Oral medications include terbinafine (76% effective), itraconazole (60% effective) and fluconazole (48% effective). They share characteristics that enhance their effectiveness: prompt penetration of the nail and nail bed, and persistence in the nail for months after discontinuation of therapy. Ketoconazole by mouth is not recommended due to side effects. Oral terbinafine is better tolerated than itraconazole. For superficial white onychomycosis, systemic rather than topical antifungal therapy is advised.
Nail fungus, or onychomycosis, is a common skin condition where a fungus infects a part of the nail including the bed, matrix, or plate. Nail fungus can result in cosmetic concerns, pain, and discomfort as well as end up affecting your everyday activities. If it is a severe infection, it may cause permanent damage to your nails or may spread beyond your nails. If you know you have toenail fungus, you can follow a few simple steps to get rid of it and return your toenail to its former health.
For more severe cases, oral antifungal medications might be required. These include fluconazole (an antifungal agent also commonly used to treat thrush), terbinafine (a broad-spectrum antifungal) and griseofulvin (usually used for skin infections). The latter is a very old drug and carries the risk of causing damage to the liver. Terbinafine is most effective and therefore is the preferred oral treatment. A 12-week course cures 70-80% of cases by causing the fungi’s cells to leak and die. It can, however, cause gastrointestinal side effects and depression.
The US Food and Drug Administration (FDA) has approved several medicines as topical applications to help treat foot and toenail fungus and prevent the fungus from recurring. PROFOOT anti-fungal products containing Tolnaftate 1% are clinically proven to cure and prevent fungal infections on skin around, adjacent to, and under nails, making it easy to treat fungal infections all day, every day, until they have cleared. ProClearz Fungal Shield is a safe and effective clear formula that dries quickly with no unpleasant odor. The 1 oz. bottle comes with a brush-on applicator designed to reach skin areas around and under nails.