is John and if you are like me one day you looked down at your feet and thought wow my toenails look pretty gross. Could be at a pool party, walking on the beach or just wearing your flip flops out in public. For me I love training in martial arts. In the martial arts gym you are always barefooted. No shoes allowed! It was there one day that it hit me, amongst all these 20 somethings with clear nails my nails looked yellow and crusty. It was really embarrassing and I vowed to clear them up once and for all.

Nail fungus never really appears out of the blue… its a gradual thing… get a crack in your nail… walk around the shower in the gym barefooted… wearing your shoes constantly without letting you toes breath and next thing you know your nail start getting little cracks and discolored. My story is that I took a break with martial arts training to have a family and to work on my career and so after 5 years decided to starting training again.  I never really cared what my feet looked like, however that changed when I got back into martial arts.

In the gym you are training in close quarters, whether you are grappling, wrestling or sparring so being clean and cleanliness in general is of a high concern. You don’t want to be that guy that has terrible body odor or super bad breath…

Now I’m no spring chicken but I’m not “old” either I’m in my late 30s but when I stepped onto the mat I noticed right away how gross and yellow my big toenail looked. Now I looked at my feet a millions times before that day stepping onto the mat, but never really noticed or cared. Yet here I was the “older” guy in the gym looking quite the part with my yellow nails and all.

From that day forward I always hid my toenail with black tape when I was in the gym. From time to time someone would ask me why I was wearing the tape and I would usually say “oh I jacked up my toes hitting the heavy bag” or “tweaked them while sparring”… at this point no one evens bothers anymore… as they must be thinking his toes are permanently screwed up!

If you take a look at the picture you can see why I usually wrap them up. They look gross!

So I have to do something… I can’t always wear tape around my toes and summer is coming up! So I’m going to detail here my experience in trying the various methods of curing my nail fungus on this blog. Following along with me and leave your comments below!

Week 2

So my strategy is just to go to local drug store and pick up a cheap bottle of anti-fungal solution from CVS. I’m using undecylenic acid. Also I’m filing my toenail down. It way too early for any real results but I think filing down the crusty parts is better than nothing at all.

Week 4

Not much has changed.  Just plugging away and applying the CVS treatment daily as well filing the yellow parts down.  I think the root base of the nail is not yellow but it seems that the nail as it grows out develops a yellow tinge as well as gets flaky and not healthy looking.

My plan is to finish the bottle out in another few weeks before switching up my treatment options.

The post My Personal Journey in Curing Nail Fungus for Good – A Weekly Treatment Diary appeared first on ToenailFungusTreatments.com.

Overview

1. The anatomy of the human nail
2. The organism behind nail fungus
3. How topical treatments work

1. The anatomy of the human nail

Overview

The skin is the largest organ in the body and its most important function is to provide a selectively permeable barrier to the outside environment. The outermost layer of skin is called the stratum corneum (SC), Latin for horned layer, which is a dynamic structure that functions to protect deep layers of the skin from infection and injury [1]. This layer is comprised of dense skin cells (15 layers deep) called corneocytes [2] that originate deep within the skin and migrate to the surface of the skin as they mature. Complete replacement of these cells in the epidermis takes approximately 1-2 weeks, as it takes about 24 hours to form a single layer of the SC. One of the most important structures of the SC is the nail, which is a flat, hardened covering at the tips of the fingers or toes that has evolved to function as a protectant for the tips of our digits. The nail covers and protects a part of the finger called the matrix (see below), which is a layer of skin under the nail from which all of the cells that become the nail arise [3].

Nail Structure

The nail itself is comprised of three main layers. From the outer structure in, they are the nail plate, the nail bed, and the nail matrix. The nail plate, also called the dorsal outer layer, is dense and hard, consisting of keratin [4]. The nail plate is a thin (0.25 -0.6mm for fingernails and up to 1.3mm for toenails), hard, yet slightly elastic, translucent, convex structure that is made up of approximately 25 layers of dead keratinized and flattened cells. These cells are tightly bound to one another via numerous intercellular links, membrane-coating granules and desmosomes, which are cell structures specialized for cell-to-cell adhesion [4].

The nail bed is the skin beneath the nail plate [5]. Like all skin, the nail bed is made of two types of tissues: deep dermis, (the living tissue fixed to the bone which includes capillaries and glands), and the superficial epidermis (the layer just beneath the nail plate, which moves forward with the plate). The epidermis is attached to the dermis by tiny longitudinal “grooves” known as matrix crests.

The nail matrix (sometimes called the matrix unguis, keratogenous membrane, or onychostroma) is the tissue that the nail protects [6]. This part of the nail bed rests beneath the nail and contains nerves, lymph and blood vessels. The matrix is responsible for producing cells that become the nail plate. The width and thickness of the nail plate is determined by the size, length, and thickness of the matrix, while the shape of the fingertip itself shows if the nail plate is flat, arched or hooked [6]. The nail matrix continuously produces nail. The matrix at the base of fingernails consists of the most rapidly dividing skin cells in the body, which grow four times faster than toenails at a rate of about 3mm a month. This tissue consists of rapidly proliferating skin cells that soon fill with the protein keratin. This is the protein that gives strength to the nail [7].

The nail-plate (corpus unguis) is the actual nail that we usually refer to as the “fingernail” or “toenail.” This part of the nail is made of a clear protein called keratin. Several layers of dead, flattened cells make the nail strong and able to protect the end of the finger, yet partially flexible. The nail-plate is comprised of dorsal, intermediate, and ventral layers. The dorsal outer layer is dense and hard, consisting of keratin. However, despite its hardness, this layer of the nail is only a few cells thick (approximately 0.5mm) [8]. The dorsal and ventral layers of the nail plate have the highest concentration of lipids in the nail, and affect penetrability of treatments (see below) [9]. In intermediate layer of the nail plate contains highly compressed, flattened cells, in comparison with the other two layers, which contain softer, less compressed cells [10].

The Protein Keratin: Giving Strength to Nails

Keratin refers to a family of fibrous structural proteins that give nails their hardness. Keratin is the key structural material that comprises the outer layer of human skin, hair and nails. Single pieces of keratin, or monomers, assemble into bundles to form intermediate filaments, which are tough and insoluble. These filaments are the building blocks of the nail.

Keratin filaments are comprised of keratinocytes, which are keratinized cells [11]. Keratinocytes serve many important functions, most important of which is the production of the structural protein keratin. Keratinocytes are formed deep in the skin and progresses up through the epidermis to the dorsal outer layer of the nail. During this migration, the cell is transformed right before reaching the SC into a mature keratinocyte, called a corneocyte (or squames, from the Latin word squama for scale or armor) [12].

This transformation causes the cell to change in a number of important ways. For example, the cell loses both its nucleus and cytoplasm, forms a tough outer structure called the cell envelope, expels a large amount of lipids into extracellular spaces, and aggregates large amounts of keratin inside itself. The resultant corneocyte is comprised of about 80% keratin by dry weight. By this stage the corneocyte is in reality a dead cell, as it lacks a nucleus and is no longer actively conducting biological processes. However, it now serves a structural purpose in the nail. Following maturation, this cell is shed in the normal skin cell turnover process.

2. Onychomycosis: nail fungus

Onychomycosis is a term that describes a number of different infections of keratinized tissues of the nail due to a fungus [13, 14]. A number of different fungi can cause onychomycosis, including Candida, dermatophytic molds, and nondermatophytic molds. Of these, dermatophytes are the fungi most commonly responsible for onychomycosis [13]. The most common dermatophyte species that causes onychomycosis infections is Trichophyton rubrum [15].

Onychomycosis can be picked up form the outside environment in a number of ways, but some of the most common factors that can lead to a infection include: an injury to the nail or skin near the nail, getting a manicure or pedicure with utensils that have been exposed to an infective fungi, having moist skin for a long time (for example, wearing closed-in shoes for an extended period of time), walking around in moist environments that harbor the fungi (for example, a gym locker-room) or having a nail deformity or disease. Essentially, fungi prefer warm, moist environments. Therefore, lengthy exposure of the nail to these conditions can increase one’s chances of picking up a fungal infection from the outside environment.

An onychomycosis infection begins as a small, white spot of fungi underneath the fingernail or toenail, typically in a region of the nail called the hyponychium. This is the part of the nail immediately under the nail plate but above the nail bed that is located at the tip of the finger or toe, and is the most common location for initial nail infection. The fungi responsible for causing onychomycosis reproduce and increase in numbers by making copies of itself – a process called clonal reproduction [15]. This process can happen very quickly. As the fungal infection multiplies, it can invade deeper layers of the nail, and can eventually involve virtually any part of the nail anatomy, including the matrix, nail bed or nail plate. The extent of infection can vary greatly from individual to individual.

3. How Topical Treatments Work

Topical drugs are the usual course of action of treatment of Onycomycosis because drugs can travel between cells via intercellular channels, and there exist a diverse array of topical treatments available both on the market and over the counter. Depending on the extent of the infection, these treatments must penetrate the nail and even the nail bed and matrix in order to reach the infection.

Topical treatments are treatments that are applied directly to the nail, and then soak through the nail into the nail bed and matrix. Thus, the ability of a drug to get through the nail is of utmost importance. The nail is made up of both fat-like (“lipid”) and water-like elements. Intercellular lipids are part of the barrier system of the skin; thus, it is not surprising that the stratum corneum (SC) contains a large amount of intercellular lipids. These lipids are found in extracellular space between corneocytes. It is generally accepted that these lipids play a key role in limiting the diffusion of topical onychomycosis treatments through the SC. This was a problem originally in the development of treatments for onychomycosis, as most topical fungal treatments were originally designed for non-nail application; thus, they were lipophilic and not suitable for topical application to the nail.

What are lipids? Lipids are fat molecules that have a polar head and two non-polar tails. The polarity in the head results from a molecular interaction between oppositely charged phosphate and nitrogen groups. This results in one side of the molecule being hydrophilic, or water loving, while the other side of the molecule is hydrophobic, or water hating. These molecules can bind together based on their water-hating and water-loving properties to form chains of lipids called membranes. The polar, water-soluble heads of the membrane point toward the water on the inside and outside of the cell, while the non-polar, fatty-acid tails point away from water and toward the interior of the membrane. The resulting bi-layer of lipid molecules thus contains an oily inner core. This core functions as a selective barrier that prevents water-soluble substances from moving past them.

The nail itself is comprised of approximately 7-12% water [4], and its many layers of dense, flattened keratin are considered hydrophilic (water-loving) [16, 17]. Water-soluble treatments, therefore, are much more effective as topicals than are lipid-soluble treatments, given the water-loving properties of the nail. In fact, the nail has been found to be more permeable to water than skin is [17]. Given the fact that keratin forms a hard, compressed covering over the tip of the finger, how exactly do topical treatments that are water-based get through the nail into the nail bed? There exist water-filled channels or pores spanning the membrane through which these substances diffuse.

Some exceptions to the water-fat rule do apply. For example, Vitamin E is a fat-soluble vitamin. Although it can be “water solubilized” in the lab to help its absorption through the intestinal wall, once it is absorbed into the body it would appear to behave as a fat-soluble vitamin does. Thus, the properties of some treatments must be studied carefully to determine how they will interact with the nail anatomy when applied topically, rather than orally.

REFERENCES

[1] https://en.wikipedia.org/wiki/Stratum_corneum
[2] https://en.wikipedia.org/wiki/Corneocyte
[3-ed was 12] https://en.wikipedia.org/wiki/Nail_matrix
[4] https://en.wikipedia.org/wiki/Nail_plate
[5] https://en.wikipedia.org/wiki/Nail_bed
[6] https://en.wikipedia.org/wiki/Nail_matrix
[7] https://en.wikipedia.org/wiki/Keratin
[8] https://www.nyscc.org/cosmetiscope/archive/tech1101.html
[9] https://www.ncbi.nlm.nih.gov/pubmed/10344627
[10] https://www.ijdvl.com/article.asp?issn=0378-6323;year=2012;volume=78;issue=3;spage=263;epage=270;aulast=Grover
[11] https://en.wikipedia.org/wiki/Keratinocyte
[3] K. A. WALTERS and G. L. FLYNN, Permeability characteristics of the human nail plate, International Journal of Cosmetic Science 5, 231-246 (1983)
[12] https://www.cosmeticsandtoiletries.com/research/biology/130232783.html
[13] https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002306/
[14] https://www.mayoclinic.com/health/nail-fungus/DS00084
[15] https://jcm.asm.org/content/37/11/3713.abstract
[16] https://www.anacor.com/pdf/Exp%20Opin%20%20Investig%20%20Drugs.pdf
[17] https://deepblue.lib.umich.edu/bitstream/2027.42/72442/1/j.1467-2494.1983.tb00348.x.pdf

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The good news is that you can heal your nail fungus cheaply and naturally without much effort. Baking soda is one of the most common substances in your house, but it is scientifically proven to stop the spread of nail fungus. This will help keep it to one finger or toe, and it will stay localized to just one place on the nail. Tea tree oil is another topical medication that has anti-fungal properties to kill off the bugs in your nail. Used together, these all natural remedies provide a safe, effective way to manage a nail fungus problem.

What is Nail Fungus?

Nail fungus is often an embarrassing, difficult condition. Whether you have it on your fingernails or toenails, you can often encounter difficulties in treating the fungus. Some of the symptoms of nail fungus include nail discoloration and a loosening of the nail. In fact, your nail can even fall off because of the fungus underneath it. Your nails can become brittle and change in shape entirely due to the condition. The most common signs are a thickening of the nail itself and yellowing of the nail bed. Sometimes the yellow color can manifest as streaks. You can have crumbling to the outside of the nail or dirt that accumulates under the nail bed.

Those who tend to get nail fungus are people who have Athlete’s foot, jock itch, or ringworm. You also increase your risk by getting manicures, pedicures, having an injury to the nail, or having constant moisture around the nail bed. Closed shoes are another known culprit for nail fungus.

How Alkalizing Substances Fight Nail Fungus

Baking soda is not an anti-fungal, per se. In fact, studies into baking soda’s mechanism of action show that it does not kill off any fungus that is present. Instead, the presence of baking soda keeps fungus from growing and spreading out of control. It is fungal-static, which means that it inhibits the growth and spread of the fungus to other nails.

Part of the reason that baking soda helps control fungus is that it changes the pH value of the skin and nails. When the pH is changed from a very acidic, sweaty environment to a dry, alkaline environment, fungus cannot grow. Fungus needs the acidity and the wet environment to continue to proliferate, and if you apply baking soda, you remove these properties and help cure your nail fungus.

Baking Soda as a Solution

Since baking soda works against the fungus that is living in your nails, you can use it in a number of ways. One way to use it is to take a cup of baking soda and add it to a foot bath. You can soak your feet – or hands – in the baking soda water for 30 minutes, twice per day to help discourage the growth of fungus under your nails. This often helps the mixture get underneath the nail bed, and it is effective for nail fungus that is not treatable in other ways.

The second way to use baking soda is to make a paste of baking soda and lukewarm water, and then you apply this paste to your nail. Try to work the paste into the cuticle and under the nail bed. Allow the mixture to stay on your nail for at least 20 to 30 minutes. You can do this twice per day to help control the fungus.

The last way to use baking powder is to help control the moisture on your feet. After the two methods used above, you should make sure that your feet are very dry. You may even consider using a hair dryer to discourage the further growth of fungus. Putting baking soda in your socks before wearing shoes can help you control the amount of sweat and moisture that builds up on your feet.

After using baking soda for a week or so, you may notice your nail turning white. This is a common side effect of baking soda use, and it can help if your nail fungus has discolored your nail bed. Sometime, the nail will actually fall off after treatment, and you will see that a new nail is growing underneath. This is the main goal of baking soda therapy, but don’t force your nail to fall off. Consider seeing a doctor regarding your nail fungus if you are a diabetic.

Tea Tree Oil Solutions

If baking soda doesn’t kill fungus but helps to stop its spread, you need something that has proven action against it. One of the most powerful natural remedies for fungal infections is tea tree oil. Derived from the plant Melaleuca alternifolia and steam distilled, tea tree oil has anti-bacterial and anti-fungal properties that have been recognized for centuries. Even better, this treatment is all natural and is applied topically. This is in stark contrast to the medications that doctors prescribe for you that are ingested and often have side effects that can sometimes be worse than the condition.

You can use a course of baking soda on your nails to stop the fungus, and then use 100 percent tea tree oil to kill off the fungus that already exists. You should take two to three drops and place them on the nail bed, allowing them to absorb into the skin and cuticle. You can even take a drop of the oil and direct it underneath the nail bed. With the combination of these two natural treatments, you should see changes in your nail fungus condition within a week. You can easily avoid costly prescription medications and have the nails you always dreamed of.

References

Medline Plus; Fungal Nail Infections; Linda J. Vorvick, MD; October 2010

https://www.nlm.nih.gov/medlineplus/ency/article/001330.htm

Master Gardener; Baking soda: will fungi fail and roses rejoice?; Linda Chalker-Scott, Ph.D.; 2009

https://www.puyallup.wsu.edu/~linda%20chalker-scott/horticultural%20myths_files/Myths/magazine%20pdfs/Baking%20soda.pdf

Mayo Clinic; Tea Tree Oil; 2012

https://www.mayoclinic.com/health/tea-tree-oil/NS_patient-teatreeoil

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If you want to get rid of your nail fungus, you are going to have to stay dedicated to the task and try as many different remedies as you can. Don’t give up too soon on something, though. It can take months to see any improvement in nail fungus, even with doctor prescribed treatments. With home remedies, you have to use the treatments consistently and loyally, even when it seems like it won’t work. Of course, your best course of action is to prevent nail fungus from the start.

Tips for Using Topical Nail Fungus Treatments

If you have a topical nail treatment for your nail fungus, you are ahead of the game, but you can do a few things to make that treatment even more effective than merely rubbing it on your nail and leaving it alone. Topical nail treatments need to penetrate the hard, brittle nail that the fungus has created. Unfortunately, nail is not absorbent, so if you have thick nails, that topical solution is just sitting on top of the nail and not attacking the fungus. For starters, keep your nails clean and dry at all times. Fungus and bacteria in general love a warm, wet environment. If you have sweaty feet, use an anti-fungal foot powder to keep your feet dry.

• 1. Don’t use nail polish because this only acts as an additional barrier for the topical treatment to penetrate.
• 2. File your nails down and rough up the surface of the nail with a nail file to allow the treatment to penetrate down to the tissue.
• 3. In extreme circumstances, you can have the nail removed entirely so that the medication can kill off the fungal infection. The toenail will grow back after eight to ten months. Permanent toenail removal is not often recommended for fungal infections unless they are causing a great deal of pain.

How to Prevent Nail Fungus Infections

If you do get your nail fungus under control, you want to prevent further infections. In fact, you want to prevent spreading the infection to your other nails because you will have even more difficulty getting rid of the infection if it spreads. For instance, pay attention to the spaces between your toes. They can often harbor bacteria and lead to the fungal infection spreading from one toe to the next. Keep your socks and shoes clean, as well. You should change your socks at least one per day, but change them more if you have sweaty feet. Your shoes should be well-ventilated and fit your feet well. Too tight and they can lead to moisture and more fungus growing.

Always trim your nails straight across to prevent them from pushing against footwear. This can cause trauma and an entrance pathway for the fungus. File down thickened parts of the nail to keep them clean and dry. If your hands are exposed to water frequently – such as a dishwasher – wear rubber gloves to protect your nails from fungus. People who bite their nails or pick at the skin around their nails are more prone to a fungal infection because the teeth can open up an infection pathway and the mouth introduces bacteria into the wound.

Always wear shoes in public showers or other places where bacteria may be present on the floor, and give up the artificial nails that trap bacteria beneath the nails. If you must get a manicure, be sure to go to only a reputable salon that takes proper hygienic measures. Most importantly, wash your hands immediately after working with your infected nail. Do not touch your other nails after cutting, treating, or otherwise dealing with the infected nail. Wash your hands, and then move on to care for the other nails.

Simple Home Remedies to Treat Nail Fungus Infections

You can do a great deal of different soaks, solutions, and topical applications of home remedies to help heal your nail fungus infection. One of the most common home remedies that can be used in conjunction with other treatments is the use of vinegar. You can soak your feet in a vinegar solution that is one part vinegar to two parts water. You should keep your feet soaking for at least 15 to 20 minutes to allow the solution to penetrate the nails and tissue more thoroughly. Another variation on this soak is to use apple cider vinegar. Experts suggest a 50/50 lukewarm water to apple cider vinegar bath. Again, soak for 15 minutes. You can also apply vinegar directly to the toe two to three times per day. No matter how you use vinegar, make sure you wash and dry your feet thoroughly when you are done with your soak. Any moisture that is left behind is a breeding ground for the fungus and will have the opposite effect you are looking for.

Another popular soak is to use mouthwash to help kill off some of the fungus under your nail. Wash your feet first by taking a bath, then pour antiseptic mouthwash into a basin and soak your nails in it for 30 minutes. You will need to wash your feet or hands with soap and water after your soak, and make sure to dry well, too. Disinfect the basin that you use for your soaks to prevent the fungus from growing in it between soakings. You could end up reinfecting yourself or possibly infecting other nails.

Vick’s VapoRub is another home remedy that is often used to fight nail fungus. Experts recommend creating grooves in the infected nail with a nail file to aid absorption. You simply put a glob of the VapoRub on the nail bed and let it absorb. This treatment can be used a few times a day for several days, but different references have different instructions for the VapoRub remedy. You might have to try several techniques to find something that works.

You can find several outlandish treatments for nail fungus out there, but they are worth mentioning if they help. You can make a solution that is one part pine cleaner and one part soy sauce. Using a dropper, apply this to the affected nail after washing your feet or hands. Another possible treatment is garlic. One remedy calls for sleeping with garlic cloves in the ends of your socks or using a garlic paste to apply it directly to the nail. Whatever you find to help with you nail fungus, if you start to feel pain, irritation, or redness, stop using the treatment and contact your doctor. If you cannot get any relief from your nail fungus situation and it is becoming painful, you may need to see your doctor for more definitive treatment that may include prescription medication.

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Many over the counter (i.e., non-prescription) anti-fungal treatment options are available, however some are not very effective at treating true nail fungal infections. Oral prescription medications, such as Lamisil and Sporanox, can be  an effective means of treating fungal nail infections as well as tea tree oil, but treatments can take as long as four months to fully work. Other treatment options include a prescription antifungal nail polish called Penlac, however this make take up to one year to show improvement. In addition, some topical medications may be used along with a prescription medication.

Overview of Dr. Paul’s Piggy Paste

A recent addition to the market of over-the-counter nail fungus treatments is a product known as “Dr. Paul’s Piggy Paste.” This product is not touted as a means to treat the fungal infection itself, but rather as an easy way to improve the appearance of toenails that have been thickened and discolored by the presence of nail fungus.

According to an article published in May of 2010 in the Bloomington, IL newspaper Pantagraph, the physician-inventor of Dr. Paul’s Piggy Paste – Dr. Paul Kinsinger – concedes that the product cannot be touted as a treatment for toenail fungus, citing the fact that Piggy Paste has not been through the clinical trials needed to substantiate such claims. However, he does use anecdotal evidence from use in his own medical practice – as well as sales of the product – to support his assertions that the product works to improve the appearance of nails affected by fungal infections.

The concept for Piggy Paste originated from Dr. Kinsinger’s experience with the well-known historical practice of soaking toes in a solution of half vinegar (acetic acid) and half water for approximately five minutes a day for nine months, which has anecdotally been shown to clear up toenail fungus. Realistically speaking, however, most people who suffer from toenail fungus do not have the time to devote to doing this every day. So, Dr. Kinsinger simply decided to make the process easier. He worked with a compounding pharmacy to develop a product that delivers the vinegar to the toe in an easily absorbable paste. He then worked with the pharmacist to finalize the formulation for individual prescriptions. Dr. Kinsinger recruited more than 100 of his own patients who had toenail fungus to apply a pea-sized amount of the paste to each affected nail and cuticle once per day, and then cover with a bandage for a minimum of two hours. According to Dr. Kinsinger, 81 patients saw their nails clear within three to four months and new nails grew in without fungal spores.

Ingredients of Dr. Paul’s Piggy Paste

It is important to note that Piggy Paste is not specifically marketed to treat the nail fungus itself, only to improve the appearance of affected toenails and new nail growth. Accordingly, there are no conventional anti-fungal ingredients in Dr. Paul’s Piggy Paste, such as those commonly found in over-the-counter antifungal medications (e.g., terbinafine [the active ingredient in topical Lamisil]).

As listed on the product’s website, the ingredients in Dr. Paul’s Piggy Paste include: propylene glycol, ethoxydiglycol, acetic acid (vinegar), thymol (a common ingredient in mouthwash), hydroxypropylcellulose, dimethyl sulfoxide (DMSO), menthol-USP, and butylated hydroxytoluene (BHT). Acetic acid, thymol, and menthol appear to be the active ingredients, with DMSO acting to deliver the ingredients to the nail bed, and the remaining ingredients present to provide the paste-like medium.

Active ingredients:

Acetic Acid (Vinegar)
When fungus invades a nail, it alters the pH balance of the nail and surrounding skin. The acidity of vinegar helps to restore the pH balance to more natural levels, as well as to relieve the itching and pain caused by the fungal infection. Since the fungi that frequently infect nails do not like acidic environments, the vinegar essentially creates an environment that is no longer hospitable to the growth of the fungus and ultimately halts the growth and spread of the fungus.

Thymol and Menthol
Thymol is the primary essential oil from in the herb known as thyme. Menthol is an oil-based extract from mint plants. Both thymol and menthol have antibacterial and antifungal properties, and are common ingredients in over-the-counter medicated chest rubs such as Vicks® VapoRub®, as well as a common ingredient in toothpastes and mouthwashes. Their antibacterial and antifungal properties have fostered their reputation as effective ingredients in products designed to treat nail fungus.

Numerous anecdotal and layman’s reports have testified to the effectiveness of thymol, menthol, and medicated chest rubs in general, as a means of treating fungal nail infections. The scientific literature also lends some support for their use. For example, a 2003 study by Ramsewak et al. investigated the effectiveness of a medicated chest rub similar to Vicks® to prevent the growth of fungal nail infections. They found that both thymol and menthol were two of the most effective ingredients at preventing the growth of the fungi that were studied.

In Dr. Paul’s Piggy Paste, the combination of acetic acid, thymol, and menthol – with their ability to restore pH balance to the nail and kill existing fungal spores – likely work together to enable the new nail to grow out clear and free of fungus.

Inactive ingredients:

Propylene glycol
Propylene glycol has many uses; however, in the medication and cosmetics industry it is typically used to maintain moisture and is also used as a solvent.

Ethoxydiglycol
Ethoxydiglycol is a cosmetic-grade solvent that is used in many skin care preparations as a carrier for active ingredients.

Hydroxypropylcellulose
Hydroxypropylcellulose is typically used as an ingredient in prescription artificial tear compounds designed to treat insufficient tear production and other eye problems. It can also be used as a thickening agent and as an emulsion stabilizer.

Dimethyl sulfoxide
Dimethyl sulfoxide, or DMSO, is a natural byproduct of the wood industry. When used topically, it can help to speed wound healing, treat inflammation, and toenail fungus. Although it does not, however, have antifungal properties, DMSO is incredibly penetrative and helps to drive anti-fungal medications down into the nail bed and surrounding tissues. It is likely that it plays this role in this formulation of Piggy Paste.

Butylated hydroxytoluene (BHT)
Butylated hydroxytoluene is an antioxidant compound typically used as a fragrance in cosmetic products.

References

https://www.mayoclinic.com/health/nail-fungus/DS00084

https://www.piggypaste.com

https://www.disabled-world.com/artman/publish/article_377.shtml#ixzz1frXECJRo

Ramsewak RS, Nair MG, Stommel M, Selanders L. In vitro antagonistic activity of monoterpenes and their mixtures against ‘toe nail fungus’ pathogens. Phytother Res. 17(4):376-379.
https://www.atsdr.cdc.gov/toxfaqs/TF.asp?id=1121&tid=240 (Propylene Glycol ToxFaQs™)

https://www.drugbank.ca/drugs/DB00840

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Over the years we’ve had the opportunity to collect testimonials from people who left comments on ToenailFungusTreatments.com, who have used different types of nail fungus remedies. After analyzing them, we’ve created some useful suggestions for those who want to eliminate nail fungus.

Of course, nothing is ever 100% guaranteed, but if we can learn from others with similar problems, we have a better chance of crossing off one more problem we have from the list that seems to accumulate many problems as we age.

How Doctors Heal Patients

In fact, I was thinking about doctors and how they learn. I know that if you ask any doctor who he or she learned the most from, they will say their patients. In the practice of medicine, a doctor who pays the most attention to the results that their patients are receiving, and makes appropriate adjustments is often the most successful – both with people and against disease.

Recognizing this feedback loop was very valuable, we started collecting reports on remedies from our readers and have been able to create some basic guidelines for anyone with nail fungus problems who wants to use these treatments to get clear nails again.

Guidelines From Our Readers about Nail Fungus Remedies

Remedies for nail fungus are plentiful. Lamisil, a prescription and over-the-counter medication, is often recommended by medical doctors; both general practitioners and dermatologists. Home remedies such as tea tree oil, hydrogen peroxide, vinegar, or even Vick’s Vapor Rub could work. Even Star Trek technology has hit the nail fungus scene and doctors may use laser to zap the fungus into infinity. All of these remedies have good possibility of being successful.

Whatever remedy you use, remember that it’s not enough to focus on the remedy itself. You still have to clean the nail – and do it right. And you still have to thoroughly wash your feet daily.

The treatments must reach the nail bed. The fungal infection starts at the nail bed, not on the nail itself. Nail beds are composed of a thick keratin layer and your remedy must penetrate this to get those fungi predators that are lurking below the surface, knowing that they are well out of your reach. Develop a fungi killer mentality, as if you will be relentless about any of their lives!

General foot care is imperative: always trim and file down your nails. Also, don’t hide your feet, as difficult as it may be. Keep your nails and toes well-ventilated. And as much as you want to paint your toenails, don’t do it. Healing will need the area to be undisturbed.

Testimonials Give You a Breadth of Information Not Found Otherwise

With these in mind, let’s examine testimonials on each of the above-mentioned remedies and learn a little background on the fungus, why the remedies work and other great tidbits of info. Now, just for the record, I did make spelling and grammar changes just to make them easier to read.
Tea Tree Oil and Zetaclear

Have you ever thought that it’s possible that our Creator might have realized that sometime in life we could get nail fungal infections and created a natural remedy for it?

The amazing thing is that almost every culture has a different remedy for nail fungus, and all of them have the potential to work. Some of these remedies become popular and carried to other cultures; some may even make newspaper headlines, and others may even be recommended by medical doctors.

Tea tree oil is one such remedy. Patients at the Mayo Clinic often ask about this treatment, which is why they have a page about it on their website at www.mayoclinic.com However, there’s always a problem with natural remedies being recommended by doctors and hospitals who are funded by pharmaceutical companies: a natural remedy such as tea tree oil cannot be patented and doctors and pharmaceutical companies stand to lose money by recommending it.

So don’t expect the Mayo Clinic to be your source for all the positive results obtained in studies. If you received positive results you wouldn’t have a need for an office visit.

Nevertheless, the Mayo Clinic does report that Tea tree oil has been used traditionally to prevent and treat infections and has antiseptic properties. They counter this with a “lack of definitive available evidence”.

The fact of the matter is that the words, “traditionally used to prevent and treat infections”, is in itself a badge of effectiveness. This means that over decades the remedy has been used. And people don’t keep using something that doesn’t work, do they?

Zetaclear is a natural tea tree oil based remedy; it’s simply essential oils combined together for the purpose of supporting healthy nails.

Here are some testimonials on the use of tea tree oil in nail fungus infections:

Ugly Toenail Transformed to Beautiful and Perfect

“I have been using tea tree oil from Melaleuca on my toenail (great toe only) for about six weeks with amazing results! I apply it every night after soaking my feet in the bathtub. I started out by pulling the nail out so the oil would go under the nail as well as on top of it.

Now the nail is really loose in the affected areas, which I am clipping off a little at a time. A beautiful new perfect looking nail is growing up from the bottom! The toe is still pretty ugly but after watching it get worse and worse for the last few years, I am THRILLED! P.S., I went to a podiatrist before starting the treatment and he didn’t even want to discuss anything except oral Lamisil. I decided to try the tea tree oil and I am so glad that I did!”

Results Seen Over 7 Months

I have been using zetaclear and tea tree oil for toenail fungus for about 7 months now. I paint it on my nails every day, and have kept my toenails filed down thin so it will penetrate. The nail fungus looks MUCH better…”

Restored Hope that Healing is On Its Way

“Incredible!! My dermatologist couldn’t be bother & wanted me to spend big $ for the podiatrist. Vicks & OTC did not work for months! Tea Tree Oil after a month has had a positive effect. Still at it!! But hopeful now!”

Tea Tree Oil Works!

“I have had a nail fungus for several years. The fungus discolored about half of my big toenail. I have been using tea tree oil daily for 8 weeks. The discoloration has moved up the nail and the fresh nail is natural colored. I believe that it will take about 6 more weeks to eliminate the fungus completely.”

Discovered that Naked Nails are Necessary for Healing

“I’ve had fungus on both big toes and both little toes for years. Let it go for years, ignored it, and kept getting pedicures for YEARS!!!! Well, over a year ago I decided to try formula 3 which didn’t do much.

Just about 3 mos. ago I started DMSO and tea tree oil. Well, it’s working. I apply with a nail polish brush from a nail polish bottle and mix equal amounts of the DMSO and tea tree oil. My nails take a long time to grow but are finally almost grown out and what a difference.

I had a dermatologist tell me a couple mos. ago that it’s really difficult to get rid of nail fungus infections and to just forget it and get them painted. Wow, nice doctor!

The jury is still out on an absolute cure but they are definitely improving and I feel it’s almost cured! Don’t get a pedicure and get them painted. This will only prolong the infection and actually will be a waste of your time. Your nails must remain naked the whole time you’re treating them.”

Worked on Intestines Simultaneously with Probiotics

“I cut my nail down as far as I could with nail clippers, then filed the top, too. I used a metal file to clean under the nail after every shower. I then put tree tea oil on it in the form of Zetaclear. The bottle had a brush in it. I began taking probiotics and I think this is what did the trick. It is a very expensive bottle – $60 for a small bottle, but after 3 months it is gone!”

Never Give Up on Nail Fungus

“I had nail fungus for many years. I tried ALL of the remedies including tea tree oil, Listerine, oregano oil, bleach, hydrogen peroxide and others. Finally tried a product called Zetaclear. This stuff cleared my nails in only a few months. Good stuff.”

Vick’s Vapor Rub Works for More than Chest Ailments

Vick’s Vapor Rub is a unique combination of petroleum jelly and oils along with active ingredients that can fight the infection, such as menthol. Let’s find out what happened when people used it on their nail infections.

Test Between Lamisil Versus Vick’s Vapor Rub

“I’ve had toenail fungus for 25 years. My wife asked her doctor to prescribe oral Lamisil but an assistant mentioned he was doing a study on Vick’s Vapor Rub. She took the Lamisil and I decided to try Vicks. She totally cleared up hers in 3 months and so did I!

I got complacent and stopped Vicks after 6 months and the fungus returned in 6 weeks. Hers did not return. So Vicks requires a lifetime commitment.

Here’s the method of how to do it:
First, wash your feet very well.
Then exfoliate any dead skin from under and around the nails, where possible.
Apply Vicks under the nail where possible and slather on top of nails.
Whenever possible go barefoot, but the Vicks can leave grease stains, so be careful where you walk.
Apply twice a day.
Don’t stop for a day. Be committed and scientific about the process and I’m sure some of you will have the same results.”

Some Remedies Take Time and Effort

“The doctor is right. It’s 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.”

“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.”

Weak Immune System Can Predispose You to Fungal Infections

“I suffer from a faulty immune system and am prone to frequent fungal infections. One of the best treatments for nail fungus is to use an emery board to thin the entire nail. I try to make sure that I do it while the nail is a little damp to avoid creating too much nail dust with fungal spores in it. I do this the first time and again as needed to keep the nail thin and more permeable.

Then I begin to rub in Vicks VapoRub. Store brands are acceptable but I tend to still go for the name brand. I continue to apply the Vicks twice a day for several weeks and it works. It has all sort of natural oils in it that create an inhospitable environment and kills the fungus.

Remember to swab around the nail and all your nails just to be sure that you catch anything that may be starting up. These fungi eat keratin, the hard material that nails and hair are comprised of. A toenail infection can spread to fingernails, and even to hair. It is also very contagious and spread between family members.

I recommend having the afflicted family member wear flip-flops in the shower and for good measure I will pour a little white vinegar in the shower/tub after someone takes a shower.

Another affordable way to deal with nail fungus is to thin the nails with an emory board and using a cotton ball swab the nails with Listerine. These approaches are more affordable and less complicated than the beer method, etc. Best of luck to you all.”

Fungal Nail Infections Can Spread to Other Nails

“When I was in rehab after hip surgery, they cut my toenails, and I didn’t want to criticize them but they went from one toe to the next after trimming the big toenail that had the terrible fungus. It didn’t take long for every nail to show the beginnings of a fungal infection.

That was 4 years ago and I’ve battled it ever since… until 2 weeks ago, when I rubbed Vicks Vaporub under and over every nail. I am so pleased with the outcome. They look sooooo much better now. They aren’t totally clear, but it’s improving everyday. Please try it and report your findings on here in about two weeks. Good luck.”

Vinegar: The Kitchen Remedy that Housewives Love

Vinegar is really an acid; it’s called acetic acid. Acetic acid can destroy the dermatophytes, microbes that feed on the skin, and cause nail infections. The official term for nail infections is onychomycosis.

When using vinegar, soak the affected nails of the hands or feet in a solution of 1 part vinegar to 2 parts water for only 20 minutes a day.

This is the same procedure that you can use for Listerine; just replace the vinegar with Listerine.

Soak with Vinegar and Forget the Rest

“I wish I would have started vinegar baths WAY sooner. I let my big toe get worse and worse, just covered it with nail polish until it was just hollow with fungus underneath, and then turned black with bacterial infection.

Then I tried a holistic remedy that included oregano extracts and a lot of other agents that dried it out a lot and now it has cracked in half down the middle.

Finally I read up and discovered most chat rooms promote vinegar. I have been soaking my foot twice a day for about a month, and the three affected nails are (slowly) growing in smooth and pink. But the big toe has just a fraction of a nail right now – with the two sides of the old nail flapping over it like shutters. I am keeping it there, and tape it closed with a band-aid during the day just to protect the nail bed. My advice is to soak with vinegar, and forget the rest.”

Fungal Spores are Like Eggs Waiting to Hatch

“Apple Cider Vinegar actually changes the pH balance of the foot. This creates an environment that the fungus cannot survive in. Think of a human surviving in an environment without oxygen. Same thing.

Spores can and will survive, waiting for the right conditions to exist however; so this pH balance will have to be maintained or the fungus will once again come to life. Like eggs waiting to hatch.”

3. Hydrogen Peroxide Cleans Wounds and Fungus

Hydrogen peroxide is nothing but oxygen and hydrogen molecules together. It’s an oxidizer that is capable of being used as a cleaning agent, as bacteria is killed when it comes into contact with the peroxide.

Hydrogen peroxide is a translucent, colorless liquid, slightly more viscous than water.

Use Precautionary Tactics As Well

“I have used peroxide with great success. I have not fully gotten rid of it, but my condition is much, much better. I try to pour some on the infected nail every time I get out of the shower. After I cut my toenails, I pour some on the nails as a disinfectant.”

Remedies Combined are Better than Remedies by Themselves

“I found the best remedy for my fungus: mix a 50/50 combination of apple cider vinegar and 3% hydrogen peroxide. Apply to the nails until no more fizz bubbles come out. Then mix it in a 50/50 combination of water and bleach. If the fungus is really bad, add more bleach and soak your toes in this mixture for 30-40 seconds. Then rinse and dry your toes.

Next mix tea tree oil with petroleum jelly (vaseline) and apply it to the nail. Cover with a band aid so it’ll stay on all day long. The fungus will be gone within a week.

Quick tip: I filed down my nail to make it thinner so the mixtures would hit the fungus directly, this works faster.”

Lamisil, Doctor’s Choice for OTC & Prescription Medication

The medical profession generally uses terbinafine hydrochloride (Lamisil) for nail infections, which are technically called onychomycosis. Lamisil works by inhibiting the enzyme responsible for creating the cell wall of the fungi. Without a cell wall, fungi can’t live or reproduce.

Direct Attack on Fungi To Prevent Reproduction Works

“I have used a combination of Lamasil 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 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; fungal spores are only vulnerable 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.”

Push the Topical Creams Under the Nail for Best Results

I’ve been using Lamasil topical cream for my big toenail infection. While using a nail file to push the cream under the nail, 2 months later with once a day application, the nail is clear colored and there is no more curving and burrowing in the skin. Also have been using iodine and pushing it under the nail. All the topical solutions do penetrate the nail, so lift the nail up a bit with a file and push the iodine or Lamasil in there. Hope it works for you also.”

5. Laser Treatment: Is Star Trek Technology Working Yet?

“I spent nearly $600 over a 4-month period for three laser treatments on a single toe with no improvement. It was ineffective and not worth the $$. I’d recommend saving your money and avoiding laser treatment for toe fungus until more R&D is done. It did not work for me, and I only have fungus beneath one of my large toenails.”

Very Expensive Medical Treatment Didn’t Profit Her

“I have had the three Pinpoint laser treatments for nail fungus with little improvement. Some of the least infected nails have improved some but not the ones with more fungus. I know every patient is different but before you spend $1000 or more, be ready for the fact that you could be very disappointed. Spent $1000 to wear sandals but the bad nails still look bad. Save your money.”

Expensive Laser Treatment Zapped Her Wallet, Too

“I had Pinpointe Laser treatments. I had two treatments within 10 months and I thought my toenails were improving, but they are NOT. I’m so upset I could cry. The cost to me was a little over $1000 and I had to drive over 2 hours in order to have the treatment done. I feel. I think I’m just doomed to have this forever. BTW, I also purchased Steri-Shoe when I had my first treatment.”

If you use a combination of different treatments, you have a greater chance of success. This is because an individual only attacks the fungi on one level. For example, the antimicrobial effects of tea tree oil will have one specific effect on the fungus and take a certain length of time to work. However, if you added a second treatment that interfered with the reproduction of the fungi, now you’ve initiated a second line of defense against the infection.

Imagine what would happen if you added a third remedy and possibly a fourth. Attacking the fungi from four different perspectives can give you results in a shorter period of time. And that’s really what you want, isn’t it?

There is no such thing as a quick cure for nail infections. That’s because the nail is slow-growing, taking about six months to grow fully out. Any infected part of the nail must grow out. Thus, you need a lot of patience.

Once the new nail growing out is not infected, you have cured it. Below is my best treatment for toenail fungus. I want you to have it and be able to show your pretty feet to the world again!

Tom’s Toenail Fungus Treatment

1. Always dry feet and toes thoroughly after bath/shower. No pedicures at all and keep nails short. Use a fungicide powder like Lamisil or Desenex and be sure it gets into all nail corners.

2. Alternate two or three remedies and use twice a day. I like Lamisil cream, Fungi cure (paints on) and tea tree oil which is the best anti-fungal in the world. Alternating really helps because it keeps surprising your fungus with a new attack.

3. Acid footbaths (like Listerine or vinegar) help but they are no substitute for continuous topical applications, like described above.

4. The internal meds are very dangerous. You don’t need them if you are patient and keep at it. If you must take something, take acidophilus which is great for you anyway.

With all these new ideas for how to eliminate toenail fungus presented in this article, your head may be spinning with the possibility of a bright future. The best way to start is to select two or three remedies and use them together. Keep a journal of what your strategy is and your daily progress. Write the guidelines in your journal so you recall them now and in the future. Your journal can help others who have toenail fungal infections,

Since there are thousands of people suffering from toenail fungal infections, referring back to your journal for specific details can make a big difference in their lives. And that’s what life is all about – overcoming obstacles so that others may also benefit!

The post Nail Fungus Sufferers: What Works and What Doesn’t? appeared first on ToenailFungusTreatments.com.

Nail fungus (onychomycosis) is the most common affliction of the nails, characterized by abnormal nail color, texture, and thickness. Nail fungus is caused by an infection of one of several possible species of fungi, with humidity, improper footwear, nail trauma, genetic predisposition, and immunosuppression considered contributing factors4. Both continuous and pulse itraconazole treatment regimens have demonstrated efficacy against nail fungus. A clinical response can be observed after several months of systemic treatment with orally administered itraconazole in over 80% of patients. Long-term remissions are observed in the majority of patients, although a small percentage of patients that have been successfully treated do ultimately relapse. Factors affecting treatment outcome include the site of infection (fingernail vs. toenail) and the species underlying the infection5,6. The efficacy of itraconazole in achieving clinical response and long-term cures of nail fungus is likely attributable to its ability to be absorbed into the nail and remain there at therapeutic levels for at least 6 months after completion of treatment5,7.

In addition to its use in the eradication of nail fungus, itraconazole has been used for treatment and prevention of systemic fungal infections in immunocompromised cancer patients8. However, recent studies have suggested that azole anti-fungal compounds may also be directly effective against certain types of cancer and prolong patient survival. Econazole kills leukemia, breast cancer, and colorectal cancer cell lines in a dose-dependent manner and slows the growth of colorectal cancer in mice9-11. Ketoconazole also suppresses the growth of colorectal cancer in mice, and potentiates the activity of nocodazole, a known chemotherapeutic agent12. Moreover, combination chemotherapy including ketoconazole increased the response length and overall survival of patients with androgen-independent prostate cancer13.
Intriguingly, accumulating evidence suggests that itraconazole may in fact be an even more potent chemotherapeutic agent than econazole or ketoconazole. Several recent studies have demonstrated that itraconazole specifically targets key molecular pathways involved in cancer. Itraconazole was shown to inhibit the mammalian target of rapamycin (mTOR) pathway, a signaling network regulating cellular growth and proliferation that is frequently activated in tumors. Inhibition of mTOR signaling by itraconazole is dependent on the aforementioned ability of itraconazole to block metabolism of lanosterol, which is also a precursor of cholesterol in humans. Proper synthesis and transport of cholesterol within the cell is required for mTOR pathway activation14.

The Hedgehog (Hh) pathway, normally involved in embryonic development and stem cell regulation, is another signaling cascade that is aberrantly activated in a variety of human tumors. Itraconazole was recently identified in an unbiased screen for small-molecule antagonists of the Hh pathway, with inhibitory activity over 10 times more potent than any other azole anti-fungal. Interestingly, unlike the mTOR pathway, the role of itraconazole in Hh pathway inhibition is not dependent on its role in cholesterol biosynthesis, but on its ability to compete with natural activators of the essential Hh pathway component Smoothened (SMO). Experiments in mouse models of medulloblastoma and basal cell carcinoma harboring activating mutations in the Hh pathway further demonstrated that itraconazole could suppress the growth of Hh-dependent tumors15.
Another key feature of tumors is their ability to induce angiogenesis, or the formation of blood vessels, to obtain their own blood supply. Itraconazole was also identified in a screen for small molecules that block proliferation of the cells that constitute the inner lining of blood vessels. As with the Hh pathway, the inhibitory activity of itraconazole was unique among all azole anti-fungals. In addition to inhibiting cell cycle progression of endothelial cells in vitro, itraconazole was shown to suppress growth factor-dependent angiogenesis in mouse models of blood vessel formation, indicating its potential use as an anti-angiogenic compound16.
Itraconazole has also been linked to regulation of cellular processes that protect against cancer. Cytokines are small molecules that serve diverse functions within the body’s immune system and during cancer progression. Certain types of cytokines that are released in response to infection and inflammation can activate immune cells capable of killing tumor cells. However, other types of cytokines that promote proliferation and survival of normal blood cells can be exploited or produced by cancer cells. Itraconazole is a modulator of cytokine activity that can both increase production of cytokines involved in host defense and lower levels of cytokines that promote leukemic cell growth17,18.
Another important component of the body’s defense against cancer is the production of antioxidants that protect tissues from the potentially cancer-inducing effects of carcinogens, mutagens, and naturally occurring free radicals. NAD(P)H:quinone oxidoreductase 1 (NQO1) has been shown to be a direct target of itraconazole. The major role of NQO1 is the maintenance of cellular levels of antioxidants, but NQO1 also contributes to the stabilization of tumor suppressor proteins. Itraconazole treatment increases NQO1 levels, and therefore may promote both cellular detoxification and tumor suppression19.
Together, these studies suggest that itraconazole, an anti-fungal compound currently used to treat nail fungus, may also be a novel chemotherapeutic and chemoprotectant agent. Because the anti-fungal effects of itraconazole have been extensively studied for over 25 years, its safety and potential side effects are already well characterized. Excitingly, the doses of itraconazole already used to treat nail fungus and other types of systemic fungal infections result in blood serum levels well within the range needed to achieve the observed anti-cancer effects15,16. Clinical trials to determine the effect of itraconazole in treating lung cancer, skin cancer, prostate cancer, breast cancer, and leukemia are now underway20.

References

1 Drugs@FDA – FDA Approved Drug Products website https://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm

2 Odds FC. Intraconazole – a new oral anti-fungal agent with a very broad spectrum of activity in superficial and systemic mycoses. Journal of Dermatological Science 5(2): p. 65-72 (1993).

3 Vanden Bossche H, et al. Anti-Candida drugs – the biochemical basis for their activity. Critical Reviews in Microbiology 15(1): p. 57-72 (1987).

4 Welsh O, et al. Onychomycosis. Clinics in Dermatology 28(2): p. 151-159 (2010).

5 Gupta AK, et al. Itraconazole for the treatment of onychomycosis. International Journal of Dermatology 37(4): p. 303-308 (1998).

6 Hay RJ, et al. An evaluation of itraconazole in the management of onychomycosis. British Journal of Dermatology 119(3): p. 359-366 (1988).

7 Matthieu L, et al. Itraconazole penetrates the nail via the nail matrix and the nail bed – an investigation in onychomycosis. Clinical and Experimental Dermatology 16(5): p. 374-376 (1991).

8 Cronin S and Chandrasekar PH. Safety of triazole anti-fungal drugs in patients with cancer. Journal of Antimicrobial Chemotherapy 65(3): p. 410-416 (2010).

9 Ho YS, et al. Molecular mechanisms of econazole-induced toxicity on human colon cancer cells: G0/G1 cell cycle arrest and caspase 8-independent apoptotic signaling pathways. Food and Chemical Toxicology 43(10): p. 1483-1495 (2005).

10 Soboloff J, et al. Sensitivity of myeloid leukemia cells to calcium influx blockade: application to bone marrow purging. Experimental Hematology 30(10): p. 1219-1226 (2002).

11 Zhang Y, et al. Purging of contaminating breast cancer cells from hematopoietic progenitor cell preparations using activation enhanced cell death. Breast Cancer Research and Treatment 72(3): p. 265-278 (2002).

12 Wang YJ, et al. Ketoconazole potentiates the antitumor effects of nocodazole: In vivo therapy for human tumor xenografts in nude mice. Molecular Carcinogenesis 34(4): p. 199-210 (2002).

13 Scholz M, et al. Long-term outcome for men with androgen independent prostate cancer treated with ketoconazole and hydrocortisone. Journal of Urology 173(6) p. 1947-1952 (2005).

14 Xu J, et al. Cholesterol trafficking is required for mTOR activation in endothelial cells. Proceedings of the National Academy of Sciences 107(10): p. 4764-4769 (2010).

15 Kim J, et al. Itraconazole, a Commonly Used Anti-fungal that Inhibits Hedgehog Pathway Activity and Cancer Growth. Cancer Cell 17(4): p. 388-399 (2010).

16 Chong CR, et al. Inhibition of angiogenesis by the anti-fungal drug itraconazole. ACS Chemical Biology 2(4): p. 263-270 (2007).

17 Bruserud Ø. Effects of azoles on human acute myelogenous leukemia blasts and T lymphocytes derived from acute leukemia patients with chemotherapy-induced cytopenia. International Immunopharmacology 1(12): p. 2183-2195 (2001).

18 Inoue H, et al. Modulation of the human interleukin-12p40 response by a triazole anti-fungal derivative, itraconazole. Scandinavian Journal of Infectious Disease 36(8): p. 607-609 (2004).

19 Korashy HM, et al. Induction of the NAD(P)H:quinone oxidoreductase 1 by ketoconazole and itraconazole: a mechanism of cancer chemoprotection. Cancer Letters 258(1): p. 135-43 (2007).

20 ClinicalTrials.gov: A service of the National Institutes of Health.

https://clinicaltrials.gov/ct2/results?term=itraconazole+cancer

The post From Toenails to Tumors: Itraconazole in the Treatment of Nail Fungus and Cancer appeared first on ToenailFungusTreatments.com.

Fungal infections of the toenails are much more common than infections of the fingernails. It has been estimated that anywhere between 2 and 14% of adults have onychomycosis, and as people age, they are also more likely to have the infection. It is more likely to occur to the nails of people under a number of circumstances, including those who have had:

• Nail trauma
• A depressed immune system, such as after chemotherapy, HIV infection, or certain immunosuppressant medications
• Diabetes mellitus (as many as 26% of diabetics have onychomycosis)
• Poor circulation in the legs and feet
• Difficulty cutting their toenails correctly

Onychomycosis is not dangerous. The affected nails become thick and difficult to cut. People with affected toenails may experience discomfort. This is especially true for the big first toenail. The pressure of shoes on it can be painful. Affected nails can get caught on clothing. There is a definite cosmetic problem with onychomycosis, especially of the fingernails. Most people want to get rid of the infection and make the nails appear more normal.

Fortunately, there are a few good or guaranteed ways to treat onychomycosis and a few treatments to avoid. This is not for lack of trying. Medical doctors as well as homeopaths and people experiencing the problem have all tried many different ways to get rid of the fungus. While no one has found a perfect cure all,  there are a few treatments that are worth trying as the results are promising.

Most of the fungi that cause nail infections are called dermatophytes, meaning that they like to grow in the skin. Candida, commonly called yeast, can also cause onychomycosis.

The appearance of an involved nail depends on where the infection begins. Most of the time, fungus gets into the sides or end of the nail. This results in a thickened and yellowed nail with debris underneath that most people recognize as a fungal infection. It can also penetrate from straight above the nail, which causes a superficial white, powdery appearance. Fungus can get into the nail from where it begins, especially in people with depressed immune systems. In these cases the entire nail will grow out with fungus in it. The more of the nail that is involved, the harder it is to treat.

Diagnosis of Onychomycosis

Before starting any treatment for this condition, you want to make sure that you are diagnosed properly. Other things can look like onychomycosis, including but not limited to nail damage as well as the changes in nails seen in people with psoriasis. Ideally you should see a doctor, and the doctor should take a sample of the nail and the debris beneath to look at under a microscope and to send for culture. Sometimes the microscopic examination and culture have to be done twice to get a definite diagnosis. You should be positive of the fungal infection before you start on any oral medication, if that is what you decide to do.

If you want to try over-the-counter medication or home remedies first, if they aren’t dangerous, there is not much risk. However, since there are other conditions associated with abnormal nails, if you don’t see a doctor, you might be delaying the diagnosis of some other illness.

Treatment of Onychomycosis

All treatment of onychomycosis, whether traditional or alternative, in a doctor’s office or at home, using medicines or surgical techniques, is less successful than treatment of other fungal infections, for example, in the skin. The fungus seems to be quite successful at living in and around nails.

Before specific treatment of onychomycosis of the feet begins, there must be a general assessment of the feet. Tinea pedis or “athlete’s foot” should be treated with an antifungal cream. This can be obtained over the counter or as a prescription. Lamisil® (terbinafine), Nizoral® (ketoconazole), Mycelex® (clotrimazole), Naftin® (naftifine), Loprox® (ciclopirox olamine) and others, including generic formulations are all effective. Calluses should be smoothed and moisturizer applied to any dry, cracked skin. Toenails should be kept short.

The feet need to be kept dry. This means thoroughly drying feet and toes after bathing. Absorbent cotton socks should be worn and changed when wet.

If it is suspected that a common shower is the source of the infection, for example, at a college dormitory, flip flops or other sandals can be worn into the shower. The feet showed by washed thoroughly with soap, dried, and the above suggestions continued. Towels and bath mats must be washed frequently in warm water.

If family members have tinea pedis, they should also be treated.

Any treatable underlying problem, such as diabetes, needs to be controlled as well as possible.

Fungal fingernail infections are associated with different problems. There can be fungal infection of the skin of the hands, which should be treated. People with fungal fingernail infections often have wet hands a lot of the time. This can be work related or due to many activities at home, from doing the dishes to keeping the bathrooms clean. White cotton gloves can be worn under rubber gloves when cleaning.

If damage has been done to fingernails due to artificial nail application or other materials, it is possible that there is more than just a fungal infection present. It is harder to be sure of a diagnosis of onychomycosis of the fingernails than toenails. A visit to the doctor is probably a good idea.

Treatment by a Physician

Treatment must begin by making sure the hands and/or feet are being taken care of properly, as mentioned above. A primary care doctor, or podiatrist (foot specialist) or dermatologist (skin specialist) may be able to help with this, depending on what the person needs to have done, what the person expects, and what the experience of the physician is.

Usually in the case of fungal infection of the toenails, trimming and removing extra thick toenail material is the first thing that needs to be done. Sometimes the nails are so thick and hard that it is virtually impossible for a person to trim them at home. Doctors have special instruments that enable them to cut off more. Podiatrists have burrs, which are kind of like sanders and can file down the nails.

For some people, getting the nails trimmed and back to something like a normal size and shape may be all the treatment that is needed. They may just need regular visits to keep the nails trimmed. This is especially important for people with diabetes, poor circulation, and elderly people with bad vision. The feet and nails can become a source of serious bacterial infections if they are not taken care of.

There are no studies to show what the natural history of onychomycosis is. Does it always spread? It does not seem to cause any serious problems. So for some people, nail trimming and reassurance is all that is necessary.

All treatments attempt to kill the fungus and allow uninfected nail to grow out. It takes approximately 6 months for fingernails to completely regrow, 12 months for toenails to grow out, and 18 months for the great toenail to grow out. A person cannot know if the fungal infection has been cured for that amount of time.

Topical Medications

It seems reasonable to try to treat toenail infections with the same type of antifungal medications used on the skin. The only topical medicine approved for use in the United States is ciclopirox olamine 8% (Penlac) which is a lacquer. There are other medications available in other countries.
Penlac needs to be put on the surface of the entire nail and the skin around it every day. Once a week, it is removed along with debris and unattached nail.

Naftin, Lamisil, and Loprox creams may also be used for onychomycosis. There have only been small studies done using these creams. There are topical medications available in other countries that may at some point become available in the United States.

The use of urea cream may help any topical medication penetrate the nail. Urea can also dissolve the toenail.

There is very little chance of an actual cure with topical preparations. They must also be used for months to years. However, if a podiatrist or doctor can significantly trim and pare down the thickened nail, and topical treatment is used, the cosmetic result may be satisfactory for some people. Podiatrists may also drill a hole in the nail to allow medication to get underneath. This is not as painful as it sounds.

Topical treatment may be the only choice for anyone who cannot take oral medications for fungus.

Surgery

As described above, trimming the nail and removing debris should be part of all onychomycosis treatment. It was believed that removal of a nail at the beginning of therapy, especially the big toenail, might increase the chance of a cure. This is no longer done routinely. It is only done when everything else fails and the nail is creating a significant problem because of its shape and size.

Oral Medication

At one time it was thought that oral medication might be the answer to the problem of onychomycosis. Getting anti-fungal medicine into the bloodstream would deliver it to the base of the nail, and under the nail, making sure to kill all the infection. However, oral medicines do not work as well as expected, and their side effect profile may make the cure worse than the disease. It depends on the severity of the fungal infection, other medical problems that underlie the condition, and the medication itself.

The most commonly used oral medication, and the treatment of choice for onychomycosis is terbenafine (Lamisil®). This medication has been proved to kill most of the fungal organisms that infect nails in the laboratory as well as in actual patients. The dose is 250 mg a day for six weeks to treat fingernails, and 12 to 16 weeks to treat toenails.

Common side effects of terbenafine therapy include headache, rash, and upset stomach. Serious side effects occur in less than 1% of patients, including severe rash and reduction in white blood cells. The most worrisome side effect is liver damage, which is usually mild and reversible. Liver abnormalities that are enough to cause symptoms only happen in approximately one out of 50,000 exposures, with complete liver failure much less common than that. However, anyone with liver disease cannot take terbenafine. Liver function tests should be done before beginning therapy. Many doctors repeat these tests after 4 to 6 weeks. About 3.4% of patients who take terbinafine stop the medication because of side effects.

Itraconazole (Sporonox®) is also used. 200 mg a day can be given for 12 weeks to treat a toenail infection. There is also “pulse therapy.” This means giving 200 mg twice a day for one week out of a month, for two months to treat fingernails and three months to treat toenails. 5% to 10% of patients develop nausea, vomiting and/or liver damage. Sporonox can also cause congestive heart failure; patients with existing heart failure cannot take it. In general, there are fewer side effects with pulse therapy than daily therapy. However, even with pulse therapy there can be liver damage bad enough to necessitate a liver transplant.

Fluconazole has also been used to treat onychomycosis. It only needs to be taken once a week, for a total of 3 months for fingernails or 6 months for toenails. It does not work as well as terbinafine or itraconazole.

Whether or not any of these treatments have cured the fungal infection is never known for many months, until the fingernails or toenails have grown out. Terbenafine had a higher cure rate than itraconazole. The outcome can be measured by appearance of the nail or absence of fungal elements. The “cure” rates have been measured as low as 50%, and as high as 80%. Even when the fungi are gone, the nail may not appear completely normal because of some other underlying problem or damage to the nail bed. There are also frequent relapses. The use of creams applied to the nails after oral therapy may help prevent relapse.

The cost of this treatment is high. It is estimated that the cost to cure onychomycosis with terbinafine is from $2,500 to $8,000. There is still a 30% chance of recurrence after a cure.

Alternative Treatments and Home Remedies

Considering the cost, side effects, and low success rate of prescription medication, looking for alternative treatments seems very reasonable. Some alternatives have been mentioned in terms of general care of the skin and nails.

One herbal remedy that seems to be very successful in treating onychomycosis is tea tree oil. Tea tree oil has been studied for a number of skin problems and is already available as a prescription medication for genital warts. Tea tree oil can kill the fungi that cause nail infections in the laboratory setting. There have been some small clinical trials of tea tree oil in treating nail fungus that show promise, although rigorous, large scientific studies have not been published.

In one trial, a combination of a known antifungal (butenafine hydrochloride) together with tea tree oil was used in a randomized, double-blind study in 60 patients with fungal infection of toenails. Treatment included the cream as well as clipping and removing as much toenail as possible, for 8 weeks. At 16 weeks, 80% of participants given the active ingredients were said to be cured, in that their symptoms were better and involved toenail removed. The placebo in this case was tea tree oil, which did not cure any patients. This is an example of a possible way tea tree oil might be used along with another local cream but not by itself.

Other home remedies have included soaking the nails in vinegar, or water with baking soda, strong tea, and bleach. Bleach application can be dangerous. The bleach would have to be diluted to avoid chemical burns. When these home remedies are used along with care of the nail, such as cutting it correctly and removing debris, they may improve the appearance of onychomycosis. Tea tree oil is a home remedy at the current time; it may become a prescribed medication in the future. Any promising home remedy can interest doctors and researchers enough to look into it further.

Tea tree oil taken orally is also considered an alternative treatment for onychomycosis, but there is little evidence at this time that drinking tea tree oil does anything to cure the fungal infection.

There are 2 alternative treatments whose active ingrediants contain tea tree oil, Zetaclear & Funginix.

New Treatments for Onychomycosis

Doctors continue to look for a good way to cure onychomycosis. Studies have been done using photodynamic therapy. This is a way of using light to cure the infection. Doctors recently reported successful treatment of two patients. The affected toenails of the patients were pretreated with a substance called 5-aminolevulinic acid (ALA). They were also pretreated with urea, and the involved nails were covered with plastic film and aluminum foil to shut out light. Before treatment, the area was uncovered and light was used to make sure the ALA had penetrated the nail. A pulsed laser light was then used to treat the involved nail. The treatment was slightly painful for about a day. Treatment was repeated once a week for 6 to 7 treatments. At the end of treatment, the nails appeared cured. No fungi could be grown from the nails. Reevaluation at 3 to 6 months still showed apparently normal nails.

There are many different ways of delivering heat or light to infected nails. There are a number of different lasers capable of treating nail fungus. One is called the “Noveon.” It is a dual-wavelength, near-infrared diode laser. This particular wavelength kills fungi without damaging normal tissue. In one recent controlled study, 26 infected toes were treated. Treatment took place on days 1, 14, 42 and 120. All were followed for at least 180 days. 85% were judged improved because of clear nail growth. This study was done to make sure the treatment was both safe and effective. There are other laser systems under investigation.

Many laser systems are being tested or will be tested to see if they can help cure or control onychomycosis, and it appears that some of them will. Laser treatment will probably not completely cure the infection but help control it, and may be useful along with other therapies. Plastic (cosmetic) surgeons often possess a wide variety of lasers and devices that deliver heat or energy. It is likely that the best type of laser treatment will be found in the relatively near future. However, this treatment will always be expensive.

While some will be looking at lasers and other possible oral medications, other researchers will continue to evaluate herbal remedies and home remedies to look for safe and inexpensive treatment for onychomycosis.

References

Roberts DT, Taylor WD, Boyle J. Guidelines for treatment of onychomycosis. British Journal of Dermatology 2003; 148: 402–410.

De Berker D. Fungal Nail Disease. New England Journal of Medicine 2009; 360: 2108-16.

Choi S. Fungal Infections. Manual of Dermatologic Therapeutics 7th edition. 2007. Arndt KA, Hsu JTS, editors. Lippincott Williams & Williams. Philadelphia, PA 2007.

Elizabeth T, Meireles F, Gadelha Rocha MF, et al. Successive Mycological Nail Tests for Onychomycosis: A Strategy to Improve Diagnosis Efficiency. The Brazilian Journal of Infectious Diseases 2008; 12(4):333-337.

Syed TA, Qureshi ZA, Ali SM, et al. Treatment of toenail onychomycosis with 2% butenafine and 5% Melaleuca alternifolia (tea tree) oil in cream. Tropical Medicine and International Health 1999; 4(4): 284-287.

Martin KW, Ernst E. Herbal medicines for treatment of fungal infections: a systematic review of controlled clinical trials. Mycoses 2004; 47: 87–92.

Rehbock, D. Common Nail Conditions that are treated by the podiatrist. SA Pharmaceutical Journal – January/February 2009: 32-36.

Watanabe D, Kawamura C, Masuda Y, et al. Successful Treatment of Toenail Onychomycosis With Photodynamic Therapy. Archives of Dermatology 2008; 144(1).

Landsman AS, Robbins AH, Angelini PF, et al. Treatment of Mild, Moderate, and Severe Onychomycosis Using 870- and 930-nm Light Exposure. Journal of the American Podiatric Medical Association 2010; 100(3).

The post How to Treat Nail Fungus (Onychomycosis) 2019 Edition appeared first on ToenailFungusTreatments.com.

Soaking nails affected with nail fungus in a mixture of dark beer and acidophilus can be a highly effective treatment, eliminating the fungus and preventing the growth of new bacteria. Acidophilus is an extremely useful bacteria that can help to ward off infections. In combination with the alcohol found in beer, acidophilus creates an acidic climate that nail fungi cannot survive in.

So how exactly does the beer soak method work to cure nail fungus?

The alcohol in the dark beer acts to soften the affected nails and surrounded nail bed. The white vinegar that is included in the mixture helps to provide a beneficially high acidic level. Environments containing high levels of acidity prohibit harmful bacteria such as fungus from growing and surviving, while allowing beneficial bacteria such as acidophilus to grow and thrive. In simple terms, the white vinegar helps to kill the fungus while allowing the acidophilus to grow and fight the remaining fungus. Read on for a step-by-step guide to using the acidophilus beer soak method for nail fungus infections.

Ingredients Required for the Soak
• Bowl or tub large enough to soak hands or feet
• 4 cups white vinegar
• 2 pints dark beer such as Guinness Stout or another very dark variety
• 1 acidophilus sachet: should contain approximately125 billion acidophilus organisms, this is the standard amount per sachet.
• Nail file

Directions for Using the Soak
1. Mix the white vinegar, dark beer and acidophilus together in the bowl or tub.
2. Soak the hands or feet in the mixture for approximately 30 minutes.
3. Remove the hands or feet from the soaking mixture.
4. Wash hands or feet thoroughly with soap and warm water before patting dry.
5. Use this soak twice a day, covering and storing in a cool place between uses.
6. This mixture can be used for up to 48 hours before the active ingredients will loose their effectiveness.
7. Continue to use this soaking mixture twice a day for three to six months.

Once per week, the affected toenails and fingernails should be filed down immediately following soaking in the mixture. Once the nails have been filed, the hands or feet should be re-submerged for an additional 30 minutes in the beer and acidophilus soaking mixture. This will allow the newly exposed nail to be treated, further limiting the growth of the fungus. Also you can radically increase the chances of curing the nail fungus infection by using a tea tree oil product like zetclear in conjunction with the beer soak method.

It is important that this treatment schedule is followed precisely; any missed treatments will result in a longer over all treatment period. Users of this treatment method will begin to see results in as little as one week or in some cases, depending on the severity of the fungal infection, it may take much longer, even up to one month. When the nail fungus infection begins to be effectively cleared up, users will notice that healthy nails will start to grow from the start of the nail bed. The new, unaffected nails will be clear from the tell tale signs of yellowing and thickness. It should take approximately twelve weeks for the new healthy nails to completely grow in and fully replace the nails that were effected by the fungus. If the skin surrounding the nails becomes sensitive during treatment, one may reduce the soaking sessions from twice a day to just once per day.

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There are a number of home remedies that have been tried over the years to treat onychomycosis and fungal nail infections. The problem with all of them and even with topical prescription medicines is that the remedy is not always able to penetrate the nail to the site of the infection. This keeps many home remedies from being very effective on onychomycosis. Also, there are no clinical trials that have looked at the various home remedies in the treatment of nail fungus. On the other hand, there is very little risk associated with the popular home remedies and most are inexpensive. Also there is some anecdotal evidence that they could work for some people.

Just as with prescription onychomycosis treatments, if the nail bed and lunula are affected, topical, over-the-counter, home remedies will not be effective. An oral medication is required and, currently, these medications are only available with a prescription.

One of the popular, inexpensive treatments that has been tried is to soak fingernails or toenails in Listerine. Listerine contains ethanol, thymol, eucalyptol, and benzoic acid. Listerine is known to kill bacteria and has recently been shown to have antifungal properties. In fact, this treatment was potent against Candida infections which cause one of the four main types of onychomycosis. Therefore, Listerine could theoretically eradicate a nail fungus infection if it could penetrate to the site of the fungus.

No clinical trials have been performed looking at Listerine and onychomycosis but proponents of the treatment suggest soaking fingernails or toenails in Listerine for 10 minutes each night. Listerine’s ability to kill dermatophytes is less impressive and less well known. Since most onychomycoses are caused by dermatophytes, Listerine may not be universally effective.

Another onychomycosis along these same lines is vinegar. Vinegar, also known as acetic acid, can potentially destroy the dermatophytes that cause onychomycosis. The process is the same for Listerine—people that would like to try this remedy should soak their fingers or toes in one part vinegar and two parts water for 20 minutes per day. Treatment should be continued until symptoms resolve or the skin around the nail becomes irritated. There is no advantage to using apple cider vinegar versus other vinegar types since they all contain acetic acid primarily. Also, over-the-counter preparations that contain acetic acid as their primary ingredient are not more or less special than plain vinegar.

One of the more promising home remedies for onychomycosis is Vicks VapoRub. Again, there are no clinical trials supporting this treatment, however physicians have witnessed improvements in some people using this ointment. Why might this home remedy work where others fail? In the case of Vicks VapoRub it is as much about the carrier as it is about the active ingredient. The oils and petroleum jelly in Vicks can dissolve and soften the nail when used repeatedly over time. This allows the active ingredients like menthol to penetrate the nail and fight the fungal infection.

The only really way to use Vicks VapoRub is topically; the precise “dose” and duration of therapy is anyone’s guess. Many people apply it to their affected toenails or fingernails at night and wear a sock or glove to keep the Vicks VapoRub next to the nail. Unfortunately this also tends to hold moisture next to the nail and moisture promotes fungus growth. If you are going to use Vicks VapoRub and a sock or glove, make sure the covering is 100 % cotton and “breathes” to prevent moisture accumulation.

One natural product that has fairly impressive antifungal activity is tea tree oil or Melaleuca alternifolia. When used in vitro (meaning in a dish), tea tree oil was able to kill or inhibit all of the major causes of onychomycosis including Trichophyton rubrum, Trichophyton mentagrophytes, and Candida species. There have been two clinical trials of tea tree oil on onychomycosis one showing a 20% cure rate and the other showing a 0% cure rate. Apparently 100% tea tree oil needs to be used to see an effect. While cure was only achieved in a fraction of patients (or none) nail appearance improved in many more.
Interestingly tea tree oil was very effective in treating tinea pedis, a superficial fungal infection of the foot. In this case the topical agent can easily reach the offending fungus.

One topical treatment that contains Tea Tree Oil is Zetaclear.

Another herbal preparation that has some antifungal activity is Camellia sinensis or green tea extract. In a dish, this herb was able to kill Candida glabrata. It is affect on dermatophytes is unknown and there have been no clinical trials to determine if it has an effect on patients with onychomycosis.

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.
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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