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The best toenail fungus treatment for 2024, according to dermatologists

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The best toenail fungus treatment for 2024, according to dermatologists

Are your toenails looking more "Hellraiser" than "Happy Feet"? If so, toenail fungus could be the culprit behind your nail nasties.

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It’s an embarrassing topic no one likes to think about, let alone discuss. But the truth is that toenail fungus or onychomycosis, to use the medical term, is incredibly common and can happen to anyone. In fact, 1 in 10 people are affected, and for those over 70, this statistic jumps to 1 in 2.

Toenail fungus starts innocently enough, appearing as a small white or yellow spot under the tip of your toenail. It’s easy to overlook or dismiss as dirt or a minor discoloration. But, as it progresses, it causes unsightly, discolored and crumbling nails.

Neglecting these symptoms can result in more severe issues, such as pain and discomfort, especially when wearing shoes. To make matters worse, treating toenail fungus is notoriously tricky. Dr. Chris Adigun, a board-certified dermatologist at Dermatology & Laser Center of Chapel Hill, explains that it requires patience and that infections often recur.

She stresses that only prescription topical and oral medications are clinically proven to tackle toenail fungus, but even these, especially the topicals, often don’t guarantee a complete cure.

That said, many over-the-counter ointments, foot soaks and brush-on liquids can be effective for mild cases. Since toenail fungus is typically not a serious medical issue, it’s reasonable to try home treatment, suggests Dr. Amit Garg, a board-certified dermatologist and professor at Zucker School of Medicine at Hofstra/Northwell in New Hyde Park, N.Y.

The challenge with all these options is finding the one that works best for you. To tackle this issue, we consulted three dermatologists to understand why treating toenail fungus is so difficult and which active ingredients in OTC products have the most potent antifungal properties. Armed with this information, we researched dozens of products, evaluating them based on ingredients, ease of use, cost and customer reviews. Below are the best toenail fungus treatments for 2024, according to experts.

Price: $9 per applicator/bottle | Active ingredient: Tolnaftate, 1% | Application: Apply twice a day (morning and night)

Fungi-Nail takes the prize for best overall toenail fungus treatment because it's easy to use and has a precision pen applicator that allows you to zero in on tricky-to-reach nail edges. It's also available as a brush-on liquid or ointment when you need to cover a wider area.

All three versions contain tolnaftate, a known fungus killer, says Dr. Danilo C. Del Campo, a board-certified dermatologist at Chicago Skin Clinic.

Tolnaftate is included in many products for fungal skin infections such as athlete's foot, jock itch and ringworm. Del Campo says it's best, however, to opt for a preparation designed for nails.

A big caveat — with this and all topical toe fungus products — is that the active ingredient may not reach where it's needed. Nails are hard, Garg points out, and a medication that's readily absorbed into the skin may fail to penetrate the nail plate and reach the tissue underneath.

Pros
  • Three preparations to choose from: liquid, ointment or pen applicator
  • Contains skin-soothing aloe and lavender oil, plus tea tree oil and eucalyptus, which have antifungal properties
Cons
  • May not penetrate deep enough into nail bed
  • Active ingredient may irritate skin
$9 at Amazon

Price: $17.50 for a 6-ounce jar | Active ingredients: Menthol, eucalyptus oil, thymol | Application: Apply with finger or cotton swab at least once a day

Yes, it's that ointment your mom rubbed onto your chest when you were sick as a kid. But both Del Campo and Garg say it just might improve the appearance of a mildly infected toenail. The menthol and eucalyptus oil that give Vicks its famous minty smell also have antifungal properties — as does a secondary ingredient called thymol, Garg notes.

In fact, according to a 2022 research review, there is some limited evidence that Vicks can help improve toenail fungus. One of the studies included in the review found that of 18 people, 15 saw their toenail fungus at least partially clear up after dabbing the affected area with Vicks at least once a day for a year. (Toenail fungus treatment is a long-haul process, the experts say.)

"I do suggest Vicks to certain patients," says Del Campo, who also cites the tactic as his grandmother's favorite remedy. It's cheap and low-risk, he notes, and it may be enough for some people.

Pros
  • Inexpensive and long-lasting
  • Long history of safe use on the skin
  • Scientific evidence supports its use for toenail fungus
Cons
  • Strong odor
  • A bit messy to apply
  • May not penetrate deep enough
$17 at Amazon
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$18 at Walmart$22 at CVS Pharmacy

Price: $20 for 2 0.5-ounce bottles | Active ingredient: Undecylenic acid, 25% | Application: Brush on twice a day (morning and night)

Tobcharm is the leading option here because it contains natural fungus fighters, lavender and tea tree oil and a maximum-strength concentration of undecylenic acid, or UA.

The UA compound is derived from the castor oil plant, and it's one of the oldest known fungus-fighters, Del Campo notes. "Undecylenic acid provides an accessible option for managing fungal conditions without a prescription, backed by decades of use," he says.

Still, the effectiveness of UA for toenail fungus varies widely, Del Campo says. One way to improve your odds is to use a product with a high enough concentration of UA; another is to use it diligently, he emphasizes.

Pros
  • Active ingredient has proven antifungal powers
  • Contains skin-softening olive oil
  • May be budget-friendly (Baar says one bottle does the job)
Cons
  • Users must massage in the liquid after using the brush
  • May irritate skin
  • May not penetrate deep enough
$20 at Amazon

Price: $18 for a 16-ounce pouch | Active ingredient: Tea tree oil | Application: Soak feet for 15-20 minutes as needed

This foot soak packs a punch with its combination of tea tree oil and apple cider vinegar, natural ingredients known for their antifungal properties. It also offers bonus skin-soothers like Epsom salt and chamomile oil. Plus, pampering your whole foot, not just your nails, may help relieve symptoms of athlete's foot, which often goes hand-in-hand with toenail fungus. In fact, toenail fungal infections often begin as athlete's foot: As Adigun puts it, "You basically 'catch' the infection from yourself." In other words, if you have athlete's foot, you may end up passing the fungus to your toenails. 

One downside is that foot soaks are a bigger time commitment than other remedies — you have to mix the ingredients in water until they dissolve, then soak your feet for 15 to 20 minutes. In addition, overdoing Epsom salt soaks can dry out or irritate your skin.

Pros
  • Contains skin-soothing Epsom salt and essential oils
  • Also helps address athlete’s foot
  • Can be a de-stresser
Cons
  • Time-intensive
  • Unlikely to penetrate the nail
  • Overuse may dry skin
$20 at Amazon

Price: $16 for a 1-ounce tube | Active ingredient: Terbinafine hydrochloride, 1% | Application: Apply once or twice a day

Lamisil is known for its ability to vanquish athlete's foot and jock itch, thanks to its active ingredient, terbinafine, a highly potent antifungal. In fact, when it comes to toenail fungus, oral prescription terbinafine is considered the most effective treatment. That said, the terbinafine in topical antifungals doesn't have the same effect because it's acting from the outside, where (once again) the issue is whether it can penetrate the nail and get where it needs to go.

At the same time, there is research suggesting that topical terbinafine — though at a hefty concentration of 10%, not the lower 1% found in Lamisil — can effectively kill toenail fungus with a low risk of side effects. In general, Garg says, it's a matter of weighing risks and benefits: Oral drugs for toenail fungus are most effective but can have side effects and interact with other medications, so some people may prefer (or need) topical treatment. 

Pros
  • Contains a powerful antifungal ingredient
  • Easy to use
  • Budget-friendly
Cons
  • Not designed for nail application
  • May not penetrate deep enough
$16 at Amazon

Price: $21 for a .34-ounce container | Active ingredient: Tolnaftate, 1% | Application: Apply twice a day (morning and night)

We like the way this 2-for-1 partners tolnaftate with a nail repair solution. Let's face it: You want an antifungal that works, but you also want that unsightly nail to look better while you're waiting. Opti-Nail promises to help. 

Step one is to apply the nail repair liquid, which contains lactic acid, glycerin and other ingredients designed to brighten the nail. Then, you brush the tolnaftate solution on top. Both products are housed in one handy pen that makes application easy and mess-free. That said, you end up getting a relatively small amount of the antifungal treatment for the price. 

Pros
  • Contains an effective antifungal
  • Contains ingredients to boost nail appearance
  • Easy to apply
Cons
  • More expensive
  • May not penetrate deep enough
  • May irritate the skin
$18 at Walmart
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$23 at Amazon$32 at CVS Pharmacy

Price: $19 for 14 patches | Active ingredient: None | Application: Wear once a day for 6-8 hours

Kerasal patches are an excellent choice if you want to improve the appearance of your fungus-damaged nails while continuing your primary antifungal treatment.

They're easy to apply (and despite the name, you can wear them during the day if you prefer).

It's important to stress that they contain no antifungal medication. The manufacturer says the ingredients — including glycerin and tartaric acid — can help fungus-damaged toenails look better by hydrating and exfoliating the area. Consider these an addition to whatever else you're doing to battle your fungal infection.

Pros
  • Easy to use
  • Little risk
Cons
  • Pricey (manufacturer suggests up to six months of use)
  • Contains no antifungal ingredients
$19 at Amazon
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$19 at Walmart$26 at Rite Aid

Price: $14 for 12 packets | Active ingredient: Aluminum acetate | Application: Soak feet for 15-30 minutes, up to three times a day

Experts stress that if your toe hurts, you should see a doctor. "Toenail fungus should not hurt," Adigun says. If there's pain, that could mean there's something else going on, like a bacterial infection. And sometimes what looks like toenail fungus is actually a different animal altogether, Del Campo notes: The skin condition psoriasis, for example, sometimes appears in the nails first.

That said, if you're having minor skin irritation — whether from a topical antifungal or a bout of athlete's foot — Del Campo says Domeboro foot soak is a time-honored soother. The brand has been kicking for over 60 years, and the benefits of the active ingredient, aluminum acetate, have been recognized for even longer. "Sometimes the old stuff works," Del Campo says.

The tactic does take some effort — dissolving the powder into water, then soaking your feet for up to a half hour, multiple times a day. Somewhat paradoxically, aluminum acetate can also end up causing skin irritation for some people, so ease into the treatment and work up to three soaks per day, if your feet can handle it.

Pros
  • Soothes minor skin irritation from many causes
  • Widely available and budget-friendly
Cons
  • Time-intensive
  • May irritate skin (or eyes if you splash)
$14 at Amazon
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$14 at Rite Aid$18 at CVS Pharmacy
  • Active ingredients. Look for antifungals that can kill the types of fungus that frequently invade the toenail. These include terbinafine, tolnaftate, undecylenic acid (UA) and clotrimazole.

  • The severity of your problem. OTC products will only work for mild cases of toenail fungus. As an example, Garg says that it may look like you only have one or two nails superficially affected — that is, the nail appears affected, but not the skin under the nail. If your situation is more severe, don't mess around with home remedies. Adigun stresses that even prescription-strength topical medications aren't always effective for treating more serious fungal toenail infections.

  • Duration of use. Toenail fungus does not succumb easily. The experts point to prescription treatments: Topical medications are typically taken for a year, and even pills generally take three months to work. In other words, buckle up for the long haul and plan to use OTC treatments for the foreseeable future if you hope to experience results.

The short answer is no. Toenail fungus treatment requires consistent and ongoing application of antifungal ingredients, and even long-term treatment may not clear up challenging infections.

It's a tough question. A toenail takes a year or longer to grow out, Del Campo notes. So even if a treatment is knocking out the fungus, you'll probably have to wait patiently to see a completely healthy-looking nail. What all three dermatologists did say: If you've been using an OTC antifungal for two months and aren't seeing any improvement, it's time to see a doctor.

In general, the experts say it's wise to consult a doctor as soon as you think you have toenail fungus. While Garg offered a loose definition of a "mild" case that may respond to home treatment, he says it's also tough to judge the severity of a fungal infection with your own eye, especially when you can't readily see what's going on with the tissue underneath your toenail. If you see a doctor, you'll have a better sense of the issue and can opt for OTC treatments if you prefer. If your fungal infection looks more extensive — or "if you have any doubts," Del Campo says — make that appointment.

Finally, it's important to understand that your overall health can contribute to whether or not a toenail fungal infection is more concerning. If you have a serious health condition, like diabetes or HIV, you should see your doctor at the first sign of a problem, according to the Centers for Disease Control and Prevention.

Fungus is everywhere, so it's hard to avoid altogether, Garg points out. Even among people who use oral medications to treat toenail fungus, 20%-25% see a recurrence, often within two years. Some people are just prone to foot fungus, Adigun says.

However, Garg says you can take simple steps to reduce the risk of a recurrence — keep your nails trimmed, change your socks regularly and sprinkle antifungal powder in your shoes. And since athlete's foot can spread to the toenails, Adigun says that treating and preventing that condition is also key.

Chris Adigun, MD, board-certified dermatologist, Dermatology & Laser Center of Chapel Hill, Chapel Hill, N.C.

Danilo C. Del Campo, MD, board-certified dermatologist, Chicago Skin Clinic

Amit Garg, MD, board-certified dermatologist and professor of dermatology, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, N.Y.

Berkley A, et al. (2024). Anti-fungal properties of tea tree oil, oregano oil, lavender oil, coconut oil for nails, and a survey of pharmacy students’ views. https://crimsonpublishers.com/acam/pdf/ACAM.000680.pdf

Ousaaid D, et al. (2021). Antifungal and antibacterial activities of apple vinegar of different cultivars. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369171/

Rodríguez JV, et al. (2022). Meta‐analysis of the antifungal activities of three essential oils as alternative therapies in dermatophytosis infections.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545424/