One of the most demoralising things about fungal nail infections is the fact that, more so than any useful information on prevention or treatment, it is their stubbornness – or, in other words, their ability to linger on for months or, if improperly treated, years.
There is, of course, plenty of truth behind this reputation. After all, it is incredibly unlikely that a fungal nail infection will go away of its own accord – and all the more likely that it will eventually spread to other toes, unless an effective treatment is used.
Similarly, the prevalence of a few ‘old wives' tales’ serve to muddy the waters for those seeking out genuinely effective treatments – and, in turn, suggests that the infection is so indefatigable that one must resort to some rather unpleasant measures, such as bleach baths and the unpalatably named ‘garlic rub’, in order to stand a hope of ridding themselves of it.
In reality, there are a number of fungal nail treatment options that have proven themselves highly effective at eradicating the infection altogether and, as a result, allowing a clean, new and healthy nail to grow in the place of the old one, rather than treating the superficial symptoms temporarily.
Still, owing to the stubbornness of a fungal infection, the only way for anyone to reap the most benefit from these treatments is to use them consistently, and until the entire infection has been eradicated. If patients only wait for the tangible signs to subside, such as odour and discoloration, they may well find that the fungus regrows from its root (buried deep within the nail) in a brief timeframe.
With that in mind, here are the most effective treatment options for fungal nail infections, as of 2021.
As far as treatments for fungal nail infections go, we are all likely to be most familiar with the use of topical options, which can be applied directly onto the nail (rather like a clear nail varnish) and the surrounding cuticle.
Trosyl is a prescription-only, topical treatment containing the broad-spectrum antifungal, tioconazole. This ingredient has been proven highly effective against a long list of common fungal infections which can invade the skin and cause unpleasant symptoms. In the case of a fungal nail infection, it need only be applied once every twelve hours, though patients must be careful to maintain a consistent schedule, as sporadic use is not likely to have any significant impact on the infection.
As with any treatment that intends to eliminate the infection, rather than the symptoms, it will take some time before treatment can be stopped. As a topical treatment, however, it presents a low risk of side effects (aside from the potential for local irritation), so ongoing use is little more than a mild, daily inconvenience.
It is, however, far more effective when used in milder cases, where only one nail is infected by the fungus. Any topical treatment, however affective, will struggle to penetrate as deeply as the infection – a fact which often means that topical treatment takes upwards of a year to make a difference.
As such, for a more aggressive approach to treating the condition, oral medications offer a faster and more persistent course of treatment.
In cases where the infection has had the opportunity to grow more invasive – or, as mentioned above, spread beyond just the first nail – then the use of fungal nail tablets containing the active ingredient terbinafine continue to prove highly effective.
Terbinafine is used as a topical and oral medication in the treatment of a wide range of fungal infections. It is available under its generic name, or as the branded medication, Lamisil.
One tablet is typically taken daily, following a finger pick blood test to confirm the presence of the fungal infection. If taken consistently, results usually appear within 3-6 months – but it is vital that treatment does not end until the infection has a chance to clear completely.
Of course, as with many oral medications, side effects are more prevalent than they would be in topical treatments. Tablets do, however, significantly cut down on the anticipated treatment time, even in more severe cases, so, for many, the positives outweigh the potential side effects.
Treating fungal nail infections is a tricky business – but only if you don’t know where to start. Their stubbornness is the reason why they boast such a long list of ‘failed treatments’, but there remains a number of antifungal medications capable of targeting the root of the infection, rather than the side-effects which only run skin deep.