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).
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.

Snake root extract comes from a plant in the sunflower family. A 2008 study conducted by the Centro de Investigación Biomédica del Sur and published in Planta Med, found that applying the extract to the affected nail over three months was more effective than treatment with the prescription anti-fungal Penlac (ciclopirox). Like natural remedies? Here are some more options.
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 A common outdated name that may still be reported by medical laboratories is Trichophyton mentagrophytes for T. interdigitale.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.
Diagnosis is made based on clinical exam and can be confirmed by viewing scrapings of the nail under a microscope, or growing the fungus in a culture medium. This is not an easy condition to cure, so rather than trying home treatment with over-the-counter medications, it's best to see your doctor. As with many conditions, nail fungus infections are easier to treat if you catch them early.
No one knows where a specific person catches the fungus, as it is everywhere. However, since the fungus does thrive in warm moist areas (like sweaty feet), there are certain areas one should avoid or use with caution. Shower floors, locker rooms, and swimming pools are suspected of being sources of the fungus, although there are no studies proving this fact. Nail polish and acrylic nails also make the nail less "breathable" and make the nail more susceptible to fungal infection. Fungi are everywhere -- in the air, the dust, and the soil. Hygienic measures such as spraying socks and footgear sound sensible, and perhaps these measures can even help a little bit. However, avoiding tight, nonbreathing shoes or steering clear of athletic facility floors may very well be the best prevention available. Daily washing of the feet and drying between the toes can help to prevent nail fungus. The fungi carried on the coats of pets, like cats and dogs, don't often cause nail fungus. Wearing white socks does not help.
​The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images and graphics, is for informational purposes only. The content is not intended to substitute for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find an Orthopaedic Foot & Ankle Surgeon" tool at the top of this page or contact your primary doctor. 
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.
Conventional treatment typically involves thoroughly washing the feet daily or twice daily, followed by the application of a topical medication. Because the outer skin layers are damaged and susceptible to reinfection, topical treatment generally continues until all layers of the skin are replaced, about 2–6 weeks after symptoms disappear. Keeping feet dry and practicing good hygiene (as described in the above section on prevention) is crucial for killing the fungus and preventing reinfection.
Modern treatments made surgery a last resort. “Before we had these 21st century medications, we didn’t have a good choice in how to deal with toenail fungus,” said Dr. Hinkes. “Oftentimes patients would come in, and out of frustration and lack of any real significant clinical cure with medication, they would ask for their nails to be permanently removed.”
There are several preventive foot hygiene measures that can prevent athlete's foot and reduce recurrence. Some of these include keeping the feet dry, clipping toenails short; using a separate nail clipper for infected toenails; using socks made from well-ventilated cotton or synthetic moisture wicking materials (to soak moisture away from the skin to help keep it dry); avoiding tight-fitting footwear, changing socks frequently; and wearing sandals while walking through communal areas such as gym showers and locker rooms.[8][13][28]
Athlete's foot was first medically described in 1908.[9] Globally, athlete's foot affects about 15% of the population.[2] Males are more often affected than females.[4] It occurs most frequently in older children or younger adults.[4] Historically it is believed to have been a rare condition, that became more frequent in the 1900s due to the greater use of shoes, health clubs, war, and travel.[10]
Topical antifungal agents can be used but are often ineffective. Oral terbinafine is considered to be the first-line treatment for confirmed onychomycosis; the treatment course is generally 6 weeks for fingernails and 12 weeks for toenails.9 Azoles can also be used. Surgical debridement or removal of the affected nail is also a consideration for cases that are resistant to antifungals, and laser treatments for onychomycosis appear to be a promising area for future study.10

Toenail fungus is an infection that gets in through cracks in your nail or cuts in your skin. It can make your toenail change color or get thicker. It can also hurt. Because toes are often warm and damp, fungus grows well there. Different kinds of fungi and sometimes yeast affect different parts of the nail. Left untreated, an infection could spread to other toenails, skin, or even your fingernails.
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