What Are the Best Treatments for Toenail Fungus (Onychomycosis), and How Does It Look?

If you’ve noticed yellowing and thickening of your toenail, it’s possible that you have toenail fungus. And you’re not alone: Toenail fungus (onychomycosis) is a very common infection for many adults. The good news is, there are good treatments for toenail fungus out there. 

Toenail fungus treatment works slowly, so you’ll need to be patient. Improvement can even continue after you stop treating the nail fungus. 

Let’s take a closer look at the best toenail fungus treatments that will help clear up your toenails for good. 

What causes toenail fungus?

Toenail fungal infections happen when a fungus comes in contact with the nails and invades them, causing yellowing and thickening of the nails. This can be caused by:

• Walking barefoot in a public area, like a pool

• Using an infected nail clipper

• Having athlete’s foot or touching someone else’s skin who does

It’s important to note that fungus can also affect the fingernails, but this is less common.

Images of what toenail fungus looks like

When a fungal infection affects your toenails, it can cause changes in nail color, shape, and length, such as:

• Yellow, green, brown, or black discoloration

• Nail thickening

• Broken off or misshapen nails 

Here are some photos to help you see what toenail fungus can look like.

Pills to treat toenail fungus

Oral medications (medications you take by mouth) generally work faster for toenail fungus than topical medications that you apply to the toenail. They have higher cure rates, and the overall treatment time is typically shorter. 

That said, it can still take 9 to 12 months to see full results. And you’ll need a prescription for these pills. 

Here are the best toenail fungus medications. 

Creams and topical treatments for toenail fungus

Prescription nail polishes are an option to treat toenail fungus. They take a long time to work though. Also, they aren’t as effective as pills for severe cases. That’s because they don’t penetrate the nail very well. 

That said, they’re still a good option for people with mild cases of toenail fungus or for those who can’t take the oral medications. 

Examples include: 

• Efinaconazole (Jublia, Clenafin) — 10% nail solution

• Tavaborole (Kerydin) — 5% nail solution

• Ciclopirox (Ciclodan, Penlac, Loprox) — 8% nail solution

Side effects are usually minor and include redness or burning at the area where you apply it.

Over-the-counter and natural treatments for toenail fungus

You have some options if you’d rather try over-the-counter (OTC) treatments first. Keep in mind that these treatments are usually used for fungal skin infections, and they don’t work as well in the nail. Having said that, here are some of the best OTC toenail fungus treatments: 

• Terbinafine (Lamisil)

• Tolnaftate (Tinactin)

• Clotrimazole (Mycelex)

Natural treatments and home remedies for toenail fungus may be another option. Early studies suggest that these treatments may be effective, but more research needs to be done to see how well they work. 

Here are some natural treatments that may help:

• Tea tree oil

• Vicks VapoRub

• Propolis extract (honeybee resin)

• Spirulina (a type of algae)

Other treatments for toenail fungus infections

When medications don’t help and only one nail is affected, removing the nail partially or completely is an option. Researchers are also studying light therapy and lasers as possible toenail fungus treatments. More research needs to be done to see how effective these treatments are. 

What to watch for when taking oral medication for toenail fungus treatment

All of the pills for toenail fungus can cause liver toxicity. This is rare, though, and it’s reversible after you stop the medication. To prevent this complication, your primary care provider or dermatologist will run your liver function blood tests before you start treatment and then midway through your treatment. 

These pills can also interact with other medications you’re taking — including supplements. Your healthcare team will look at your medication list to make sure there aren’t any drug interactions before starting a new treatment.

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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Images used with permission from VisualDx (www.visualdx.com).