Oral antifungal therapy has a high cure rate, depending on the medication. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back. Currently, an oral antifungal therapy is considered the best treatment for toenail fungus because of higher cure rates and shorter treatment duration compared to topical therapy.
Making a few simple lifestyle changes can help prevent a fungal infection of the nails. Taking good care of your nails by keeping them well trimmed and clean is a good way to prevent infections. You should also avoid injuring the skin around your nails. If you’re going to have damp or wet hands for an extended amount of time, you may want to wear rubber gloves.
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
Dermatophytes — fungus that grows on the skin, hair and nails but don’t penetrate tissues of the body. Athlete’s foot or Trichophyton rubrum is the most common dermatophyte and can actually infect the toenails. Infection can also begin by touching objects that have dermatophytes on them, such as nail clippers, nail files, socks, shoes, shower floors, etc. Dermatophytes are the cause of most fungal toenail infections.
Persistent fungal signs can show up slowly but last for years. Getting rid of toenail fungus can take some patience and requires time to fully heal. It can take several months until treatment is successful, but doing things the right way and getting rid of the underlying cause of nail fungus is the only thing that will keep the infection from coming back again.

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Medical treatment of onychomycosis is suggested in patients who are experiencing pain and discomfort due to the nail changes. Patients with higher risk factors for infections such as diabetes and a previous history of cellulitis (infection of the soft tissue) near the affected nails may also benefit from treatment. Poor cosmetic appearance is another reason for medical treatment.

A band of tissue called the plantar fascia runs along the bottom of the foot. It pulls on the heel when you walk -- and it works best with the proper arch in your foot. Walking barefoot, or in flimsy shoes without sufficient arch support, can overstretch, tear, or inflame the plantar fascia. This common condition can cause intense heel pain, and resting the feet only provides temporary relief.

Research suggests that fungi are sensitive to heat, typically 40–60 °C (104–140 °F). The basis of laser treatment is to try to heat the nail bed to these temperatures in order to disrupt fungal growth.[37] As of 2013 research into laser treatment seems promising.[2] There is also ongoing development in photodynamic therapy, which uses laser or LED light to activate photosensitisers that eradicate fungi.[38]


The definition of over-the-counter (OTC) products means that they are available by ordinary retail purchase, not requiring a prescription or a license. Although there are few OTC medications aimed to treat fungal nails, many of these medications have not been tested and therefore are not approved by the U.S. Food and Drug Administration (FDA) for the treatment of onychomycosis. Most OTC agents are aimed at treating fungal infection of the skin rather than the nail. Some medications list undecylenic acid and/or propylene glycol as main ingredients. These ingredients inhibit fungal growth; however, they may not adequately penetrate the nail to be effective in treating fungal nails.
Fungal nail infections can be difficult to treat. Talk with your doctor if self-care strategies and over-the-counter (nonprescription) products haven't helped. Treatment depends on the severity of your condition and the type of fungus causing it. It can take months to see results. And even if your nail condition improves, repeat infections are common.
Research suggests that fungi are sensitive to heat, typically 40–60 °C (104–140 °F). The basis of laser treatment is to try to heat the nail bed to these temperatures in order to disrupt fungal growth.[37] As of 2013 research into laser treatment seems promising.[2] There is also ongoing development in photodynamic therapy, which uses laser or LED light to activate photosensitisers that eradicate fungi.[38]

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.
If you have diabetes, you may have reduced blood circulation and nerve supply in your feet. You're also at greater risk of a bacterial skin infection (cellulitis). So any relatively minor injury to your feet — including a nail fungal infection — can lead to a more serious complication. See your doctor if you have diabetes and think you're developing nail fungus.
×