Terbinafine can cause gastrointestinal (stomach and bowel) problems and a temporary loss of taste and smell. It can also interact with certain antidepressants and heart medications. Overall, terbinafine has far fewer drug-drug interactions than itraconazole. Nevertheless, it’s still important to tell your doctor if you are taking any other medication. As a precaution, this medication should not be taken during pregnancy or if you are breastfeeding.
If common remedies do not offer relief within three to four months of consistent use, or if the discomfort worsens, contact your doctor. Extreme infections may require the temporary surgical removal of the nail. A replacement nail will usually grow. As the new nail regrows, it is good practice to treat it with an antifungal cream to prevent reinfection.
Fungal athlete's foot may cause a rash on one or both feet and even involve the hand. A "two feet and one hand" pattern is a very common presentation of athlete's foot, especially in men. Hand fungal infections are called tinea manuum. Fungal athlete's foot may also be seen along with ringworm of the groin (especially in men) or hand(s). It is helpful to examine the feet whenever there is a fungal groin rash called tinea cruris, or jock itch. It is important to treat all areas of fungal infection at one time to avoid reinfection. Simply treating the soles and ignoring the concurrent fungal infection of toenails may result in recurrences of athlete's foot.
Before taking action and finding the best nail fungus treatment for you, it is important to note that toenail fungus and skin fungus, such as athlete’s foot, often manifest together. For the best results, both should be treated at the same time to prevent an ongoing infection. You can recognize athlete’s foot by the dry, scaling, peeling skin on the bottom of the feet. Your feet may also itch, or exude a noticeable odor.
Dr. Kyoung Min Han is a podiatrist (foot and ankle specialist) practicing in Southern California. Dr. Han completed her undergraduate education at the University of California, San Diego, and went on to the New York College of Podiatric Medicine to pursue her medical training. She returned to her native Southern California to complete a three-year foot and ankle surgical residency, followed by subspecialty training in a sports medicine fellowship.
Onychomycosis does not necessarily require treatment. The antifungal medication, terbinafine, taken by mouth appears to be the most effective but is associated with liver problems. Trimming the affected nails when on treatment also appears useful. There is a ciclopirox containing nail polish, but it does not work as well. The condition returns in up to half of cases following treatment. Not using old shoes after treatment may decrease the risk of recurrence.
^ Jump up to: a b American Academy of Dermatology (February 2013), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Academy of Dermatology, retrieved 5 December 2013. Which cites:*Roberts DT, Taylor WD, Boyle J (2003). "Guidelines for treatment of onychomycosis" (PDF). The British Journal of Dermatology. 148 (3): 402–410. doi:10.1046/j.1365-2133.2003.05242.x. PMID 12653730.
Nail fungus is usually harmless. But many people find discolored or thickened nails unpleasant to look at and want to get rid of the fungus as soon as possible. Fungal nail infections can also spread, and may infect other people. Regardless of the treatment you choose, it will take a while until the nail looks normal again. It’s especially important to be patient where toenails are concerned. It can take a year for a healthy big toenail to grow back. Nail fungus can sometimes be very persistent despite treatment. It can also come back after successful treatment.
Try using oil of oregano along with another essential oil called melaleuca, which is also known as tea tree oil. The uses of tea tree oil will astound you, including its ability to act as a natural antifungal agent. Use these two oils topically on your toenail fungus daily. I recommend three drops of oil of oregano and two drops of melaleuca applied directly on the toenail, four times a day, ideally.
Cultured dairy or fermented foods (ideally organic and raw) — these are beneficial for replacing good bacteria in the gut since they provide probiotics. Probiotics help control yeast and also have numerous immune-enhancing effects. For other sources of probiotics, in addition to yogurt or kefir try cultured foods like kimchi, kombucha or sauerkraut.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Toenails or fingernails may be affected, but it is more common for toenails to be affected. Complications may include cellulitis of the lower leg.
An imbalance of healthy micro-flora in the body can also be a big cause of fungal overgrowth like onychomycosis. Be sure to partner a good probiotic supplement with your choice of toenail fungus remedy. Thriving, healthy gut bacteria hinder the growth and spread of parasitic fungi and other microbes by limiting their available living space. Also, lactobacillus bacteria found in most probiotic supplements actually secrete a biproduct that is poisonous to Candida. Just make sure that your supplement contains no sugar or artificial fillers that may inadvertently feed the unwanted fungus.
Rotate your shoes – Change your shoes often. Even though you may have that favorite pair that you like to wear all the time, it is better for your feet to switch up your shoes from time to time. Even wearing the same pair of shoes two days in a row can elevate your risk for toenail fungus. Place shoes that you are not wearing in an area where they will get plenty of air.
One of the more interesting remedies for toenail fungus is organic cornmeal. Corn naturally hosts a form of fungus that is harmless to the human body but deadly to Candida – the most common fungal parasite that causes infections in people. In a container big enough to fit your foot (or both feet if needed), mix one cup of cornmeal and about two quarts of water. Allow the cornmeal to soak in the water for at least one hour then submerge the infected foot (or feet) in the mixture for a half hour or more. While the frequency of use for this remedy is up for debate, sources have reported success with treatment performed as seldom as once per week. Others say to perform it daily. Because cornmeal is totally harmless to skin and nails, realistically the treatment can be repeated as often as you like.
Many podiatrists now consider this an effective treatment, but because it’s new, there’s not enough concrete data to compare with other treatments. Dr. Hinkes raises another concern: “A clinical cure and a mycological cure are two different things. With the clinical cure, you look at the nail and it looks fine. It’s pink and shiny and smooth and it looks great. But if you sample the nail, you might find that there’s mold or fungus there, so it does not have what we call a mycological cure—mycology is the study of fungi.
The Internet is filled with anecdotal information on how to cure toenail fungus using home remedies. Vinegar is a commonly recommended home remedy. Some people apply various oils such as tea tree oil, coconut oil, essential oils, and oil of cedar leaf (such as Vicks VapoRub) to their nails as well. The effectiveness of these home remedies is highly doubtful. Application of household bleach and hydrogen peroxide is also not recommended due to lack of evidence that these treatments work. These agents can also cause unwanted skin irritation. Thickened nails that have been affected by fungus can be difficult to trim. Using topical urea cream will soften the nail and make it easier to trim. These creams do not require a prescription.