Toenail fungus, also called onychomycosis, is a common problem that many people experience. It’s estimated that as many as 20% of us have it, and it’s actually more common on toenails than fingernails.
If you’ve ever tried to get rid of toenail fungus, you probably already know how frustrating it can be. It seems like you can treat it and treat it, and it just keeps coming back.
So, why is toenail fungus so hard to kill? This article will explain why toenail fungus is so stubborn, and what you can do about it.
How does toenail fungus start?
Toenail infections are caused by fungi, microscopic organisms that like to live in warm, moist places.
One common type of fungus that causes toenail infections is called a dermatophyte. These organisms are all around us, indoors and outdoors, always on the lookout for a place to live and reproduce.
Usually, the fungi get into your toenail through a small cut or crack in your nail or the skin around it.
Some things make you more likely to get a toenail fungus, such as:
- Wearing shoes that are too tight
- Walking barefoot in damp places, like locker rooms or swimming pools
- Having poor circulation
- Having a weakened immune system
- Having other skin or health conditions
Why is toenail fungus so hard to treat?
Toenail fungus is notoriously stubborn. Here’s why:
The nail’s natural barrier
Toenails are hard and thick. That makes it difficult for medications to reach the fungus underneath. Topical medications, like creams and polishes, often struggle to penetrate the nail plate effectively. It’s like trying to water a plant through a brick wall!
Location and persistence
Fungi are like unwelcome houseguests who settle in deep. They can live way down in the nail bed and matrix (where the nail grows from). Even if the visible part of the nail looks better, the infection may still be lurking underneath, ready to resurface.
Slow nail growth
Toenails grow at a snail’s pace. That means that even if a treatment is working, it takes a long time to see results. Oral medications, for example, need to be taken for 90 days. Then, it takes another three months for the nail to grow out and look normal again.
Immune system limitations
You’d think your body’s defenses would kick in and fight off the fungus, right? Unfortunately, the immune system isn’t always great at clearing toenail infections on its own. It’s often busy dealing with other things, and the fungus can hide out in the nail, evading detection.
What Counts as a Cure?
When we talk about curing toenail fungus, there are two kinds of cures:
- Clinical cure: This means there are no more visible symptoms. Your toenail looks normal.
- Mycological cure: This means there are no fungal spores left on your toenail.
Here’s the thing: just because your toenail looks normal doesn’t mean the fungus is completely gone. You can achieve a clinical cure without a mycological cure. This is why clinical cure rates can be misleading, and are usually higher than the actual cure rates. It’s important to have your toenail clippings rechecked for fungus after treatment.
Treatment Options for Toenail Fungus
So, you’ve got toenail fungus. What can you do about it?
Home Remedies
Some people swear by home remedies, though the science behind them is pretty limited. Still, they’re often worth a try since they’re low-risk. Some options include:
- Vinegar soaks: Mix one part vinegar with three parts warm water and soak your foot for 10 minutes.
- Filing: File down the top surface of the nail before trying any treatment. This can help the product get through the nail to the infection.
Keep in mind that these remedies don’t always work. It’s best to talk with your doctor about what to expect.
Over-the-Counter (OTC) Products
You can find antifungal creams and ointments at your local drugstore. Unfortunately, they don’t always penetrate the nail well, so their effectiveness can be limited. Still, studies show that about 60% of people see some improvement after several months of using OTC products.
Prescription Topical Treatments
If OTC treatments don’t cut it, your doctor might prescribe a stronger topical medication. Examples include amorolfine, efinaconazole, tavaborole, and ciclopirox. These have clinical cure rates of about 35% to 60%.
Prescription Oral Medications
Oral medications, like fluconazole, griseofulvin, itraconazole, and terbinafine (Lamisil), are generally more effective than topical treatments. Oral therapy is typically successful 70-80 percent of the time, with clinical cure rates around 80%. However, these medications can have side effects, so your doctor will need to monitor you closely.
Laser Therapy
Laser therapy is another option. Clinical cure rates vary, but they’re typically in the 60% to 75% range. It’s also worth noting that most insurance companies don’t cover laser therapy for toenail fungus, so it can be an expensive option.
Prevention: A Proactive Approach
The best way to deal with toenail fungus is to prevent it from happening in the first place. Here’s how:
- Foot hygiene: Wash your feet with soap every day and dry them thoroughly, especially between your toes. Wear shower shoes in public places.
- Proper footwear: Choose shoes made of natural materials like leather. Rotate shoes so they can dry out between wearings. Change socks frequently to prevent reinfection. Spray your shoes with Lysol.
- Nail care: Don’t share nail clippers or files. If you get pedicures, make sure the salon sterilizes its tools.
Frequently Asked Questions
Should I wear socks to bed with toenail fungus?
Generally, it’s best to avoid wearing socks to bed if you have toenail fungus. Fungus thrives in warm, moist environments. Leaving your feet exposed to air overnight helps keep them dry, which can inhibit fungal growth. If you must wear socks, choose breathable cotton or wool and change them frequently.
How do you kill stubborn toenail fungus?
Stubborn toenail fungus often requires a multi-pronged approach. This includes prescription oral antifungal medications, topical antifungal treatments, and sometimes, even nail removal. Patience is key, as treatment can take several months to a year. Talk to your doctor about the best course of action for your specific situation.
Can you ever completely get rid of toenail fungus?
Yes, it is possible to completely get rid of toenail fungus, but it can be challenging and recurrence is common. Success depends on factors such as the severity of the infection, the type of fungus, and adherence to the treatment plan. Early diagnosis and aggressive treatment are crucial.
Should you scrape out toenail fungus?
It’s generally not recommended to scrape out toenail fungus yourself. This can cause further damage to the nail and surrounding skin, potentially leading to secondary infections. A podiatrist can safely debride (trim or file down) the affected nail to allow topical medications to penetrate better.
What one cup of this will destroy your nail fungus?
There is no scientific evidence to support the claim that drinking “one cup of this” will destroy nail fungus. Many home remedies are touted for their antifungal properties, but their effectiveness is often limited. While some people find relief using vinegar soaks or tea tree oil, these are not proven cures and should not replace medical treatment.
In Summary
Toenail fungus can be challenging to get rid of. While it’s technically possible for your immune system to take care of it on its own, that is unlikely to happen.
Whatever treatment method you choose, it’s important to stick with it and take steps to prevent reinfection. For example, soaking your feet in diluted vinegar once or twice a week after you finish treatment can help kill off any lingering fungus.
If you think you have toenail fungus, the best course of action is to see a doctor or podiatrist for diagnosis and treatment recommendations.