Do OTC Topical Nail Fungus Treatments Work?

Onychomycosis is a common fungal nail infection that affects 1 in 10 people (per Cleveland Clinic). In 90% of cases, onychomycosis is caused by a group of fungi called dermatophytes that feed on keratinous tissue, making the toenails — and sometimes even the fingernails — a prime target for these tiny microorganisms.

Too small to be perceived by the human eye, dermatophytes can be contracted by direct contact with an infected person or a contaminated surface. Once they've chosen you as a host, the microorganisms wiggle their way between the toenail and the nail bed where they feast on the protein keratin, which makes up our hair and nails. As they metabolize the keratin, the dermatophytes produce a toxic byproduct that causes inflammation in the tissue of the nail bed, and eventually compromises the structure of the nail (per Global Nail Fungus Organization). Fungal nail infections also evoke some changes in the appearance of the nails. Yellowing, thickened, weakened, broken and misshapen nails are common signs of an onychomycosis infection.

While fungal toenail infections are all too easy to contract, they are notoriously hard to get rid of. Over-the-counter medications containing clotrimazole, tolnaftate, or undecylenic acid are sold as treatment options for onychomycosis. However these products are widely unsuccessful, as they tend to treat the skin surrounding the nail and not the infected nail itself (per Drugs.com).

Prescription medication has proven to be more effective against fungal nail infections, especially when oral and topical medications are used in tandem. According to the American Academy of Dermatology Association, prescription medications amorolfine, ciclopirox, efinaconazole, or tavaborole have all been approved by the U.S. Food and Drug Administration (FDA) for the treatment of onychomycosis. However, even with the use of prescription medications, onychomycosis can take months to clear up, and in many cases the infection can reappear after treatment. Depending on the severity of your infection, your doctor may recommend other treatments such as laser therapy or surgical removal of the nail (per Drugs.com).