Fungal infections of the nail account for nearly half of all nail problems. It’s an infectious condition that not only looks ugly, but it is a progressive condition that can cause pain, and spread to the skin or other nails if it isn’t treated properly.
Fact: Nail fungus is notoriously difficult to treat due to the biological properties of the nail. The success rate is relatively low, and the recurrence rate is high.
Fiction: Conventional medicine won’t work; try alternative therapies found on the Internet.
It’s true that nail fungus is difficult to treat. If you start treatment early it will work faster, and recurrence is less likely, but some people are naturally more susceptible to fungi. The real challenge in treating nail fungus is that topical medication has a difficult time getting into the nail where the fungi reside. Oral medications are far more effective at killing the fungi for this reason, but oral medication can be toxic or interact with other medications, so these added risks need to be taken into account.
Does it mean that conventional or evidence-based treatments are useless? No. It means that patients need to have the patience to go through the treatment, sometimes as long as 18 months to clear the infection and make sure they are doing everything they can, lifestyle-wise, minimizing the chance of re-infection. The alternative therapies found on the Internet that “guarantee success” are not the answer. Although many things kill fungi, the challenge is to get the treatment through the nail, which these therapies simply will not do. At best, they will improve the outermost part of the nail where the topical can reach.
Here are the proper steps to follow:
1: See a doctor if you suspect nail fungus. Symptoms of nail fungus often aren’t apparent in the early stages. There are many conditions like nail psoriasis, or simply nail trauma that can resemble symptoms of nail fungus. You want a proper diagnosis.
2: Research the credible prescription treatments approved by Health Canada. Your doctor will likely recommend one of the following treatments: Jublia (Efinaconazole), Lamisil (Terbinafine), Penlac (Ciclopirox), and Sporanox (Itraconazole).
3: Whatever treatment plan you and your doctor decide upon, stick to it. All of these treatments take time. Even after a nail infection is cleared, the nail plate remains damaged until it grows out and is clipped. As nails are slow to grow, it can take 12 to 18 months before the nails look entirely normal, even when the treatment is successful.
There are four prescription-strength treatments available for nail fungus in Canada.
| Treatment/Therapy | Form | Liver Toxicity | Drug Interactions |
| JUBLIA | Topical | No | No |
| LAMISIL | Oral | Yes | Yes |
| PENLAC | Topical | No | No |
| SPORANOX | Oral | Yes | Yes |
The oral drugs tend to have a higher cure rate than the topical drugs as they can penetrate deep into the nail, but they have higher risks of drug interactions and other unwanted effects.
Jublia is a new topical drug that has made innovations to increase drug penetration and has a high rate of cure as a topical medication, which is often favored by dermatologists due to its lower risk. All therapies take patience and adherence to treatment to work properly. As nails grow slowly, the appearance of the nails may not clear for up to 18 months as the nails need to grow out and then clipped. Talk to your doctor about the treatment option that is best for you.
For more information about effective treatments for nail fungus, visit Nail Fungus Guide
