Nail Fungus

(aka onychomycosis)


Fungus is all over in the environment, but it tends to flourish in dark, warm, moist

environments, so it is not surprising to find it on the feet, whether it is in the 

form of athlete’s foot (aka tinea pedis) or nail fungus (aka onychomycosis).


When the toenails become affected, it can make them thickened, discolored,

brittle, and the surrounding toe painful. There is also a cosmetic component to

it, which can make it embarrassing for people with nail fungus to walk around

with open-toed shoes or to go barefoot. 



The fungus infects the nail by getting underneath the nail plate; therefore,

whenever the nail is traumatized, it can cause it to loosen or elevate, at which

time the fungus invades. This may be from blunt direct trauma, such as

dropping something on the nail or stubbing the toe, but can also occur from

repetitive microtrauma, like while wearing tight shoes, running long distances,

and hiking/walking downhill.


People that walk around barefoot in public places, those with athlete’s foot, and the elderly are also at increased risk for getting toenail fungus.



Unfortunately, toenail fungus is often chronic and difficult to treat, and no one treatment option is 100% successful. As a result, there are several different treatment options available, from at-home remedies to over-the-counter topical medications to clinic procedures. There are associated risks with each option, though, so it is important to discuss these options with your healthcare professional prior to starting any of them.


No Treatment

That’s right! Because it is difficult to rid the nail completely of fungus, oftentimes it is left untreated. In this case, it is important to routinely keep the nails trimmed back and filed down (thinner). If you are unable to maintain the length or shape of your nails because the fungus has made them thick and difficult to trim, contact the doctor, who offers medical pedicures in-office or in the comfort of your home. 



Topical medications are often the first-line treatment option. Some are available over-the-counter while others require a prescription. They must be applied daily (for up to a year) and nail polish should be avoided during treatment. Like the at-home remedies, you have to wait months before noticing whether or not they are working. There is a low success rate with use of the topical medications because of the difficulty of these medications penetrating the thickened nail plate.


Oral anti-fungal – e.g. Lamisil 

Lamisil has a greater success rate than the topical medications because it is systemic; however, there is still no guarantee of curing the fungus. The medication is taken daily, for up to 3 months at a time. Because of the rare chance of affecting the liver, liver function tests must be taken before, during, and after treatment.


Keryflex™ Nail Restoration

This is a cosmetic procedure in which a synthetic resin is applied to

the natural nail, producing a nonporous artificial nail using UV light.

Indications include nail fungus, nail trauma, brittle nails, and other

nail dystrophies. It is not covered by medical health insurance and

requires routine visits for fillers.

Click here to learn more about Keryflex.


Laser therapy

This is a procedure that uses heat to kill the current fungus. It is likely

not covered by health insurance and typically requires multiple

treatments spaced about 2-3 months apart. You can apply nail polish

immediately after treatments.


At-home remedies – e.g. Vicks® VapoRub™, Tea tree oil 

Because the success rate of fungal treatment options is less than perfect, and many of the treatment options can become costly, many people have tried at-home remedies. Two of the most common remedies used for nail fungus are Vicks® VapoRub™ and tea tree oil. They should be applied on bare toenails that do not have polish on them. 


Toenails grow at a rate of about 1mm per month so it may take a few months before it is determined whether or not the remedies are working. It’s important to remember, these are not anti-fungal treatments.



It is not only difficult to cure nail fungus, but it is also difficult to prevent it from coming back since it is all over in the environment. Things you can do to help prevent nail fungus include…


  • Keeping your feet dry

  • Avoid barefoot walking in public places 

  • Avoid sharing personal items with others that have athlete’s foot or nail fungus

  • If you have athlete’s foot, anti-fungal cream or lotion on your feet, and anti-fungal powder in your shoes may help


Disclaimer: The above information is meant for educational purposes only and should not be construed as medical advice. Should you feel that you are suffering from nail fungus or another foot-related issue, please schedule an appointment to see the doctor.