Best Toenail Fungus Treatment

Big picture: If you want clearer-looking nails fast, start here—and stick with treatment for months. Always talk to a clinician if you have diabetes, poor circulation, significant pain, or if OTC care isn’t working.

TL;DR Recommendations

Best overall (moderate–severe): Oral terbinafine (Lamisil). Highest cure rates (72–76%) with a 6–12 week course; full results as the nail grows out over 9–12 months (supported by an AAFP rapid evidence review). Ask your doctor about liver labs and drug interactions.

Best alternative: Oral itraconazole (Sporanox). Useful when terbinafine isn’t suitable or yeast/molds are suspected; cure rates around 60%. More drug interactions; discuss with your provider (see AAFP guidance).

Best OTC for mild–moderate or maintenance: High‑potency undecylenic acid 25% (e.g., MyNuNail Pen). Estimated 30–50% effectiveness with consistent daily use for 6–12 months; gentle and easy to apply.

Best Rx topicals (mild–moderate): Efinaconazole (Jublia), tavaborole (Kerydin), ciclopirox. Daily for 9–12 months; complete cure rates 6–18%; minimal systemic risks. For context, see this UCLA Health overview on treatment options.

Best non‑drug adjunct: Laser therapy. Variable results (30–60%); often combined with topicals; higher cost and usually not covered by insurance. As noted in the same UCLA Health overview.

Essentials to boost any treatment: Thin/file weekly, keep feet dry, rotate breathable shoes, disinfect nail tools, treat athlete’s foot, and stick with therapy for months.

See a clinician now if: You have diabetes, poor circulation, significant pain, nail detachment, rapid spread, or no improvement after several weeks of consistent OTC care.

Comparison Table: effectiveness, duration, side effects, and cost at a glance

Note: Costs are approximate and vary by country, pharmacy/clinic pricing, and insurance.

*Amorolfine availability varies by country.

Quick tip: Thin → apply → keep dry. File the nail weekly, apply treatment consistently, and keep feet dry for best results.

Introduction: What causes toenail fungus and why treatment takes time

Toenail fungus (onychomycosis) starts when fungi enter tiny cracks in the nail or surrounding skin, thriving in warm, moist environments (sweaty socks, tight shoes, locker rooms). Once inside, they can reach deep layers and even the nail matrix, where topicals struggle to penetrate. Nails grow slowly and have limited blood supply, so visible clearing takes months and recurrence can happen without maintenance.

Symptoms and how it spreads

Early signs include white or yellow spots under the nail tip. Over time, nails can thicken, crumble, discolor, and lift from the nail bed. It spreads via public showers, pools, gyms, shared tools, and from untreated athlete’s foot.

• Common signs:

• Discoloration (white/yellow/brown)

• Thick, brittle, crumbly edges

• Misshapen nails; detachment from the nail bed

• Common spread sources:

• Locker rooms, pools, shared nail tools

• Athlete’s foot extending to toenails

Risk factors and quick prevention wins

Higher risk with age, excessive sweating, tight shoes, nail trauma, diabetes, psoriasis, poor circulation, and weakened immunity. Men are slightly more affected, but it’s common in all adults.

• Higher risk if you:

• Are 50+ or have a history of athlete’s foot

• Wear tight/non-ventilated shoes or sweaty socks

• Walk barefoot in communal areas

• Live with diabetes, psoriasis, or immune compromise

• Prevention wins:

• Rotate shoes; choose breathable materials

• Disinfect clippers; don’t share nail tools

• Dry thoroughly between toes; use moisture-wicking socks

Diagnosis matters: If you’re unsure it’s fungus—or there’s no progress after several weeks—ask a clinician about lab confirmation (KOH, culture, or PCR). Several nail conditions (psoriasis, trauma) can mimic fungus.

How we ranked the best toenail fungus treatments (5 criteria)

We scored each option so you can choose confidently:

1. Effectiveness and cure rates from clinical evidence

2. Safety and interactions

3. Ease of use and adherence

4. Cost and access

5. Regulatory status (FDA approval/OTC monograph)

When choosing between treatment approaches, understanding the differences between topical antifungal vs oral medication can help you make the best decision for your specific situation and severity level.

Active topicals can reach mycologic cure up to ~55% and complete cure ~15–18% in studies; orals offer the highest cure in moderate–severe cases; lasers are typically adjuncts. Topicals are gentler with fewer systemic effects; orals may require liver monitoring and careful interaction checks. We prioritized options with strong results, solid safety, and practical routines.

Best toenail fungus treatments (ranked)

• Match your severity, budget, and tolerance for side effects

• Combine debridement/filing and foot hygiene with any therapy

Still deciding between plant-based/topical approaches and prescriptions? Read our guide to natural vs. prescription antifungal treatment.

1) Oral terbinafine (Lamisil) — highest cure rate for moderate–severe cases

Targets dermatophytes—the most common culprits—better than anything else. Typical course is 6–12 weeks; nails look clear as they grow out over 9–12 months. Discuss baseline liver labs and drug interactions with your provider; ongoing routine labs are usually individualized based on risk and symptoms.

• Why it’s first-line: strong cure rates, low cost, once-daily dosing

2) Oral itraconazole (Sporanox) — alternative when terbinafine isn’t suitable

Useful when terbinafine isn’t an option or when yeast/non-dermatophyte molds are suspected. Expect similar treatment length and a higher interaction profile. Relapse rates can be higher vs. terbinafine.

• Best for: non-dermatophyte/mixed infections or terbinafine intolerance

3) High-potency undecylenic acid 25% OTC — MyNuNail Anti Fungal Treatment Pen

A targeted, at-home option without a prescription. The 25% undecylenic acid is recognized under the FDA topical antifungal monograph for athlete’s foot and ringworm; using on toenails is off-label. Twice-daily use, plus weekly filing, can support appearance and cleanliness and may aid maintenance after prescription therapy.

• Best for: mild–moderate cases and maintenance after oral therapy

4) Prescription topicals — efinaconazole 10% (Jublia), tavaborole 5% (Kerydin), ciclopirox 8%, amorolfine 5%

Good for mild–moderate infections or if you can’t take pills. Daily use for ~9–12 months is typical. Irritation is uncommon and usually mild. Costs vary widely by product and insurance.

• Pros: minimal systemic risk; safe for long-term use

• Cons: lower complete cure rates; requires daily adherence

• What to expect: complete cure ~15–18%; mycologic cure ~53–55% around 48–52 weeks in trials

5) Laser therapy — adjunct/cosmetic

A non-drug route with variable, often cosmetic improvement. Evidence for a durable cure remains insufficient; many insurers consider lasers not covered. Works best only as an add-on to topical care and debridement.

• Good fit for: people avoiding pills or with medication contraindications who understand the limitations and cost

6) Other OTC/natural support — tea tree oil, hydrogen peroxide soaks; Kerasal for cosmetic renewal

Helpful for appearance and hygiene, but limited for full fungal clearance. Use as add-ons alongside proven antifungals.

• Best use: mild cases, maintenance, cosmetic improvement

Featured pick: MyNuNail Anti Fungal Treatment Pen (25% Undecylenic Acid)

Disclosure: This section features our product. OTC antifungals are labeled for athlete’s foot and ringworm; using them on toenails is off-label. Results vary. For moderate–severe onychomycosis, talk to a clinician about prescription options; many people use OTC products adjunctively with nail care.

High-strength undecylenic acid (25%) in a precision pen for clean, twice-daily application. Fast-absorbing, non-greasy, and easy to incorporate into a routine. 90-Day Money-Back Guarantee and free 3–5 day shipping on orders over \$50.

• Key benefits:

• 25% undecylenic acid (OTC antifungal active under FDA monograph—athlete’s foot/ringworm)

• Precision brush for mess-free application

• Fast-absorbing, non-greasy finish

Why it stands out: concentrated undecylenic acid + botanical complex

The 25% undecylenic acid targets common surface fungi, supported by a curated blend of essential oils to aid penetration and comfort. For a deeper dive into effective ingredients, explore our ingredient overview on the MyNuNail Blog.

Expected results and timeline

With twice-daily use and weekly filing, many see cosmetic/appearance improvements in 6–12 weeks (less discoloration, smoother edges). Full toenail regrowth can take 6–12 months. After improvement, maintain 3×/week to help prevent recurrence.

• Typical timeline:

• Weeks 2–6: cleaner look; edges less brittle

• Weeks 6–12: reduced yellowing; smoother thickness

• Months 3–6+: healthy outgrowth gradually replaces damaged nail

How to use

1. Trim and lightly file nail surface 1–2×/week

2. Apply to clean, dry nails (entire nail, edges, and cuticle line) twice daily

3. Let dry before socks/shoes

4. After improvement: continue 3×/week for maintenance

Ingredients and specs (3 mL; 24-month shelf life)

Includes undecylenic acid 25%, essential oils (tea tree, snakeroot, manuka, oregano, eucalyptus, clove bud, peppermint, lavender), propolis, vitamin E (tocopheryl acetate), aloe vera oil, sweet almond oil, and jojoba oil. Clear, travel-friendly pen.

Buyer’s guide: choose the right treatment for your severity and health

• Quick Matchmaker

• Mild: Start MyNuNail Pen twice daily; file weekly; maintain 3×/week after improvement

• Moderate: MyNuNail Pen twice daily + diligent filing; consider a podiatry visit if progress stalls

• Severe or painful: See a clinician for oral therapy; continue topical for maintenance

• Diabetes/immunosuppression: Seek medical care first—topicals are add-ons

When to see a doctor and confirm diagnosis

Get a clinical exam and lab confirmation (KOH/culture/PCR) if there’s no progress after several weeks, significant thickening, pain, or detachment. Always seek early care with diabetes, circulation issues, or weakened immunity.

• See a clinician if:

• No improvement after several weeks of diligent OTC care

• Pain, detachment, or spread to nearby skin

• You have diabetes, neuropathy, poor circulation, or immunosuppression

• You’re considering oral antifungals

Red flags and special situations

Urgent attention for worsening pain, spreading redness, swelling, foul odor, or systemic symptoms (fever, chills). In pregnancy or immunosuppression, avoid self-treatment without guidance.

• Act now if:

• Rapid color change or sudden thickening

• Warmth, swelling, or draining fluid

• Fever/chills with foot changes

• New numbness, tingling, or ulcers (especially in diabetes)

Combination strategies and adherence tips

• Thin → apply → let dry fully

• Twice daily until improved, then 3×/week

• Set reminders; keep a pen at home and one in your bag

• Replace old nail tools; disinfect after each use

• Keep shoes dry, rotate pairs, and use moisture-wicking socks

Foot hygiene and prevention

• Wash and dry feet daily (between toes)

• Trim nails straight across; avoid tight shoes

• Treat athlete’s foot promptly

• Wear sandals in public showers/pools

• Maintain topical 3×/week for several months after improvement

FAQs

What is the most effective treatment for toenail fungus?

For moderate–severe cases, oral terbinafine (Lamisil) typically delivers the highest cure rates (~72–76%) with a 6–12 week course. If terbinafine isn’t suitable—or yeast/mold are suspected—itraconazole (Sporanox) is a reasonable alternative (~60%). Rx topicals help mild cases but require daily use for 9–12 months and have lower complete cure rates. Laser therapy is a non-drug adjunct with variable, often cosmetic results. High-potency OTC undecylenic acid (25%) is a practical adjunct for mild–moderate cases and maintenance (off-label for nails).

Can toenail fungus go away without treatment?

Rarely. Most infections persist or spread. Nails often thicken, become brittle, and discolor over time. Start a proven therapy and stick with it for months.

How long until I see clearer nails, and can I paint my nails during treatment?

Expect 6–12 months for a clear nail to fully grow out. Many see cosmetic improvements within ~3 months with consistent filing and application. If using polish, let treatment absorb fully first, use breathable polish sparingly, and remove weekly to file and reapply treatment.

Are laser treatments worth it?

They can be helpful if you can’t take oral meds or prefer a non-drug option—but consider them adjunct/cosmetic. Most clinics suggest 1–4 sessions. Results vary and are most reliable when paired with consistent topical care.

How do I prevent reinfection?

Keep feet dry, rotate breathable shoes, change into moisture-wicking socks, disinfect nail tools and shower floors, treat athlete’s foot, and continue a topical 3×/week for maintenance after clearing/improvement.

Citations & further reading (consumer-friendly starting points)

• American Academy of Family Physicians (AAFP) – Rapid evidence review (2021)

• UCLA Health – Overview on toenail fungus treatments (2023)

• FDA OTC Topical Antifungal Monograph (undecylenic acid and other actives – labeled for tinea pedis/corporis), plus insurer policies on laser coverage

• Standard dermatology references on onychomycosis diagnosis (KOH/culture/PCR) and debridement

Important medical disclaimer

This article is for educational purposes only and isn’t a substitute for professional medical advice. Always talk to your healthcare professional about your situation—especially if you have diabetes, circulatory problems, immunosuppression, pregnancy, or severe/painful nail disease.