Fungal Nail Infections
Medications
Antifungal medicine is standard treatment for a fungal nail infection. The goals of treatment are to have few or no side effects, provide a long-term cure, and reduce treatment time.
- Antifungal pills (oral medicine) offer the best chance of a cure. But they also require close monitoring for dangerous side effects and are generally reserved for moderate-to-severe or difficult-to-treat fungal nail infections. Pills include terbinafine (Lamisil), itraconazole (Sporanox), and fluconazole (Diflucan).
- Antifungal topical medicine (creams, lotions, gels, and lacquers) are applied to the infected nail and surrounding areas of the skin. But they may not be as effective as oral medicines. They may be used for mild-to-moderate infections and to help prevent an infection from returning or to prevent athlete's foot from spreading to the nails. Topical medicines include terbinafine (Lamisil) and ciclopirox (Penlac).
Factors to consider when choosing a fungal nail infection treatment include:
- The type and location of infection. Fingernail and toenail infections are usually treated with different medicines, and the treatment time for fingernails is usually shorter. If you have a mild fungal infection or are concerned about the risks of oral antifungal medicine, consider using a topical treatment, such as Lamisil or Penlac.
- Your susceptibility to fungal nail infection. If you develop fungal nail infections often, you may need longer-term treatment.
- The medicine. Griseofulvin (Grifulvin V) was one of the first oral antifungal medicines. But it did not provide a long-term cure, had serious side effects, and required a long treatment time (12 to 18 months). The newer oral antifungals are more effective, relatively safe for healthy individuals, and don't take as long to work.
- Your risk factors for dangerous side effects from oral antifungal medicines. If you have a history of blood or liver disease or plan to drink alcohol during antifungal treatment, oral medicine is not a safe treatment option for you.
- Drug interactions. Commonly prescribed medicines can affect the levels of antifungal medicine in your body. Similarly, other medicines can build up in the bloodstream when taken with antifungal pills. Before you take oral antifungal medicine, let your doctor know what other medicines you are taking.
- The dosing method, if you are taking oral medication. Depending on the medicine and the severity of the infection, you may be able to choose between pulse therapy (taking medicine daily for 1 week a month for 2, 3, or 4 months) or continuous therapy (taking medicine each day).
- The cost for the entire course of medication treatment. Some oral antifungals cost more than others. Pulse dosing is often less expensive than continuous therapy.
For more information on deciding whether to use oral antifungal medicines, see:
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| Author: | Maria G. Essig, MS, ELS | Last Updated: July 24, 2008 |
| Medical Review: | Kathleen Romito, MD - Family Medicine Alexander H. Murray, MD, FRCPC - Dermatology | |
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