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Johns Hopkins Health Alert

The Truth About Toenail Fungus

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If your toenails are discolored, thick, and brittle, chances are you have nail fungus, or onychomycosis, a common condition caused by an infection under the nail bed. Home remedies for nail fungus abound, but unfortunately none of them actually works. To really treat fungus, you have to take a trip to your doctor.

You can get rid of nail fungus -- but not with Vicks VapoRub, bleach, Listerine, tea tree oil, or vinegar, says podiatrist Zachary L. Chattler, D.P.M., an instructor in the Department of Orthopaedic Surgery at Johns Hopkins. All of these "cures" are myths. And don't waste your money on over-the-counter products; they may cure athlete's foot and other fungal infections of the skin, but they won't work on nail fungus.

Which treatment will work depends on the severity of the infection. If the fungus is caught early and has not spread to the entire nail, your doctor may recommend a prescription antifungal topical lacquer, ointment, or cream, like ciclopirox (Loprox).

However, these therapies probably will not get rid of fungus for good, says Dr. Chattler, since topical treatments wipe off easily and have trouble penetrating the toenail to reach the nail bed. The most effective treatments are oral antifungal medications like itraconazole (Sporanox) and terbinafine (Lamisil), which are available by prescription and taken daily for three months. These medications work by killing the fungus at the nail root, says Dr. Chattler.

 

After the medication regimen, the toenail cuticle should look clear, but it could take up to a year for the entire nail to be fungus free, says Dr. Chattler. Unfortunately, some people are never cured. If this is the case, you may have to just manage the fungal nail, he says. Regular visits to the podiatrist to cut and file down the nail will prevent it from irritating your foot. You may also consider having the nail removed.

Protecting Your Nails. Fungi thrive in warm, wet places, so good hygiene is the best defense, says Dr. Chattler. Make sure your feet are clean and dry, and keep nails clipped straight and short. Always disinfect nail clippers, and wear synthetic socks rather than cotton or wool, which absorb moisture.

Typically, toenail fungus is more of a nuisance than a health problem, the doctor continues. But this doesn't mean you can ignore it: Left untreated, fungus can spread to your fingernails and skin. And if you have diabetes or a circulatory disorder, you need to be more vigilant in treating the fungus -- a thick, long toenail could cut your foot, which can lead to an ulcer or skin infection.

Posted in Healthy Living on December 9, 2009
Reviewed January 2011


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


Although the article says that Vick's Vapor Rub does not work - my husband and both my in-laws have used it with good success. It took almost a year & a half using it nightly but it did clear it up. Without any of the medicine side effects. They did let it get so bad that one each of their toes was growing up on top of the nail bed instead of out the end of the toe. This has to be shaved down every month or so but have been told it is caused by a fungal infection of the toe nail bed. BTW - a medical doctor told me about the Vick's Vapor-Rub.

Slather on toe nails and cover with a white sock each nite before bed.

Thanks Gwen

Posted by: Gwen L. | December 3, 2010 2:07 AM

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