Treat nail fungus – how it works!

Treat nail fungus - how it works!

Nail fungus can be treated in several ways depending on how far along the fungus is. For external treatment, unique nail polishes or tinctures are used. The internal therapy of nail fungus is carried out with the help of tablets, which usually have to be taken over several months. What else helps against nail fungus? You can find out here which medications are used and whether home remedies can help.

Nail fungus: treatment required

Unlike athlete’s foot, which can be treated relatively quickly with appropriate ointments, nail fungus on toenails or fingernails often requires a lot of patience. In any case, the earlier the treatment begins, the quicker the success will be apparent.

The reverse also applies: Nail fungus is persistent and rarely heals independently. If a nail fungus is not treated, not only can it develop into athlete’s foot, but there can also be tears in the skin, which can be the entry point for bacteria – this is a common cause of erysipelas in the leg, for example.

Any existing athlete’s foot should always be treated with nail fungus therapy.


External therapy for nail fungus

As long as the fungal spores have only affected one or two nails and no more than 50 per cent of the nail surface is affected, the fungus can still be treated externally (local therapy). Unique mushroom nail polishes (water-soluble or waterproof) or sets with creams, ointments and tinctures (e.g. with the active ingredients bifonazole, amorolfine or ciclopirox ) are available for this. The most effective remedies against nail fungus are water-soluble nail polishes with the active ingredient ciclopirox.

These antifungal (fungus-killing) preparations can be prescribed, but they are also available over the counter at pharmacies. If the pathogen is known, the appropriate antimycotic can be precisely selected. Otherwise, a broad-spectrum agent is used.

Choosing a preparation against nail fungus is essential since conventional fungal ointments do not penetrate the hard nail material to the bottom. The preparations often contain urea or potassium iodate to remove the affected nail layers so that the antimycotic can penetrate better – because the fungus sometimes sits in air-filled cavities between the nail layers. 

Well-known products against nail fungus are, for example, Canesten®, Loceryl® or Ciclopoli®.

Topical treatment tips

When using the antifungal agents for external treatment, be sure to observe the following instructions:

  • Before the nail polish or tincture is applied, the nails should be cut short and roughened with a file. Then, the antifungal agent can be well distributed in the nail.
  • So that the fungi do not grow back, it is essential to apply the product consistently according to the instructions on the package. Depending on the preparation, for example, every other day at first, then about once or twice a week.
  • Additional hand or foot baths are sometimes recommended to soften the nail – remember to dry yourself thoroughly afterwards.
  • After a specific exposure to the antifungal agent, the infected nail parts can be removed with a spatula or filed off. Remember the removed nail parts can be infectious, and use disposable files.


Internal therapy for nail fungus

If the fungal spores have already penetrated the nail bed, the nail that grows back will also be infected again and again. In this case, only additional drug treatment with tablets will help. This is also known as systemic therapy.

The antifungal agent then reaches the spores via the bloodstream and is stored in the nail bed. Active ingredients of these antifungal tablets for internal treatment are terbinafine, fluconazole, itraconazole or griseofulvin. However, the latter is rarely used since other active ingredients are more effective and have fewer side effects.

A doctor must prescribe drug treatment. The prescribed drug must be taken until the nails have grown back healthily. And that takes time because a nail grows back slowly.

Duration of treatment for nail fungus

The duration of therapy for nail fungus depends on the type of treatment and which nails are affected:

  • You have to reckon with at least three months of therapy when taking a tablet.
  • With fungal nail polish, the therapy can take about six months, but in the case of a severe infestation, it can take a year or longer.
  • Healing on the fingernails is faster, and success can usually be seen after about three months.

Laser for nail fungus

If treatment with tablets is impractical or impossible (e.g. due to pregnancy), lasers are sometimes used to combat nail fungus. This is a relatively new form of treatment for nail fungus, which is also one of the local therapies. The laser should penetrate through the nail and kill the fungi.

This treatment is considered a quick way to combat nail fungus. It requires several sessions and is still carried out by a few dermatologists. Also, the costs of pulsed laser treatment have yet to be reimbursed by statutory health insurance companies. In addition, the study situation on this method needs to be clarified.


Home remedies for toenail fungus?

There are many rumours about home remedies for toenail fungus. For example, rubbing the nails with apple cider vinegar, vinegar essence, lemon, toothpaste, lavender oil, tea tree oil, thyme oil, or baking soda should help eliminate the fungus. Even if treatment with natural remedies seems tempting, and at least some essential oils, such as tea tree oil, have a fungicidal effect, their effectiveness against nail fungus has not been proven.

There is a risk that treatment attempts with home remedies will delay effective treatment with medication – which later makes the therapy all the more lengthy. Home remedies can even have the opposite effect, for example, when footbaths or rubbing coconut oil on the skin help create a warm, humid climate where nail fungus can spread particularly well. It should also be considered that home remedies usually cannot penetrate the deep layers of the nail, where nail fungi like to settle.

Home remedies should, therefore, only be used as a support and only after consultation with the doctor treating you.

Nine tips for prevention and treatment

Even if home remedies are not considered advisable, you can do a lot in addition to using medication to fight nail fungus. The following tips can help to get rid of a nail fungus or to prevent a nail fungus infection:

  1. Dry your feet carefully after swimming or showering, especially between your toes.
  2. Wear bathing suits or slippers in public spaces.
  3. Use socks and shoes made of natural, breathable materials and give your feet fresh air often.
  4. Carry out alternating foot baths regularly, promoting blood circulation in the toes and nails.
  5. Then massage your feet and nails with thyme or tea tree oil once a week – this counteracts inflammation.
  6. Change your towels at least once a week. If you already have nail fungus, use an extra towel for your feet and change it daily.
  7. Accompanying the nail fungus treatment, the shoes should be disinfected with a suitable shoe spray since fungi find ideal living conditions in the warm, humid environment of the shoes. Bath mats, socks, bed linen and towels must be disinfected or washed at at least 60 °C.
  8. If nail fungus is already present, disinfect the equipment (nail scissors, nail file, etc.) after each foot and nail care and wash your hands thoroughly after each contact with the affected nail.
  9. If your feet are infected with toenail fungus, you should not walk barefoot at home either so as not to spread the fungi and possibly infect others.



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