Vicks VapoRub is a topical ointment. Although designed for cough suppression, its active ingredients, camphor and eucalyptus oil, may help treat toenail fungus. A 2011 study found Vicks VapoRub had a “positive clinical effect” in the treatment of toenail fungus. To use, apply a small amount of Vicks VapoRub to the affected area at least once a day.
Ingrown toenails are caused by the growth of the toenail into the surrounding nail fold. Symptoms and signs include toe pain, swelling, redness, and yellow drainage. Treatment at home involves soaking the affected foot in diluted white vinegar or Epsom salts, elevating the foot, and trimming the nails straight across. Surgery is also an option for severe cases. Prevent ingrown toenails by wearing shoes with a wider toe box and avoiding repeated injury to the toenails. Avoid curving or cutting the nails short at the edges.
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Efinaconazole (Jublia) is a medication that was approved in 2014. It is a topical (applied to the skin) antifungal used for the local treatment of toenail fungus due to two most common fungal species affecting nails (Trichophyton rubrum and Trichophyton mentagrophytes). Once-daily application is required for 48 weeks. The most common side effects of Jublia are ingrown toenails and application site dermatitis and pain.
Topical agents include ciclopirox nail paint, amorolfine, and efinaconazole. Some topical treatments need to be applied daily for prolonged periods (at least 1 year). Topical amorolfine is applied weekly. Topical ciclopirox results in a cure in 6% to 9% of cases; amorolfine might be more effective. Ciclopirox when used with terbinafine appears to be better than either agent alone.
You may use other antifungal treatments, such as antifungal nail lacquer or topical solutions. These treatments are brushed onto the nail in the same way that you would apply nail polish. Depending on the type of fungus causing the infection, as well as the extent of the infection, you may have to use these medications for several months. Topical solutions are not generally effective in curing toenail fungal infections.
Topical nail-bed fungus treatments are a safe option that almost anyone can use. They work best when the infection is treated in its earliest stages. However, these medications do not heal the nail itself, only the fungus growing on the nail bed and surrounding area. Only oral medications, which come with many contraindications and may not be safe for everyone, can treat the nail itself.
If the fungal infection has spread to the toenails, the nails must also be treated to avoid reinfection of the feet. Often, the nails are initially ignored only to find the athlete's foot keeps recurring. It is important to treat all of the visible fungus at the same time. Effective nail fungus treatment may be more intensive and require prolonged courses (three to four months) of oral antifungal medications.
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.
Onychomycosis patients may need to learn new, healthier habits to stop the fungus growing back. These could include protecting toes from sources of infection, wearing correctly fitting footwear, laundering socks in hot water with disinfectant, wearing protective footwear at the pool and gym, keeping nails short, using open-toed footwear and wearing shoes made of breathable material.
Nine out of 10 women are wearing shoes that are too small. The consequences aren't pretty – calluses, blisters, bunions, corns, and other problems. The constant rubbing can irritate the joints in the foot and lead to arthritis. Research suggests many kids are also wearing the wrong shoe size, which puts them at risk for foot deformities as they grow.
Red or black nails due to a hematoma, or blood under the nail, usually occur from trauma (like whacking yourself on the thumb with a hammer). The discolored area will grow out with the nail and be trimmed off as you trim your nails. If you have a black spot under your nail that was not caused by trauma, you may want to see a dermatologist or a podiatrist if it involves a toenail to make sure it is not melanoma (a type of skin cancer associated with pigmented cells). A simple biopsy can rule out malignancy (cancer).
If you notice any redness, increased swelling, bleeding,or if your infection is not clearing up, see your health care professional. If a bacterial infection is also occurring, an antibiotic pill may be necessary. If you have fungal nail involvement, are diabetic, or have a compromised immune system, you should also see your physician for treatment.
In some cases of suspected nail fungus there is actually no fungal infection, but only nail deformity. A 2003 source gives a figure of 50% whereas a more recent source claims that fungus is present in 65 to 95 percent of cases. Avoiding use of oral antifungal therapy (e.g. terbinafine) in persons without a confirmed infection is a particular concern because of the possible side effects of that treatment. However, according to a 2015 study, the cost in the United States of testing with the periodic acid–Schiff stain (PAS) was about $148. Even if the cheaper KOH test is used first and the PAS test is used only if the KOH test is negative, there is a good chance that the PAS will be done (because of either a true or a false negative with the KOH test). But the terbinafine treatment only cost $10 (plus an additional $43 for liver function tests). In conclusion the authors say that terbinafine has a relatively benign adverse effect profile, with liver damage very rare, so it makes more sense cost-wise for the dermatologist to prescribe the treatment without doing the PAS test. (Another option would be to prescribe the treatment only if the potassium hydroxide test is positive, but it gives a false negative in about 20% of cases of fungal infection.) On the other hand, as of 2015 the price of topical (non-oral) treatment with efinaconazole was $2307 per nail, so testing is recommended before prescribing it.
Use tea tree oil. Tea tree oil is a natural anti-fungal. One study showed that tea tree oil may be effective for nail fungus. 18% of patients who used tea tree oil twice daily for 24 weeks were cleared of the infection. To treat nail fungus with tea tree oil, use a 100% solution because lower concentrations have not been proven to be effective for this particular infection.
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