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Oral and topical antifungals are the two main treatment methods. Oral antifungals are usually the more effective. Share on PinterestRosmarie Wirz/Getty ImagesSome funguses can infect people’s nails, causing changes to their color and texture. This article examines the best treatment options for nail fungus infections. After discussing oral and topical antifungals, we consider alternative treatments, home remedies, and prevention. Oral and topical antifungals A 2022 review discusses the two main lines of treatment for nail fungus — oral (taken by mouth) and topical (applied to skin) antifungals. These medications focus on invading funguses. Oral antifungals are usually much more effective than topical antifungals. Several antifungals for nail fungus currently have Food and Drug Administration (FDA) approval. These include:terbinafineitraconazoletavaboroleefinaconazoleciclopiroxgriseofulvin Each medication has different:dosagesprecautionsside effects Research measures the efficacy of antifungal drugs by a complete cure of 48 weeks. Terbinafine Terbinafine is an oral antifungal. It has a 38% complete cure rate. Dosage frequency and duration A recent review details the typical terbinafine treatment for fingernails and toenails. For people with fingernail infections, terbinafine treatment takes 6 weeks. For toenail infections, the treatment lasts 12 weeks. In all cases, the individual must take one 250 milligrams (mg) tablet daily. Read more about nail fungal infections. Precautions Scientists do not recommend terbinafine to certain individuals. These include people:with liver diseasewith a terbinafine allergywho are pregnant Potential side effects Side effects of terbinafine may include the following:headachesgastrointestinal issuesrashvisual disturbancesissues with taste, which can sometimes be permanenttransaminitis — high levels of enzymes called transaminasesliver failure Itraconazole Itraconazole is another oral antifungal with a 14% complete cure rate. Dosage frequency and duration A 2022 review explains that people with fingernail infections must take two 200 mg capsules daily for 7 days. Itraconazole treatment involves taking one 200 mg capsule daily for 12 weeks in people with toenail infections. Precautions Doctors do not recommend itraconazole to certain individuals. These include people:with heart failurewith liver disease or liver failurewho are pregnant Potential side effects Side effects of itraconazole may include the following:damage to the heart or livergastrointestinal problemsabdominal painnausea and vomitingmild diarrhea Tavaborole Tavaborole is a topical antifungal with a complete cure rate of 6.5%. Scientists develop 5% tavaborole topical solutions with tavaborole as the active ingredient. Dosage frequency and duration In recent randomized control trials, treatment involved applying a 5% tavaborole nail solution to the affected nail. The trials lasted for 48 weeks. Precautions Overall, it is uncertain whether some people should not take tavaborole. Potential side effects Tavaborole does have some potential side effects, which can temporarily impact the area around the nail. Researchers list these as follows:application site exfoliationerythema, a type of skin rashdermatitis Efinaconazole Efinaconazole is another topical antifungal. Its complete cure rate may be as high as 17.8%. As a 2015 research article explains, the main ingredient in efinaconazole 10% topical solution is efinaconazole. Dosage frequency and duration An individual must apply efinaconazole 10% topical solution to any affected nails daily. Precautions Experts have not yet found sufficient evidence that efinaconazole 10% topical solution is unsafe for certain people. Potential side effects The following side effects may occur with efinaconazole treatment:blistersdermatitiserythemaeczemaheadachesingrown nailnasopharyngitis, or a coldupper respiratory tract infectionsinusitis Ciclopirox Ciclopirox is a different topical antifungal, and its complete cure rate may reach 8.5%. A 2019 article lists ciclopirox olamine as the active ingredient in ciclopirox 8% topical solution. Dosage frequency and duration Once per day, individuals can apply a special ciclopirox 8% nail lacquer to any affected nails. Treatment can last for 48 weeks. Precautions The article does not mention any specific precautions for using topical ciclopirox. The drug appears to be safe, with no recorded serious adverse effects. Potential side effects Some people who use topical ciclopirox may experience mild and temporary side effects. These include:burning sensationpainirritationrednesspruritus – itchy skin Griseofulvin Griseofulvin treats fungal infections of the:scalpfingernailstoenails Doctors administer griseofulvin orally for fungal infections. This drug enables newly formed skin and nail keratin —the protein that makes up the tissue— to resist fungal attacks. As the new keratin grows, the nail sheds the old infected keratin. However, newer antifungals such as terbinafine and itraconazole have largely replaced this drug. Dosage frequency and duration The oral tablet contains 500 mg of active griseofulvin. An adult should take 1,000 mg 1–4 times daily. The usual duration is 4 months for fingernails and 6 months for toenails. The dosage for children of any age is 10 mg per kilogram of body weight per day. Doctors will recommend continued treatment for at least 2 weeks after all signs of infection have cleared. Precautions Before a person starts taking this medication, doctors must identify the type of fungus. Medical professionals do not usually prescribe griseofulvin to treat minor infections that respond to topical therapy. Doctors do not recommend griseofulvin if a person has:have hypersensitivity to griseofulvin or any of the ingredientshave porphyria, a rare metabolic disorder that can affect the skinhave severe liver — hepatic — impairmenthave systemic lupus erythematosus, a chronic autoimmune disease causing skin and joint inflammationare pregnant or nursing People with moderate to mild hepatic impairment do not need their dosage adjusted. However, griseofulvin may lead to further impairment of hepatic function. Therefore, doctors will regularly monitor a person’s liver. Potential side effects Griseofulvin may cause more side effects than the other treatments for nail fungus. Potential side effects include:headachesupset stomachvomitingdiarrhea thirstfatiguedizzinessfaintness Alternative treatments Oral and topical antifungals are the primary treatment option for nail fungal infections. However, scientists continue to develop other treatment options, which do not always involve taking medication. For instance, emerging evidence suggests lasers and photodynamic therapy could treat nail fungal infections. This would involve using certain forms of light to destroy the fungus without harming surrounding tissue. In some cases, it may be helpful to surgically remove some of the affected nails. This can help topical treatments reach the fungus. In severe cases, it may also be helpful to completely remove the affected nail. Home remedies for nail fungus There is evidence that certain natural topical ointments could help with nail fungus infections. These ointments contain vitamin E and essential oils of:oreganolimetea tree At present, no reliable and recent scientific evidence suggests that home remedies can effectively treat nail fungal infections. Preventions It may be impossible to eliminate the risk of nail fungal infections. However, there are many ways in which people can reduce that risk. These include:wearing non-occlusive or open shoes, such as sandalsusing absorbent socks to absorb fluidsclipping nails shortkeeping feet dry and cold, as funguses prefer warm and damp conditions When to consult a doctor There are several symptoms of nail fungal infections. A 2022 review lists some of these as follows:thickened nailsdiscolored nailsthickened skin around the nails Anyone with these symptoms may wish to seek a doctor’s advice. Summary Scientists have developed several treatment options for fungal nail infections. Oral antifungals tend to be more effective than topical treatments. However, oral antifungals also tend to have more severe side effects, which can make them inappropriate for some people, including those who are pregnant or have liver disease. Last medically reviewed on August 15, 2022Dermatology 14 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Alessandrini, A., et al. (2020). An open study to evaluate effectiveness and tolerability of a nail oil composed of vitamin E and essential oils in mild to moderate distal subungual onychomycosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995982/Bodman, M. A., et al. (2022). Onychomycosis.https://www.ncbi.nlm.nih.gov/books/NBK441853/Griseofulvin 500mg tablets. (2019).https://www.medicines.org.uk/emc/product/10746/smpc#grefGriseofulvin. (2017).https://medlineplus.gov/druginfo/meds/a682295.htmlGupta, A. K., et al. (2019). Recent advances in therapies for onychomycosis and its management.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600855/Jinna, S., et al. (2015). Spotlight on tavaborole for the treatment of onychomycosis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662369/Kurn, H., et al. (2022). Itraconazole.https://www.ncbi.nlm.nih.gov/books/NBK557874/Leung, A. K. C., et al. (2020). Onychomycosis: An updated review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7509699/Lipner, S. R., et al. (2015). Efinaconazole in the treatment of onychomycosis.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459619/Maxfield, L., et al. (2022). Terbafine.https://www.ncbi.nlm.nih.gov/books/NBK545218/Nail fungus: Diagnosis and treatment. (n.d.).https://www.aad.org/public/diseases/a-z/nail-fungus-treatmentOlson, J. M., et al. (2022). Griseofulvin.https://www.ncbi.nlm.nih.gov/books/NBK537323/Sonthalia, S., et al. (2019). Topical ciclopirox olamine 1%: Revisiting a unique antifungal.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615394/What is the best medication for a fungal infection of the toenail? (2017).https://www.cochrane.org/CD010031/SKIN_what-best-medication-fungal-infection-toenailFEEDBACK:Medically reviewed by Jennie Olopaade, PharmD, RPH — By Mathieu Rees on August 15, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? 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