From the Guidelines
Effective treatment for onychomycosis involves oral antifungals like terbinafine (250mg daily for 6-12 weeks) as the first line of treatment, due to its higher efficacy and tolerability compared to itraconazole, as shown in studies 1. For prescription options, oral antifungals like terbinafine and itraconazole are most effective, with cure rates of 70-80% 1. Topical prescription options include ciclopirox nail lacquer (applied daily for up to 48 weeks) and amorolfine (applied 1-2 times weekly for 6-12 months) 1. Some key points to consider when treating onychomycosis include:
- The importance of confirming the diagnosis through mycological tests before starting treatment 1
- The need for patience, as complete resolution of the infection can take 6-12 months due to the slow growth of nails 1
- The role of preventive measures, such as keeping nails trimmed short, wearing breathable footwear, and avoiding sharing nail tools, in reducing the risk of recurrence or spread of infection 1
- The potential for treatment failure or relapse, and the need for alternative treatments or combination therapy in such cases 1 Natural approaches, such as tea tree oil, vinegar soaks, snakeroot extract, and ozonized sunflower oil, may also be helpful, although their effectiveness may vary and they may take longer to produce results. It is essential to note that while these natural remedies may be beneficial, they should not replace medical treatment, especially in severe cases of onychomycosis. In terms of natural remedies, some options include:
- Tea tree oil applied twice daily to affected nails, which may help due to its antifungal properties [@Example@]
- Vinegar soaks (one part vinegar to two parts warm water for 20 minutes daily), which may create an acidic environment that inhibits fungal growth [@Example@]
- Snakeroot extract, applied every third day for one month, then twice weekly for a second month, and once weekly for a third month, which has shown some effectiveness [@Example@]
- Ozonized sunflower oil applied twice daily for 3 months, which may also help [@Example@]
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Effective Treatments for Onychomycosis
- Onychomycosis is a fungal infection of the nail unit that may lead to dystrophy and disfigurement over time, accounting for up to 50% of all nail conditions 2.
- The U.S. Food and Drug Administration (FDA) has approved oral agents such as terbinafine and itraconazole for the treatment of onychomycosis, which have demonstrated good efficacy but are associated with the risk of systemic side effects and drug-drug interactions 3, 2.
- Topical medications such as ciclopirox, efinaconazole, and tavaborole are also FDA-approved for onychomycosis treatment, but generally have incomplete efficacy compared to systemic agents and may have local side effects 2.
Natural Remedies for Onychomycosis
- Essential oils have been proposed as a potential treatment for onychomycosis due to their antifungal properties and low risk of resistance and side effects 4.
- The use of essential oils incorporated into a topical formulation may be an interesting, safe, and effective alternative for the treatment of onychomycosis, although further studies are needed to evaluate their efficacy in vivo 4.
- Other natural remedies, such as tea tree oil and garlic, have been suggested as potential treatments for onychomycosis, but there is limited scientific evidence to support their effectiveness.
Prevention and Management of Onychomycosis
- Regular and prophylactic use of an effective topical antifungal may help to prevent recurrence of tinea pedis and onychomycosis 5.
- Removal of infected nail parts can facilitate the penetration of antifungal drugs and eradication of reinfection sites, and may be useful in preventing recurrences and relapses 6.
- Suppression of predisposing factors, such as diabetes and poor foot hygiene, can also help to prevent the development of onychomycosis 6.