“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: cost, medication forms, ingredients, and treatment areas.
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.
Below, you’ll find the best toenail fungus treatments on the market today.
“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.”
Price at time of publication: $13
Once applied, the maximum-strength ointment kills the fungus with the active ingredients of zinc undecylenate and undecylenic acid to help treat toenail fungus. The ointment also soothes itching and burning that can come with an infection, all while healing the skin. For best results, apply twice a day to clean, dry feet.
The ointment also soothes itching and burning that can come with an infection, all while healing the skin. For best results, apply twice a day to clean, dry feet.
Price at time of publication: $10
The combined ingredients work to dry out the fungus to prevent it from spreading. 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.
Price at time of publication: $30
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.
Price at time of publication: $15
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.
Price at time of publication: $24
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.
Price at time of publication: $50
The Arishine treatment uses two percent deacetylated chitin, three percent O-hydroxybenzoic acid, and Angelica dahurica as active ingredients to get rid of 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.
Price at time of publication: $22
Armed with that 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 ones that are soothing, 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 Nied has 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.