The 7 Best Toenail Fungus Treatments of 2023
Derby, R. Journal of the American Board of Family Medicine, January/February 2011.
OTC and Home Remedies for Foot Fungus
Do your toenails split, peel, and turn yellow? If so, you may be one of an estimated 40 million Americans who live with toenail fungus, also known as onychomycosis. The good news is, you don’t have to live like this. A number of remedies can help you walk with confidence. Here are 10 that you can buy at your local drugstore. You may even have some of them in your medicine cabinet. Although these may not be as effective as medicines your doctor can prescribe, they might be worth a try:
Undecylenic Acid
This fungus fighter is the main ingredient in many over-the-counter (OTC) products. You can buy it at your local drugstore as a liquid or a polish you paint onto your nails. It eases the raw, irritated skin that can come with a fungus.
This is a staple in OTC products for athlete’s foot, ringworm, and jock itch. It comes in a cream, powder, spray, or liquid. You may feel relief after 2 to 3 days, but keep using it for at least 2 weeks after symptoms disappear.
You’ll find this in many OTC yeast infection creams. But it’s also used to treat toenail fungus. Scientists in the U.K. found it worked for most of the patients who used it in a 12-week trial.
Physician is a high-paying career, and American doctors have some of the highest salaries worldwide, with general practitioners earning an average of $185,000 and surgeons earning $306,000 annually, according to MLive Media Group.
You can buy it as a cream or lotion.
You may know this by its brand name, Lamisil. You can buy it over the counter as a cream, gel, spray, or powder. Or you can ask your doctor to prescribe the drug in pill form. Take one tablet each day for 12 weeks. It’ll kill toenail fungus, but it may take a few months to see full results. Also, you will need to be tested periodically to make sure the drug has not affected your liver function.
Tea Tree Oil
This oil comes from a tree in Australia. It’s a popular treatment for many conditions, including foot fungus. Research shows it works as well as clotrimazole, which is found in many OTC treatments.
Mentholated Cream
You probably already use this to treat chest colds. But did you know vapor rub is also a popular home remedy for toenail fungus? There’s not a lot of proof that it works. But in one very small study — just 18 people — more than half said it did.
Snakeroot Extract
Don’t be afraid of the name. This fungus fighter comes from a plant, not snakes. People who tried this natural remedy found it worked almost as well as ciclopirox, a medicine used to treat skin infections caused by a fungus.
In the lab, plain old sodium bicarbonate limited growth of the most common types of fungi that cause skin and nail infections. You probably have a box in your pantry already.
Ozonized Sunflower Oil
Who knew sunflower oil can also fight germs? One study found that this natural remedy worked against yeasts that cause foot fungus. There’s more work to do, but so far, researchers don’t see any side effects.
Eucalyptus Oil
People love this popular plant because of its fresh scent. But it does more than smell good. It also works on toenail fungus. Scientists say it may work just as well as treatments you get from your doctor.
Show Sources
The Corvallis Clinic: “Toenail Fungus.”
National Library of Medicine: “Undecyclenic Acid Liquid.”
National Center for Biotechnology Information: “Tolnaftate.”
National Library of Medicine: “Tolnaftate.”
Davies, K. The International Journal of Clinical Foot Science, Jan. 20, 2006.
National Library of Medicine: “Terbinafine.”
Cleveland Clinic: “Tea Tree Oil.”
Derby, R. Journal of the American Board of Family Medicine, January/February 2011.
American Family Physician: “Onychomycosis: Current Trends in Diagnosis and Treatment.”
Sechi, L. Journal of Applied Microbiology, February 2001.
Bramston, C. Journal of Foot and Ankle Research, September 2015.
The 7 Best Toenail Fungus Treatments of 2023
Danielle Zoellner is a freelance writer with an emphasis in health and wellness. She graduated from the University of Missouri at Columbia.
Jennifer Nied has written about health, fitness and wellness for over 10 years. She has a degree in magazine journalism from Northwestern University’s Medill School of Journalism.
Sarah is a freelance writer with a focus on health and wellness. She has written for publications like Women’s Health, Healthline, and Parents. She taught creative writing for five years, and has a bachelor’s degree in English from Southern Connecticut State University.
Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University.
Toenail fungus is a common fungal condition that often starts after a rash on the foot spreads to the nails. When mild, it looks like white and yellow spots growing under the nail beds. If left untreated, the fungus can grow severely by hardening the nails and spreading to other toes.
Reviewed & Approved
Lamisil Terbinafine Antifungal Cream treats fungus all over the body, including athlete’s foot, making it the best overall choice. The Fungi Nail Anti-Fungal Ointment is infused with five oils and makes for a budget-friendly option.
“The more severe the toenail fungus, the thicker the nail, and the more nails involved makes it that much harder to treat the nails even with effective therapies,” says Shari Lipner, MD, a board-certified dermatologist at New York-Presbyterian Hospital/Weill Cornell Medicine. The fungus often begins in the form of athlete’s foot between the toes or on the soles of the feet. At this stage, the fungal infection is easier to treat with over-the-counter medication, and that’s where toenail fungus treatments come in. In addition to understanding stage and severity of your toenail fungus when shopping for treatments, you should carefully assess the ingredients and the type of treatment for the fungus based on its location.
We researched dozens of toenail fungus treatments and evaluated them based on the following attributes: cost, medication forms, ingredients, and treatment areas.
What to Look for in a Toenail Fungus Treatment
Severity
Toenail fungus, if left untreated, can become a tough problem to treat and will greatly influence what medications you need. In fact, it’s best not to wait until your problem is severe before starting some kind of treatment, especially if you’re hoping to stick with OTC products.
“Toenail fungus is very hard to treat, and even under the care of a dermatologist it doesn’t always resolve,” says California-based dermatologist Caren Campbell, MD. “Given how difficult it can be to treat, it’s best to get in to see a dermatologist as soon as possible to avoid it worsening.”
Furthermore, the fungus can spread to other nails and other areas of the body, adds Dr. Campbell, another reason why early treatment is ideal. If you notice the fungus spreading, or if your toenails have become thick and yellowed, you might need either a prescription-strength product or to seek help from a board-certified dermatologist.
Location
Dr. Lipner says toenail fungus starts as athlete’s foot: “It begins with a rash on the foot and spreads to the toenails,” she says.
Since treating athlete’s foot differs from treating toenail fungus, you’ll have to pay attention to where your problem is on your foot. Athlete’s foot can be addressed with antifungal ointments, sprays, and powders available over-the-counter, but if your fungus has moved to under the nail or the surrounding skin, says Dr. Campbell, you’ll need to focus on treating it with topical creams, ointments, and polishes, or oral medications.
Ingredients
Zinc undecylenate and undecylenic acid are both FDA-approved ingredients to treat toenail fungus. Also, if you seek help from a dermatologist, they will likely prescribe medications in the “azole” family. “The compound interferes with the synthesis of the fungal cell membrane,” Dr. Lipner says, which essentially kills the fungus.
One common medication in the “azole” family used to treat toenail fungus is Jublia (efinaconazole). Other medications often prescribed include the active ingredient terbinafine, which is usually prescribed as oral or topical Lamisil.
Type
Toenail fungus treatments can come in a variety of forms, but oral, topical, and homeopathic medications are the most commonly used for treating toenail fungus.
Oral Medications
Oral medications have been proven effective, but they take time to work.
“Lamisil also has the lowest side effect profile of the oral antifungal medications and works as a fungicidal which destroys a fungus by blocking its ability to ‘breath’ or make the oxygen molecules it needs to survive,” says Orit Markowitz, MD, founder and CEO of OptiSkin treatment center in New York City.
But there are several conditions that can make people ineligible for oral antifungal medications. The same underlying comorbidities, including chronic renal failure (with dialysis) and renal transplant, immunodeficiency, diabetes, cancer, and peripheral arterial disease that make someone more susceptible to toenail fungus also make them more at risk for side effects when taking the drugs. Speak with your doctor to ensure you can safely take an oral antifungal.
If you’re eligible for oral drugs, however, you may want to take a multi-pronged approach: “I prefer to do orals and topicals if patients really want a chance at a cure, since it is so difficult to treat nail fungus,” says Dr. Campbell.
You also might want to opt for an oral medication if more than one nail is affected.
“[You] might use [Lamisil] if there are multiple nails involved,” says Michelle Henry, MD, founder of Skin & Aesthetics Surgery of Manhattan, “because oral treatment is significantly more effective in clearing the fungus.”
Topical Medications
Topical treatments (like amorolfine and ciclopirox) can help with minor toenail fungus. They cause fewer and less serious side effects. But, it’s difficult for them to penetrate the nail plate so treatment is longer and efficacy is low.
“Azole antifungals like Jublia inhibit fungal elements involved in the biosynthesis of critical fungal elements like fungal cell membranes,” says Dr. Markowitz. She adds that, “topical therapies can be effective, but require lengthy and costly regimens without an established method for predicting outcome.” It could mean daily topical treatments for 52 weeks.
Natural/Homeopathic Medications
Natural preventative measures can be effective, but once fungus sets in, your best bet is a research-backed and FDA approved oral antifungal. Garlic has antifungal properties, and when used in a footbath can provide some relief.
“Given that topical prescription remedies take at least one year of daily use to work in only two thirds of mild to moderate cases, it is difficult to recommend an off-label natural remedy treatment,” says Dr. Markowitz.
You could also try tea tree oil in conjunction with other more traditional treatments, says Dr. Henry, or even white vinegar: “I often recommend white vinegar soaks: patients [put] a quarter cup of white vinegar in a bowl and soak the toenail once or twice a day.”
A complete cure can take as long as 18 months; while you wait, Dr. Campbell suggests washing your socks in hot water to prevent reinfection and using antifungal powders, like Zeosorb, in your shoes. Keep in mind that for fungal nail infections, a cure is not achieved at all in 20 to 25 percent of treated patients.
“I’ve always counseled patients that even oral medications [only] work approximately 60% of the time, so it’s oftentimes a chronic condition,” says Dr. Campbell.
Frequently Asked Questions
How long should I use a toenail fungus treatment?
Antifungal medications take some time to fight the fungus. Most products recommend twice daily application for one to two weeks, but the reality is that you’ll likely need to treat the fungus for much longer than that.
“Toenails take a year to grow out,” says Dr. Campbell. “Oral treatment is usually three months, [while] topicals need to be used for 12 months.”
If you’re treating your fungus at home and nothing changes after you’ve used the product for the prescribed time, consult your doctor for treatment recommendations and next steps.
Can topical toenail fungus treatments cause irritation?
The active ingredients in most antifungal treatments are quite potent. That means they do have the power to cause burning, stinging, swelling, irritation, redness, bumps, and other irritation on the skin. If this occurs with use, consult your doctor. But, most people are able to use the antifungal creams and gels without problems and with healing, soothing effects. “Terbinafine, or lamisil, is typically well tolerated,” says Dr. Henry. “However, undecylenic acid is often included in OTC treatments [and that] can cause irritation to the skin if used improperly.”
Below, you’ll find the best toenail fungus treatments on the market today.