Nail Fungus (Onychomycosis): What It Is and What Actually Works
Nail fungus is common — about one in ten people get it at some point. It usually starts as a white or yellow spot under the tip of your nail and slowly makes the nail thicker, brittle, or crumbly. If you want the nail back, you need a plan that matches how deep the infection is and how fast your nails grow.
Treatment options that work
Topical antifungals (nail lacquers like ciclopirox or amorolfine) can help mild, early infections. They’re easy to use but take months and often work best when the fungus hasn’t reached the nail bed. Expect small, steady gains rather than a quick fix.
Oral antifungals are the go-to for toenail infections that are thick or widespread. Terbinafine is usually first choice: common course is 12 weeks for toenails and shorter for fingernails. Itraconazole is another option, sometimes used in pulse dosing. These pills are more effective but need medical supervision — your doctor may check liver tests before and during treatment.
Other options include laser therapy and surgical removal of the nail for severe cases. Laser can reduce fungal load for some people, but results vary and it’s not always covered by insurance. Nail removal is a last resort when the nail is painful or treatment keeps failing.
Realistic expectations and timelines
Don’t expect overnight improvement. Nails grow slowly: a fingernail can take 4–6 months to look normal, a toenail 12–18 months. Even after treatment clears the fungus, a new healthy nail needs time to grow in. If you stop too early, the fungus can come back.
Home remedies like tea tree oil or vinegar soaks sometimes help mild cases but usually don’t beat prescription treatments. They’re okay to try for minor issues, but don’t rely on them if the nail worsens or you have diabetes or a weakened immune system.
Prevention is half the battle: keep feet and hands dry, change socks daily, wear breathable shoes, and avoid barefoot walking in public pools or locker rooms. Cut nails straight across and file down thick areas to let treatments reach the fungus better. Antifungal powders or sprays for shoes can cut down reinfection.
See a doctor if the nail is painful, spreading, or you have diabetes or immune problems. A clinician may confirm the diagnosis with a microscope or culture before prescribing oral meds. If you’re thinking of buying antifungals online, use a reputable pharmacy and expect to need a prescription for oral drugs.
Bottom line: mild cases can respond to topical care and good foot hygiene; most stubborn toenail infections need oral drugs and patience. Talk to a clinician to pick the safest, fastest route for your situation and to avoid wasted time on treatments that won’t clear the fungus.
