Toenail Fungus Treatment

Toenail Fungus - Overview

Toenail fungus (onychomycosis) is a common fungal infection of the nail that typically causes thickening, discoloration, and brittleness. It rarely resolves on its own and usually requires prescription antifungal treatment to clear the infection. Through Push Health, people can connect with a licensed medical provider online for evaluation and, when appropriate, a prescription for oral or topical medication sent to a convenient pharmacy.

What Causes Toenail Fungus

Toenail fungus (onychomycosis) is most often caused by dermatophyte fungi but can also be caused by yeasts and non-dermatophyte molds. Risk factors include older age, diabetes, peripheral vascular disease, repeated nail trauma, communal showers and locker rooms, and a history of athlete's foot. Nail fungus can also occur on the fingers. Symptoms include brittle nails that can turn white, yellow or even black in color. The surrounding nails and skin can also become infected. Sometimes, nail clippings are examined by microscopy or culture, especially in the setting of treatment failures.

How To Treat Toenail Fungus

Effective treatment typically requires prescription antifungal medication. Over-the-counter creams and home remedies (apple cider vinegar, bleach, tea tree oil, Vicks.) have limited or unproven benefit for established nail infections.

Toenail Fungus - Medication Options

Toenail fungus treatment typically involves prescription medications that come in both pill and topical solution forms.

Oral antifungals (generally more effective for moderate to severe disease):

• Terbinafine (Lamisil) - Often first-line treatment. Typical course 12 weeks for toenails (6 weeks for fingernails). Higher cure rates than most alternatives.
• Itraconazole (Sporanox) - Alternative treatment that requires continuous or pulse dosing regimens.

Topical antifungals (best for mild disease or when oral therapy is contraindicated):

• Efinaconazole (Jublia) 10% solution
• Tavaborole (Kerydin) 5% solution
• Ciclopirox lacquer (Ciclodan, Loprox, Penlac)

Topical agents require daily application for many months (often up to 48 weeks) and have lower cure rates than oral therapy. Combination approaches are sometimes used. Even with successful treatment, full cosmetic improvement can take 12-18 months as the damaged nail grows out. Recurrence is possible as well. Good foot hygiene helps reduce the risk of it returning.

Toenail Fungus Medications - Side Effects

Toenail fungus medications are typically tolerated well but can cause gastrointestinal discomfort, rash, liver inflammation, and worsening of existing heart failure (depending on the exact medication). These medications can also interfere with the metabolism of other medications being used. Hypersensitivity reactions can occur and patients with an allergy to a specific medication should avoid using it.

Many side effects will go away once the medication is stopped. Discuss any medication questions with a medical provider.

Toenail Fungus Medications - Online

Many medications used to treat toenail fungus require a prescription and are not available over the counter (OTC). Push Health can connect people who might need a prescription to treat nail fungus with a licensed medical provider who can prescribe one or more medications to a nearby or delivery pharmacy when appropriate to do so.

How to Get Nail Fungus Treatment with Push Health

1. Complete a brief health intake. Describe your nail symptoms (including duration and prior treatments), any pain or skin involvement, current medications, and any medical history of diabetes or liver or heart problems.
2. Connect with a licensed medical provider. A medical provider will review your information and determine what type of treatment is appropriate. Same-day consultations are available.
3. Receive your prescription. If treatment is indicated, the prescription is sent to the pharmacy of your choice. No office visit required.
4. Start treatment. Use the medication as prescribed. Continue for the full prescribed course and allow time for a healthy nail to grow out. Follow up if side effects occur or if the infection does not improve.

No health insurance or subscription is required. Medical providers are available now.