Best Treatments for Nail Fungus Known as Onychomycosis

Warts
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Amy Forman Taub, MD, FAAD

Nail Fungus or Onychomycosis, is an infection of the nail bed often caused by a fungus called a dermatophyte.

A fingernail or toenail infected with fungus will often have a yellow, thickened appearance with debris underneath the nail that crumbles easily. To determine if an individual has onychomycosis, we can perform a fungal culture which takes 3 weeks to grow.

There are topical and oral medications approved to treat this nail condition.

  • Penlac is a topical antifungal in a nail polish form that is applied to the affected nails every day until they clear. This is practical if there are only a few nails involved and the infection is mild, otherwise the effectiveness is not great.
  • The oral drug of choice is Lamisil, which is taken for a 2-3 month period (depending if it is fingernails or toenails), and has an 80% cure rate. It usually takes a full 6-12 months to see a completely normal, healthy nail again because nails only grow about a millimeter a month! There is an extremely small incidence of liver inflammation with this drug so we do need to monitor with blood tests.

If you have yellow thickened toenails that you want to look nice by spring/summer, now is the time to come in for an evaluation and to start treatment!