Not all cases of OM require treatment with medication but if your doctor has confirmed you have OM and require treatment, they may prescribe an oral antifungal medication (terbinafine, itraconazole*) based on the type of fungus causing the infection. If you are unable to take oral antifungals or have a mild-to-moderate case of OM, your doctor may opt for a topical therapy (ciclopirox, efinaconazole*) that is applied to the affected nail(s) directly.
Wei, Y.-X., Xu, X.-Y., Xu, & Song, X. (2017). A review of antifungal natural products against the pathogenic fungi causing athletes' foot disease. Current Organic Chemistry, 21, 1–13. Retrieved from https://www.researchgate.net/profile/Xun_Song/publication/319128408_A_Review_of_Antifungal_Natural_Products_Against_the_Pathogenic_Fungi_Causing_Athletes'_Foot_Disease/links/59931c65458515c0ce61efa1/A-Review-of-Antifungal-Natural-Products-Against-the-Pathogenic-Fungi-Causing-Athletes-Foot-Disease.pdf
Trichophyton rubrum is the most common dermatophyte involved in onychomycosis. Other dermatophytes that may be involved are T. interdigitale, Epidermophyton floccosum, T. violaceum, Microsporum gypseum, T. tonsurans, and T. soudanense. A common outdated name that may still be reported by medical laboratories is Trichophyton mentagrophytes for T. interdigitale. The name T. mentagrophytes is now restricted to the agent of favus skin infection of the mouse; though this fungus may be transmitted from mice and their danders to humans, it generally infects skin and not nails.

Ozonized oils such as olive oil and sunflower oil are “injected” with ozone gas. According to a 2011 study, this type of ozone exposure in low concentrations for a short duration can then inactivate many organisms such as fungi, yeast, and bacteria. Another study found ozonized sunflower oil was more effective in treating toenail fungus than the prescription topical antifungal, ketoconazole (Xolegel).
Multiple fungi species can infect the nail. Fungus grows well in warm, moist environments such as showers. Fungus infection is one of the few foot problems that affect more men than women, perhaps because more men walk barefoot in locker rooms. Age is a factor, too. Half the sufferers are people older than 70. Other risk factors include having certain medical conditions such as diabetes, vascular insufficiency and malnutrition.
There are many topical antifungal drugs useful in the treatment of athlete's foot including: miconazole nitrate, clotrimazole, tolnaftate (a synthetic thiocarbamate), terbinafine hydrochloride,[17] butenafine hydrochloride and undecylenic acid. The fungal infection may be treated with topical antifungal agents, which can take the form of a spray, powder, cream, or gel. Topical application of an antifungal cream such as terbinafine once daily for one week or butenafine once daily for two weeks is effective in most cases of athlete's foot and is more effective than application of miconazole or clotrimazole.[23] Plantar-type athlete's foot is more resistant to topical treatments due to the presence of thickened hyperkeratotic skin on the sole of the foot.[13] Keratolytic and humectant medications such as urea, salicyclic acid (Whitfield's ointment), and lactic acid are useful adjunct medications and improve penetration of antifungal agents into the thickened skin.[13] Topical glucocorticoids are sometimes prescribed to alleviate inflammation and itching associated with the infection.[13]

Topical agents such as amorolfine (Loceryl 5% nail lacquer; applied once or twice a week) and ciclopirox (Penlac 8% nail lacquer; applied daily) are usually prescribed for mild forms of the disease, but the treatment periods are long and their efficacy is somewhat limited due to poor nail plate penetration. These medications kill fungi by interfering with their cell membranes, which leads to their death.
The vesiculobullous type of athlete's foot is less common and is usually caused by T. mentagrophytes and is characterized by a sudden outbreak of itchy blisters and vesicles on an erythematous base,[7] usually appearing on the sole of the foot. This subtype of athlete's foot is often complicated by secondary bacterial infection by Streptococcus pyogenes or Staphylococcus aureus.[13]
Many individuals with athlete's foot have no symptoms at all and do not even know they have an infection. Many may think they simply have dry skin on the soles of their feet. Common symptoms of athlete's foot typically include various degrees of itching, stinging, and burning. The skin may frequently peel, and in particularly severe cases, there may be some cracking, fissuring, pain, and itching in the toe webs. Occasionally, athlete's foot can blister.
Other causative pathogens include Candida and nondermatophytic molds, in particular members of the mold genus Scytalidium (name recently changed to Neoscytalidium), Scopulariopsis, and Aspergillus. Candida species mainly cause fingernail onychomycosis in people whose hands are often submerged in water. Scytalidium mainly affects people in the tropics, though it persists if they later move to areas of temperate climate.

Unfortunately, athlete’s foot is highly contagious and the fungus can easily spread to the toes and toenails, causing infections. There are more than three million cases of toenail fungus in the US every year. Not all toenail infections are from athlete’s foot or even from a fungus; some are caused by yeast or mold. These are much harder to cure than fungal infections.
There are many possible causes of foot rashes. Additional causes include irritant or contact dermatitis, allergic rashes from shoes or other creams, pompholyx (dyshidrotic eczema), psoriasis, yeast infections, and bacterial infections (gram negative toe web infection and erythrasma). Since these conditions are often indistinguishable on superficial visual examination, it is important for your doctor to do his best to identify the precise cause. Since fungal infections are potentially curable, it is important not to miss this diagnosis.
Food intolerances — Some yeast infections are due to food allergies. Try to avoid foods that cause negative reactions of any kind and pay attention to symptoms you experience when eating things like dairy, eggs, certain nuts, wheat-containing foods and grains. If you think you have a food allergy or sensitivity, try an elimination diet to figure out what foods are causing intolerance and work on removing those foods.
Although treatment is usually sought for cosmetic reasons, nail fungus can be serious and should be treated. For example, if it is a severe infection, it can cause permanent damage to your nails. The infection can also spread beyond your nails, especially if you are in a high risk group, such as people with diabetes or impaired immune systems. High-risk people can develop cellulitis, a skin tissue infection, if toe fungus isn't treated.[4]

To get rid of toe fungus, apply 100% tea tree oil to the affected area with a cotton swab twice a day. You can also try applying Vick's VapoRub to your toe every night before you go to sleep, which may make the fungus go away. Another home remedy you can try is snakeroot leaf extract, which may clear up the fungus if you apply it to the affected area every 3 days. If home remedies aren't helping, talk to your doctor about getting an oral or topical antifungal medication.

You can use simple home remedies to get rid of toenail fungus. Or a podiatrist can take care of toenail fungus, particularly if it is caught early. Topical or oral treatments can also work on toenail fungus, as well as the removal of the infected nail. A temporary removal can work to treat the area, but a permanent removal so that the bad nail won’t grow back can also be performed.
In other words, the combination of urea and bifonazole got rid of nail fungus in an extra 10 participants. But there was no difference between the two groups six months after treatment. Also, the fungal infection returned in many participants, so it’s likely that neither of the two treatments can increase the chances of getting rid of the fungus in the long term.
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.

Over-the-counter toenail fungus treatments can cure existing infections, but only products which include 1% Tolnaftate can prevent a recurrence of the condition. Tolnaftate is the only ingredient approved by the US Food and Drug Administration for the prevention of fungal infections. Treating toe nail area fungus is only part of the solution. Preventing further outbreaks using a product with 1% Tolnaftate will keep you looking and feeling your best.
Because fungal spores can remain viable for months in these environments, frequent exposure can increase the risk of infection (and re-infection). Fungal spores can be picked up in many ways – such as wearing shoes that harbour the organism, by walking barefoot in areas where the fungus is prevalent (especially public showers and locker rooms), by wearing wet shoes or socks for long periods, through previous injury to the toe or toenail that opens a path for easy entry of the fungus, or by wearing improperly-fitting shoes.
Although treatment is usually sought for cosmetic reasons, nail fungus can be serious and should be treated. For example, if it is a severe infection, it can cause permanent damage to your nails. The infection can also spread beyond your nails, especially if you are in a high risk group, such as people with diabetes or impaired immune systems. High-risk people can develop cellulitis, a skin tissue infection, if toe fungus isn't treated.[4]

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.

Do the research before trying this product. I sure wish I had. Any "natural" product insures results with regular use but warns that the process takes weeks and even months, due to slow nail growth. These natural remedy sites also warn that you should never reuse the mixture when reapplying because any contamination with the fungus can "inhibit or create more fungus growth." This cancels out the 2nd step altogether given the redipping of the nail brush. Perhaps this product does work for some people after repeated use for many months. I'd just love to see that truth written in more reviews.


One of the best remedies for toenail fungus, apple cider vinegar can be used topically, internally, or both. Mix one part ACV and one part Epsom salts with six parts hot water.  Let the water cool so that it is still warm to the touch, but not so hot as to be damaging to your skin.  Soak feet up to twice daily for at least thirty minutes to kill fungus.  Mix two tablespoons of organic apple cider vinegar with eight ounces of warm water and add a teaspoon of honey to sweeten the beverage.
Trichophyton rubrum is the most common dermatophyte involved in onychomycosis. Other dermatophytes that may be involved are T. interdigitale, Epidermophyton floccosum, T. violaceum, Microsporum gypseum, T. tonsurans, and T. soudanense. A common outdated name that may still be reported by medical laboratories is Trichophyton mentagrophytes for T. interdigitale. The name T. mentagrophytes is now restricted to the agent of favus skin infection of the mouse; though this fungus may be transmitted from mice and their danders to humans, it generally infects skin and not nails.

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.

There are many topical antifungal drugs useful in the treatment of athlete's foot including: miconazole nitrate, clotrimazole, tolnaftate (a synthetic thiocarbamate), terbinafine hydrochloride,[17] butenafine hydrochloride and undecylenic acid. The fungal infection may be treated with topical antifungal agents, which can take the form of a spray, powder, cream, or gel. Topical application of an antifungal cream such as terbinafine once daily for one week or butenafine once daily for two weeks is effective in most cases of athlete's foot and is more effective than application of miconazole or clotrimazole.[23] Plantar-type athlete's foot is more resistant to topical treatments due to the presence of thickened hyperkeratotic skin on the sole of the foot.[13] Keratolytic and humectant medications such as urea, salicyclic acid (Whitfield's ointment), and lactic acid are useful adjunct medications and improve penetration of antifungal agents into the thickened skin.[13] Topical glucocorticoids are sometimes prescribed to alleviate inflammation and itching associated with the infection.[13]


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.
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