Onychomycosis, a fungal infection of fingernails or toenails, can be treated with topical medications, oral medications and nonpharmacologic options. Topical medications generally do not work as well as oral medications, although taking oral agents increases a person’s risk of side effects. People with onychomycosis may choose non-medication treatment particularly if they are at higher risk of medication side effects or if treatment with medication did not cure the infection.
Oral Medication
People with onychomycosis are often treated with oral antifungal medications because they are more effective and require a shorter course of treatment, according to Dr. Celeste Robb-Nicholson in the April 2010 Harvard Women's Health Watch. The most common oral antifungal medications are Terbinafine and Itraconazole, although other Azole antifungal medications can also be used. Treatment is usually for six to 12 weeks. People taking oral antifungals may experience side effects such as diarrhea, liver damage or a rash, according to Dr. Robb-Nicholson.
Topical Medications
Two topical antifungal medications are commonly available to treat people with fungal nail infections, according to Dr. Oliverio Welsh and colleagues in the March 2010 issue of Clinics in Dermatology. One is called Amorolfine and is applied to the affected nail like nail polish once a week. A person with onychomycosis repeats application of the medication until the portion of the nail that is infected grows out. Toenails usually grow out in nine to 12 months and fingernails usually grow out in six months. The second topical agent is called Ciclopirox or Penlac. Ciclopirox decreases fungal nutrients, inhibiting growth. It is also a lacquer, applied like nail polish, and is applied every day. Ciclopirox is used for 12 months. In the May 2010 Mycoses, Dr. Silvia Menendez and colleagues report a new treatment called Oleozon which is ozonized sunflower oil that is applied directly to the infected nail. Welsh recommends combining oral and topical medications to increase the cure rate.
Other Treatments
People with onychomycosis who cannot take oral or topical medications or who have continued or recurrent infection after pharmacologic treatment can benefit from nail removal or laser treatment of the infected nail. The infected nail can be removed either chemically or surgically, according to Welsh. Laser treatment is not approved by the Food and Drug Administration for treatment of onychomycosis, although early studies indicate a possible benefit.
References
- "Harvard Women's Health Watch"; By the Way, Doctor. I've Tried a Lot of Things for a Fungal Infection in One of My Toenails, But it Just Won't Go Away. What Do You Know About a New Treatment that Uses Laser?; Celeste Robb-Nicholson, MD; April 2010
- "Mycoses"; Therapeutic Efficacy of Topical Oleozon in Patients Suffering From Onychomycosis; Silvia Menendez, Leopoldina Falcon, Yordana Maqueira; May 2010
- "Clinics in Dermatology"; Onychomycosis; Oliverio Welsh, MD, Lucio Vera-Cabrera, DrSC, Esperenza Welsh, MD; March 2010
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