Almost one in four people will get toe nail fungal infections in their lifetimes, and, for many, it seems to last a lifetime as well. The condition is fostered by warmth and dampness seen in closed shoes, and causes thickening of the nail, with pitting and yellowish discoloration. In sandal season, it looks ugly, but that is about the only problem with it. This is not a condition that invades the blood stream or causes any other health issues. However, we can’t make the same claim about some of the treatments advertised. 

The big drug companies naturally would like people to take their drugs for months or years, not just a couple of weeks every time they have an acute infection. So there is a big money motive behind all the ads we see for oral drugs to fix this problem. 

That’s the deal with toenail fungus treatments that we see advertised, showing little cartoon creatures (“fun-guy’s?”) climbing out from under your toe nails. With the usual tag of “ask your doctor”, patients are told that happiness lies in taking a prescription drug orally. Based on the rate of nail growth, this could easily take 9-18 months for a toenail to grow completely out as normal. (If you have ever dropped something on your toe, and had the whole nail turn black with a bruise, you can confirm how long it took that nail to grow out completely. Finger nails grow quicker, toenails are much slower). 

The problem I have with this is one of side effects. The oral medications are not without risks, mainly to your liver. So we need to run liver tests at intervals along with the treatment, to make sure you don’t have a serious side effect to a drug that is given for a completely non-threatening nuisance.

There are a list of topical products you can see at this site:

Toenail Fungus Reviews

However, before even using any of these products (also not cheap, as you will see in the above site), consider the basics:

Daily nail management: try to spend a few minutes on the affected toes every day. Twice daily is not a bad idea if you have the time:

• Wash your feet in good soap to kill the fungi. As you know from pedicures, soaking the nails make them easier to trim.
• Use nail clippers, and a nail file, preferably one made of metal or ceramic, so it can be cleaned. (The cheap cardboard nailfiles are hard to sanitize after use). Note that the fungus grows underneath the nail, so use the pointed end of your nail tools to scrape out the dead stuff. Sand off the top and tip of each affected nail, to prevent it from becoming too thick and unmanageable.
• Apply rubbing alcohol (or pure white vinegar) with cotton balls after all the trimming, scraping and sanding is done. Just a few minutes will do the trick. This is the same alcohol we use as a swab to kill all bacteria and fungi when we insert a medical needle for lab tests. It will still kill the same fungi in the nail.
• Consider getting a professional pedicure as an occasional treat. With the right approach, the pedicurist can dig into the edges of the nail a little better than you might be able to yourself, and this can dramatically go after some of the hiding places that fungi like.
• If the above is not sufficient, then it makes sense to try one of the topical products mentioned in the article above. However, everything takes the same length of time as dictated by your speed of regrowth of that nail. 

By all means see your doctor, but don’t assume that medications belong at the front end of the treatment plan. Even with the oral drugs, you will still need to do the daily treatments anyway.