Best nail fungus treatment

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What helps against nail fungus?

Pills, nail polish, or home remedies – what works best with nail fungus? There are various options for treatment with otc nail fungus treatment from the pharmacy or therapy with pills, but a doctor can only prescribe these. Find out more about nail fungus treatment here.

Nail fungus (medical: onychomycosis or nail mycosis) is not only a cosmetic problem but, above all, a medical one. If left untreated, the fungal infection can spread to neighboring toenails or fingernails and infect the skin. Nail fungus promotes the development of the athlete’s foot and, conversely, the athlete’s foot encourages the growth of nail fungus. The spread of the fungal infection is based on the fact that foot and nail fungi have the same pathogen. Most often, a dermatophyte ( Trichophyton rubrum ) is the trigger. Our immune system is unable to fight against fungal nail infections.

In addition, an untreated fungal nail disease can hinder you in everyday life. Fungal-infected nails can become so thick over time that they are tough to cut and, due to the deformation, can even cause problems to wear the shoes. To avoid letting it get that far, a fungal nail infection should be combated as early as possible.

A nail fungus treatment requires patience because a diseased nail is only considered cured when the healthy nail has completely grown back. The average growth rate of nails is between 0.5 and 1.2 mm per week (3 mm/month); fingernails grow twice as fast as toenails. It usually takes about six months for the fingernails to heal completely and for the toenails about 9 to 12 months to heal. The earlier treatment is started, the higher the chances of recovery.

What helps against nail fungus?

The treatment of nail fungus is possible internally (systemically) with tablets and externally (topically) with medicinal antifungal nail polishes. In external treatment with antifungal nail polishes, the active ingredient reaches its target site by being brushed onto the nail. This form of treatment is usually sufficient if the nail growth zone (the white crescent moon) is not affected. If the fungal attack affects the nail growth zone, a combined treatment with nail polishes and tablets is recommended.

Various medicines are available for treating nail fungus. These fungicidal drugs for nail mycosis are known as antifungal drugs. In the fight against the fungi, the antifungal agents use different strategies: Antifungal agents against nail fungus can have a fungistatic or fungicidal effect. Fungistatic means that the active ingredient prevents the fungus from growing but does not kill it. Fungicidal active ingredients such as Proclearz, on the other hand, kill the fungi.

In addition, Proclearz acts not only on the living fungal cells but also on fungal spores. Spores are the dormant persistence form of the fungal pathogens and can lead to a flare-up of the nail fungal infection.

Nail fungus treatment from the outside with nail polish

External nail fungus treatment is possible if the nail growth zone (called the nail root or nail matrix) is free from infestation. The doctor speaks of topical treatment of onychomycosis. For this therapy option, there are special medical nail polishes available without a prescription in the pharmacy. They are applied to the diseased nail at home by yourself. Lacquer technologies, such as water-soluble lacquers with hydroxypropyl chitosan (HPCH), quickly diffuse into the nail and transport the active ingredient deep into the nail, where the nail fungus is combated.

For nail fungus treatment, you have the choice between

  • a water-soluble nail polish (Proclearz ® against nail fungus) and
  • acrylic or polyvinyl-based waterproof paints.

With most waterproof nail polishes, the nail surface must be filed thin and roughened before the first treatment to ensure that the active ingredient can penetrate the nail in a sufficiently high concentration. In the further course of treatment with these products, the nail plate must be filed regularly or if necessary. When filing, you should be particularly careful not to spread any infectious nail chips around your home or bathroom. The nail files should be single-use files and must be disposed of after each use. Otherwise, there is a risk of healthy nails becoming infected with nail fungus. Polyvinyl or acrylic nail polishes must be removed regularly with a chemical solvent (nail polish remover) to ensure that the antifungal agent gets into the nail when reapplied.

If you want to bypass filing, your pharmacy also has a special antifungal nail polish that you can apply to the nail right away. This nail polish is water-soluble, which eliminates the need to use a chemical nail polish remover. A nail polish against nail fungus is only effective if the active ingredient can overcome the compact structure of the nail. Due to the unique technology, water-soluble nail polishes with hydroxypropyl chitosan (HPCH) can penetrate the nail well and thus transport the active ingredient deep into the nail to the nail bed. One of these special nail polishes is Proclearz ® against nail fungus with the active ingredient Proclearz. Proclearz ® has a strong effect against nail fungus because the active ingredient Proclearz fights the fungal cell from the inside and outside at the same time. 

You can find detailed information about this water-soluble antifungal nail polish in the section Proclearz against nail fungus.

Nail fungus guide – video for nail fungus treatment

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Nail fungus treatment with pills

External nail fungus treatment alone is not sufficient if the nail growth zone (nail matrix) is affected. In this case, your doctor may prescribe additional tablets for you. These nail fungus drugs require a prescription. The tablets release their active ingredient through the gastrointestinal mucosa into the bloodstream, and through the blood, it reaches the nail bed. In this way, the nail fungus pathogens are combated inside; the doctor describes the nail fungus treatment with tablets as systemic therapy. Active ingredients that are administered systemically are, for example, terbinafine, fluconazole, or itraconazole.

Home remedies for nail fungus

Nail fungus home remedies: Anyone looking for an inexpensive home remedy for nail fungus on the Internet will be happy to use these two search terms. The hit list of supposedly helpful, natural remedies is long. It ranges from apple cider vinegar to baking powder, self-urine therapy, Australian tea tree oil, and toothpaste. 

Many of these home remedies for nail fungus (technical term onychomycosis) are cheap and readily available. But what most of those affected do not know: The well-intentioned mixtures and applications from Grandma’s gentle medicine cabinet help in the rarest of cases. A fundamental problem with all home remedies for nail fungus is that they cannot penetrate deep into the nail plate and therefore do not come into contact with the fungus.

An exclusive treatment with traditional home remedies is by no means recommended for nail fungus. Grandmother’s tips can make symptoms much worse. According to the Professional Association of German Dermatologists, the nail fungus will spread to other nails without the proper treatment. In addition, you may experience discomfort while walking, and a bacterial infection may develop. Both the diagnosis and the treatment of nail fungus belong in the expert hands of a dermatologist.

Home remedies for nail fungus: pros and cons

There are currently no medical studies that prove the effectiveness of home remedies for nail fungus. Possible side effects have not yet been recorded either. But what speaks for or against home remedies? The pros and cons check:

Apple cider vinegar: simple home remedy for nail fungus?

Pro: The acetic acid in apple cider vinegar is said to have fungicidal (fungicidal) and antibacterial (bactericidal) properties. For example, it is recommended in forums to dab the affected areas several times a day or to take a foot bath.

Cons: Many experience reports on the Internet confirm the positive effects of apple cider vinegar. Still, to date, there has been no study that shows that apple cider vinegar works as a remedy for nail fungus.

More about vinegar against nail fungus

Tea tree oil, sage oil, and lavender oil: all-rounders also for nail fungus?

Pros: These essential oils can reduce the growth of fungal spores. In forums, it is recommended to drip a few drops of the respective oil onto a cotton swab and spread the infected areas. 

Cons: The antifungal effects of tea tree oil, sage oil, and lavender oil are not strong enough. Clinical studies on the effectiveness of essential oils against nail fungus are not known.

More about tea tree oil against nail fungus

Baking Soda: Can Grandma’s Home Remedies Help Against Fungus?

Pro: Baking powder can be found in every household and is inexpensive. Some internet portals recommend sprinkling the affected areas with baking soda immediately after showering. The fungus is supposed to be “dried out” by this. Others mix a sachet of baking powder with a bit of water and then apply the mixture to the nails affected by the fungus. 

Cons: The same applies to this treatment variant: There is no scientific evidence of its effectiveness.

Own urine: a suitable home remedy for nail fungus?

Pro: In some forums, readers are advised to treat the affected areas with their urine early. The urea in healthy urine is also said to kill fungal spores. 

Cons: Doctors advise against this “natural” type of treatment. There is also no scientific evidence for the effectiveness of “self-medication” with one’s urine, and the urea concentration is too low to have an effect.

Toothpaste: does the pasta brush away nail fungus?

Pro: In Internet forums, there are also reports from those affected who seem to have successfully combated their nail fungus with fluorine toothpaste. Another supposed plus: “Costs almost nothing!”. Fluorine is said to have potent antifungal effects. 

Cons: This often recommended home remedy for nail fungus also applies: There is no clinical proof of its effectiveness.

Those who rely on home remedies for nail fungus run two risks: they lose time and delay effective treatment because nail fungus does not go away on its own. In addition, some of the agents listed can additionally irritate the affected area and even trigger allergies.

Conclusion on home remedies for nail fungus

From a scientific point of view, self-therapy with home remedies for nail fungus should be treated with caution. There are no clinical studies for these agents that can adequately prove an effect. To transport a fungicidal agent deep into the nail, a suitable means of transport is indispensable since the nail is only permeable to a limited extent due to its compact structure. Home remedies usually lack a suitable carrier substance, which means that active ingredients cannot penetrate deep into the nail. Therefore, from a medical point of view, no recommendation can be made for the treatment of nail fungus with home remedies.

In contrast to the home remedies, all medical nail polishes that you can find in your pharmacy have been given clinical studies and studies on the effectiveness of nail fungus and drug safety. You can obtain detailed advice on treating nail fungus from your dermatologist or pharmacist.

Treat nail fungus with laser.

Lasers have been used against nail fungus for a long time. The laser is used to remove infected nail mass. The new pulsed lasers are now explicitly approved for medical use against nail fungus and promise to push back the fungus and lighten the nail. Healthy, fungus-free nail parts and surrounding tissue should not be affected. Fungal nail treatment with the laser is not cheap, and you have to pay for it yourself, as there is no reimbursement by the health insurance companies.

Has the nail fungus lasered and enjoy beautiful nails – who wouldn’t want that? Studies show that treatment with the nail fungus laser is successful: unsightly spots recede, and the nail clears up again. As a rule, the nail fungus laser is only used if the treatment with antifungal nail polishes and tablets has not been successful or is generally undesirable. This can be the case, for example, with children, pregnant women, and breastfeeding mothers, as well as older people who often take a lot of tablets anyway.

How does the laser work?

Most dermatologists practices use so-called pulsed lasers or pulsed lasers (mostly neodymium: YAG lasers), as approved by the FDA (Food and Drug Administration, USA). These nail fungus lasers send their rays in small portions into the affected nails and inactivate the fungal structures there without damaging the nail and the surrounding tissue. For this, certain depths of penetration and wavelengths are necessary, which can lead to painful sensations. Most publications are also available on pulse lasers. The fungicidal effect of the laser is explained by the heat generated, which penetrates the nail plate entirely and is supposed to kill the fungus.

This is how the laser treatment works.

Before any nail fungus therapy, including laser treatment, a reliable diagnosis should be made. For this, infected particles of your nail have to be taken to the laboratory. If the result is there, the dermatologist proceeds with the conventional three-part therapy (removal, nail polish, tablets) only that he uses the nail fungus laser in addition to or instead of the tablets.

The procedure of the dermatologist:

They are grinding or milling the thickened nail before starting the laser treatment. With the special nail fungus handpiece of the pulse laser, the dermatologist moves in meandering movements over the entire plate of the affected nail. The visibly affected areas are lasered particularly intensively.

Duration of treatment:

From two sessions in two months to a total of four to eight sessions every four weeks. There is no standard procedure, but there should be a month between each treatment. The nail should lighten within eight to 16 weeks.

Are there any side effects?

There are usually no side effects from laser nail fungus, but the heat generated can be uncomfortable to painful for the patient and may cause bleeding.

What is the cost of laser nail fungus?

Expect 80 to 100 dollars per session. With an average infestation you need four to six sessions, with a pronounced nail fungus over several nails you have to reckon with at least eight sessions. The statutory health insurance funds do not cover the costs. However, some private health insurance companies contribute to the costs.

Is Laser Treatment Really Safe?

The FDA (Food and Drug Administration) approved laser systems that are suitable for the treatment of nail fungus have been in existence since 2010. These are mostly so-called pulse lasers. 

Cream for nail fungus – only the first step?

Nail fungus creams or ointments are useful when it comes to removing fungus-infected nail mass. You can either have the nails affected by the fungus sanded down (by a podiatrist or dermatologist) or treat them yourself with high-dose urea ointment. This makes the nail more permeable for external therapy. But be careful: only use the creams on a thickened nail, no longer on a crumbly, porous one. The removal of the infected nail mass alone is not enough, however, as the nail fungus can also have settled in and under the healthy-looking nail. In order to avoid reinfection, the treatment should be carried out with a nail polish or an antifungal cream.

All nail fungus treatment options at a glance

Method / means Application, advantages and disadvantages Remarks
Antifungal nail polish (water soluble)
  • Application quick and uncomplicated
  • Apply once a day
  • Dries in seconds
  • Avoid water 6 hours after application
  • Paint residue can be easily removed with water
  • Has anti-inflammatory and antibacterial effects
  • Deep-acting effect with 30 hours of antifungal activity
  • Broadband effect
  • Active ingredient: Proclearz
  • Available without a prescription
  • Do not use cosmetic nail polish at the same time
Antifungal cream / ointment
  • Bifonazole; also has anti-inflammatory and antibacterial effects
  • Use: once a day for several weeks
  • It is best to pre-treat with urea ointment
  • Available without a prescription
  • Mainly used for fungal infections under the nail plate or for thickened nails
Tablets with terbinafine
  • Consumption varies depending on the product and dosage, some every day, others with breaks, such as for 1 week and then take a break for 3 weeks
  • Use: a maximum of 4 months
  • Particularly suitable for older patients, as there are fewer known interactions with other drugs
  • Prescription necessary
  • Standard remedies against the pathogens that most commonly cause nail fungus (thread fungi / dermatophytes)
Itraconazole tablets
  • Consumption varies depending on the product and dosage, some every day, others with breaks, such as for 1 week and then take a break for 3 weeks
  • Application: maximum 3 months
  • Interactions with other drugs are known and should be discussed with the attending physician
  • Prescription necessary
  • Special remedy against the pathogens that are less responsible for nail fungus and for which terbinfafin or fluconazole do not work
Fluconazole tablets
  • Use once a week
  • Duration of use: 6-12 months
  • Particularly suitable for children as it is considered to be very tolerable
  • Interactions with other drugs are known and should be discussed with the attending physician
  • Less effective than terbinafine or itraconazole
  • Prescription necessary
  • The means when other substances do not work or are not allowed to be taken
Surgical nail removal
  • Results visible immediately after the treatment
  • Increased risk of relapse
  • After the procedure there is often pain and many sufferers are temporarily unable to work
  • Is only used very rarely, as even peeling off the nail is gentler
Laser treatment
  • Effectively
  • Treatment can be uncomfortable / painful and may cause bleeding.
  • Expensive
  • Only a few practices offer this procedure
  • Unfortunately, the costs are usually not covered by the statutory health insurance

Nail fungus won’t go away.

Let me say this in advance: Nail fungus treatment is tedious and demands many disciplines from those affected. Depending on the infection and fungal attack, the treatment can last up to 12 months and be carried out consistently because the diseased nail must first grow out entirely and be restored before it is considered healed. During this time, however, it requires continuous treatment of the nail. If the recommended measures are not followed, the risk of relapse is high. Because a fungal nail disease is persistent, and if treated incorrectly, it keeps coming back. Those affected often stop treatment when the first noticeable improvement occurs, which quickly turns out to be premature. However, incorrect hygiene measures or inadequate foot care can also increase the risk of infection or relapse.

Overview: Factors That Can Increase Relapse

  • Genetic predisposition
  • Occurrence of onychomycosis or tinea pedis in family members
  • Untreated athlete’s foot
  • Lifestyle:
    • Wearing shoes that are too tight
    • Frequent visits to humid environments such as gyms and swimming pools
  • Basic physiology, especially in patients with diabetes mellitus or with a severe form of onychomycosis
  • Choice of therapy, duration, the success of treatment, and adherence
  • Properties of the infecting fungus
  • Environmental factors: persistent moisture and warmth (e.g., in sport’s shoes, in the swimming pool)
  • Nail injuries

The treatment of a fungus remains a necessity not only for aesthetic reasons. If the nail fungus is not treated in time or inadequately, an infected nail can develop into a chronic course. Serious malfunctions change the structure of the nail, which in the other system promotes its deformation. Initially, the infection begins at the front edge and from there spreads over the entire nail. From then on, there is a significant change in the nail structure: In addition to the initial symptoms, an inflammation of the nail bed can result in the course of the development of an untreated infection. The fungal spores can spread further and spread to other nails or hands, and fingers. The infestation of the fingers can, in turn, result in a loss of sensitivity. From there, they are transferred to everything that the person concerned comes into contact with.

But not only environmental factors (warm and humid climate) can cause an infection. Nail fungus is one of the most common disease-related changes and can be a side effect of a chronic illness. Further risk factors are metabolic (e.g., diabetes mellitus) and neurological (e.g., peripheral neuropathy) comorbidities, circulatory disorders, and previous immunosuppressive or antimicrobial therapies. Thus, nail fungus can be an essential indicator of a chronic illness, which is why a visit to the doctor in the early stages is always urgently recommended.

With these tips, you can essentially contain the spread of a nail fungus:

  • Wash bath mats, duvet covers, and other textiles at 60 degrees Celsius if possible, or use a hygiene rinse
  • Wear flip-flops in the swimming pool
  • Use a separate towel for the feet and change daily
  • To reduce spread, put on socks and then underwear
  • Change socks daily
  • Always let shoes dry one day before wearing them again
  • Use your file and nail scissors
  • Go to the doctor in good time

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