Toenail fungus is a common fungal condition that often starts after a rash on the foot spreads to the nails. When mild, it looks like white and yellow spots growing under the nail beds. If left untreated, the fungus can grow severely by hardening the nails and spreading to other toes.
“The more severe the toenail fungus, the thicker the nail, and the more nails involved makes it that much harder to treat the nails even with effective therapies,” says Shari Lipner, MD, a board-certified dermatologist at New York-Presbyterian Hospital/Weill Cornell Medicine.The fungus often begins in the form of athlete's foot between the toes or on the soles of the feet. At this stage, the fungal infection is easier to treat with over-the-counter medication, and that's where toenail fungus treatments come in. In addition to understanding stage and severity of your toenail fungus when shopping for treatments, you should carefully assess the ingredients and the type of treatment for the fungus based on its location.
We researched dozens of toenail fungus treatments and evaluated them based on the following attributes: medication forms, ingredients, and treatment areas. We also had a medical dermatologist from our Medical Expert Board review the contents of this article for medical accuracy regarding how toenail fungus progresses and what to know about how to treat it.
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What to Look for in a Toenail Fungus Treatment
Severity
Toenail fungus, if left untreated, can become a tough problem to treat and will greatly influence what medications you need. In fact, it’s best not to wait until your problem is severe before starting some kind of treatment, especially if you’re hoping to stick with OTC products.
“Toenail fungus is very hard to treat, and even under the care of a dermatologist it doesn't always resolve,” says California-based dermatologist Caren Campbell, MD. “Given how difficult it can be to treat, it’s best to get in to see a dermatologist as soon as possible to avoid it worsening.”
Furthermore, the fungus can spread to other nails and other areas of the body, adds Dr. Campbell, another reason why early treatment is ideal. If you notice the fungus spreading, or if your toenails have become thick and yellowed, you might need either a prescription-strength product or to seek help from a board-certified dermatologist.
Location
Dr. Lipner says toenail fungus starts as athlete’s foot: “It begins with a rash on the foot and spreads to the toenails,” she says.
Since treating athlete’s foot differs from treating toenail fungus, you’ll have to pay attention to where your problem is on your foot. Athlete’s foot can be addressed with antifungal ointments, sprays, and powders available over-the-counter, but if your fungus has moved to under the nail or the surrounding skin, says Dr. Campbell, you’ll need to focus on treating it with topical creams, ointments, and polishes, or oral medications.
Ingredients
Zinc undecylenate and undecylenic acid are both FDA-approved ingredients to treat toenail fungus. Also, if you seek help from a dermatologist, they will likely prescribe medications in the “azole” family. “The compound interferes with the synthesis of the fungal cell membrane,” Dr. Lipner says, which essentially kills the fungus.
One common medication in the “azole” family used to treat toenail fungus is Jublia (efinaconazole). Other medications often prescribed include the active ingredient terbinafine, which is usually prescribed as oral or topical Lamisil.
Type
Toenail fungus treatments can come in a variety of forms, but oral, topical, and homeopathic medications are the most commonly used for treating toenail fungus.
Oral Medications
Oral medications have been proven effective, but they take time to work.
“Lamisil also has the lowest side effect profile of the oral antifungal medications and works as a fungicidal which destroys a fungus by blocking its ability to ‘breath’ or make the oxygen molecules it needs to survive,” says Orit Markowitz, MD, founder and CEO of OptiSkin treatment center in New York City.
But there are several conditions that can make people ineligible for oral antifungal medications. The same underlying comorbidities, including chronic renal failure (with dialysis) and renal transplant, immunodeficiency, diabetes, cancer, and peripheral arterial disease that make someone more susceptible to toenail fungus also make them more at risk for side effects when taking the drugs. Speak with your doctor to ensure you can safely take an oral antifungal.
If you’re eligible for oral drugs, however, you may want to take a multi-pronged approach: “I prefer to do orals and topicals if patients really want a chance at a cure, since it is so difficult to treat nail fungus,” says Dr. Campbell.
You also might want to opt for an oral medication if more than one nail is affected.
“[You] might use [Lamisil] if there are multiple nails involved,” says Michelle Henry, MD, founder of Skin & Aesthetics Surgery of Manhattan, “because oral treatment is significantly more effective in clearing the fungus.”
Topical Medications
Topical treatments (like amorolfine and ciclopirox) can help with minor toenail fungus. They cause fewer and less serious side effects. But, it’s difficult for them to penetrate the nail plate so treatment is longer and efficacy is low.
“Azole antifungals like Jublia inhibit fungal elements involved in the biosynthesis of critical fungal elements like fungal cell membranes,” says Dr. Markowitz. She adds that, “topical therapies can be effective, but require lengthy and costly regimens without an established method for predicting outcome.” It could mean daily topical treatments for 52 weeks.
Natural/Homeopathic Medications
Natural preventative measures can be effective, but once fungus sets in, your best bet is a research-backed and FDA approved oral antifungal. Garlic has antifungal properties, and when used in a footbath can provide some relief.
“Given that topical prescription remedies take at least one year of daily use to work in only two thirds of mild to moderate cases, it is difficult to recommend an off-label natural remedy treatment,” says Dr. Markowitz.
You could also try tea tree oil in conjunction with other more traditional treatments, says Dr. Henry, or even white vinegar: “I often recommend white vinegar soaks: patients [put] a quarter cup of white vinegar in a bowl and soak the toenail once or twice a day.”
A complete cure can take as long as 18 months; while you wait, Dr. Campbell suggests washing your socks in hot water to prevent reinfection and using antifungal powders, like Zeosorb, in your shoes. Keep in mind that for fungal nail infections, a cure is not achieved at all in 20 to 25 percent of treated patients.
“I’ve always counseled patients that even oral medications [only] work approximately 60% of the time, so it's oftentimes a chronic condition,” says Dr. Campbell.
Frequently Asked Questions
How long should I use a toenail fungus treatment?
Antifungal medications take some time to fight the fungus. Most products recommend twice daily application for one to two weeks, but the reality is that you’ll likely need to treat the fungus for much longer than that.“Toenails take a year to grow out,” says Dr. Campbell. “Oral treatment is usually three months, [while] topicals need to be used for 12 months.”If you’re treating your fungus at home and nothing changes after you’ve used the product for the prescribed time, consult your doctor for treatment recommendations and next steps.
Can topical toenail fungus treatments cause irritation?
The active ingredients in most antifungal treatments are quite potent. That means they do have the power to cause burning, stinging, swelling, irritation, redness, bumps, and other irritation on the skin. If this occurs with use, consult your doctor. But, most people are able to use the antifungal creams and gels without problems and with healing, soothing effects.
“Terbinafine, or lamisil, is typically well tolerated,” says Dr. Henry. “However, undecylenic acid is often included in OTC treatments [and that] can cause irritation to the skin if used improperly.”
Best Overall
Fungi Nail Anti-Fungal Ointment
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Pros
Easy application
Cures and prevents fungus
Includes aloe vera and tea tree oil to soothe irritation
Cons
Must be applied twice a day
Fungi-nail Anti-Fungal Liquid is our top pick for the best toenail fungus treatment because it both cures and prevents toenail fungus and athlete's foot while also easing irritating symptoms and improving the overall health of your skin. Its maximum strength formula includes five essential oils like tea tree oil, aloe vera, and lavender to reduce burning and itching sensations. At the same time, its active ingredient, tolnaftate, works to eliminate fungal infection.
We love that it comes with a small brush for easy application. To apply this product, make sure to put the solution both underneath the nail and around your cuticle. One potential downside to this product is that you have to apply it twice a day (both morning and night), and, depending on the severity of your infection, it could take a few months to fully eliminate the fungus. However, the good news is the application doesn't take long, and if you're able to build it into your morning and nightly routine it should be easy enough to remember to apply. It's also worth noting that it does have a slight medicinal smell, but it's not too overpowering and some may even like the smell of the tea tree oil.
Active Ingredients: Tolnaftate 1%, tea tree oil, aloe vera, eucalyptol, olive oil, and lavender | Dose: Apply twice daily (AM and PM) under the nail and around the cuticle | Uses: Cures and prevents fungal infections while reducing itching and burning
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Pros
Relaxes muscles with Epsom and sea salts
All-natural solution
Free of synthetic fragrance
Cons
Essential oils may be potential allergens
If you’re looking for an all-natural route to treat toenail fungus, then this foot soak could be for you. Not only is a foot soak a relaxing way to end your day, but the ingredients used in Purely Northwest’s soak include Epsom salt, sea salt, tea tree oil, and other oils. These ingredients soothe the skin while addressing foot and toenail fungus.
The combined ingredients work to dry out the fungus to prevent it from spreading. The benefits of the soak also include healing cracked feet and soothing aches.
This US-made product has no dyes or synthetic fragrances, making it a great all-natural solution. But results, depending on severity, might take longer to show when using the soak over prescription or over-the-counter treatments.
Active Ingredients: Epsom salt, Dead Sea salt, MSM, and Therapeutic-grade essential oils | Dose: Add 1.5 tablespoons of foot soak mix for every gallon of water. Mix with hands until the salt dissolved. Add additional salts for a more stronger or aromatic foot bath. Soak your feet for About 15-20 minutes. | Uses: Treats fungus all over feet; eliminates food odor and aches
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Best Soap
Truremedy Naturals Remedy Soap
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Pros
Great for athletes and gym goers
Cleanses and deodorizes
Also treats acne, candida, and rashes
Cons
Fragrant oils may be overwhelming
A medicated soap is another way to address toenail fungus and other forms of fungus that can grow on the feet. The Remedy Soap specifically addresses fungal infections by combining all-natural ingredients: tea tree oil, aloe, peppermint, and eucalyptus.
Tea tree oil works to soothe the skin, while peppermint balances the body’s natural oils. Then eucalyptus works to heal unhealthy skin on the feet and surrounding the nails.
This product is aimed at athletes and gym-oriented people, as sweat-induced exercise can often cause fungal infections. Remedy created the product gentle enough, though, so it can be used daily to clean the body. Besides treating toenail fungus, the soap also alleviates athlete’s foot, ringworm, jock itch, and body odor.
Active Ingredients: Tea tree oil, eucalyptus oil, and peppermint oil | Dose: Use like a standard body wash, apply and lather over the whole body. Leave soap on for 30 to 60 seconds before rinsing. | Uses: Cleanses bacteria and fungus all over skin; treats and helps prevent acne
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Pros
Penetrates underneath nail beds
Tea tree and lavender sooth skin
Money back guarantee
Cons
Results can take several weeks
Only for toe and fingernail fungus
Funginix Healthy Nail Formula uses a unique blend of ingredients to eliminate toenail fungus while healing the skin. Undecylenic acid works to kill the toenail fungus and prevent regrowth, while tea tree and lavender oil soothe the skin.
For optimal results, apply the solution on the cuticles and skin surrounding the nail. This helps the product penetrate underneath the nail bed to address the fungus. Do not apply the solution like nail polish. Funginix recommends applying the solution daily and practicing patience, as toenail fungus often takes longer to treat.
The best part about Funginix is that it offers a 90-day money-back guarantee if you’re unsatisfied with the results.
Active Ingredients: Undecylenic acid (10%) | Dose: Apply at the cuticle and at the edge of each infected nail twice daily using the brush applicator. Allow the solution five minutes to absorb. | Uses: Treats fungus on and around the toe nails
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Pros
Both cleanses and treats
Colorless and odorless formula
Gentle on irritated skin
Cons
Expensive
Probelle attacks toenail fungus by creating a multi-step solution to clean the problem area and prevent fungal growth. In the morning, use Probelle coconut oil body wash to clean the area and then apply the nail polish solution to the dried nails. In the evening, apply the Natural Fungal Gel Nail Treatment to the affected area and let it dry. Probelle claims that 94 percent of people in a clinical trial saw improvement from the system within six weeks.
The Probelle treatment system doesn’t just use a unique combination of washes, polishes,and gels to achieve results; it also harnesses the benefits of coconut oil lauric esters. But the company also says that more severe infections can take up to a year to heal because of how long it takes for nails to grow. Customers say the formula is gentle on their skin and shows results within weeks of daily use.
Active Ingredients: Lauric esters | Dose: Wash with cleanser like a normal soap. Apply just enough liquid to cover affected areas, followed by gel. | Uses: Treats and fights fungus on nails
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Pros
Convenient pen brush applicator
Treats discoloration, brittleness, and cracked nails
Easy, on-the-go treatment
Cons
Only works on nail plates
Treatment process can be slow
The Arishine Toenail Treatment has the design and convenience of a pencil. Perfect for storing in a bag or pocket while at work, the repair pencil allows you to use a paintable nail polish on your infected toenail three times a day with ease to treat a nail fungal issue.
The Arishine treatment uses two percent deacetylated chitin, three percent O-hydroxybenzoic acid, and Angelica dahurica as active ingredients to eliminate fungus and heal the damage. This solution can help treat discoloration, brittleness, split, rough, and cracked nails. Ultimately, this medicated nail polish can lead to stronger and healthier nails.
Arishine is made of natural ingredients and does not conduct animal testing. Treatment requires three applications a day and should be used for four to 12 weeks, although improvement may be visible in as few as two weeks. Arishine offers customers a satisfaction guarantee.
Active Ingredients: Deacetylated chitin (2%), O-hydroxybenzoic acid (3%), and Angelica dahurica | Dose: Applicator automatically delivers correct amount with two to three clicks. Apply around nail on cuticles and under nail bed. | Uses: Treats fungus infection on and around nails; helps heal discolored, brittle nails
How We Selected
To find the best toenail fungus treatments, we asked four dermatologists to tell us what to look for when choosing a product—and how to know when you need to step up your game, i.e. opt for something prescription-strength. The experts we spoke to included:
- Shari Lipner, MD, a board-certified dermatologist at New York-Presbyterian Hospital/Weill Cornell Medicine
- Orit Markowitz, MD, founder and CEO of OptiSkin treatment center in New York City
- Michelle Henry, MD, founder of Skin & Aesthetics Surgery of Manhattan
- Caren Campbell, MD, a California-based dermatologist
They suggested a combination of oral and topical medications, particularly ones with antifungal ingredients like zinc undecylenate, terbinafine, and efinaconazole.
With that expert info, we searched the internet for well-rated OTC treatments that make it easy to wage war against toenail fungus (because it can take a long time, so you need something convenient!). We also looked for products that hit fungus hard at the source, like creams and polishes, as well as soothing ones, like medicated soaks and scrubs, to keep the rest of your feet healthy while you work on reviving your nails.
What Experts Say
“The most common presentation of toenail fungus is a white/yellow discoloration of the nail that is thick and filled with yellow/white keratin debris. The more severe the toenail fungus, the thicker the nail, and the more nails involved makes it that much harder to treat the nails even with effective therapies." — Orit Markowitz, MD, founder and CEO of OptiSkin treatment center in New York City
Why Trust Verywell Health
As a seasoned health writer, Danielle Zoellner knows the importance of finding just the right product to fit your medical needs. Throughout her career, Danielle has interviewed a variety of experts in the medical and health fields while reviewing dozens of products. Her experience and knowledge in the field work together to help readers like yourself find the best products for your daily life.
Additional reporting for this story by Jennifer Nied and Sarah Bradley
For over 10 years, Jennifer Niedhas reviewed products, interviewed experts, scrutinized ingredients, and pored over research studies and claims, to help readers like you understand what works for your specific conditions. Every product in this piece was selected taking into account recommendations from doctors, published research, and real customer reviews.
Sarah Bradley has been writing health content since 2017—everything from product roundups and illness FAQs to nutrition explainers and the dish on diet trends. She knows how important it is to receive trustworthy and expert-approved advice about over-the-counter products that manage everyday health conditions, from GI issues and allergies to chronic headaches and joint pain.
