If you’ve noticed your toenails becoming thick, discolored, or brittle, you might be dealing with toenail fungus—also known as onychomycosis. It’s more common than you might think, especially among active Montanans who enjoy hiking, skiing, or spending time in damp footwear. As a podiatrist here in Bozeman, I often treat patients frustrated by toenail fungus that won’t go away on its own. The good news? There are several effective treatment options—some you can try at home, and others that require a visit to your foot doctor. Below are the five most effective treatments for toenail fungus.
1. Topical Antifungal Medications
Over-the-counter and prescription topical treatments can be a good first step—especially if the infection is mild or just starting.
- How it works: You apply the medication directly to the affected toenail(s), usually daily.
- Pros: Non-invasive, easy to use.
- Cons: Limited effectiveness for deeper infections since the medication may not fully penetrate the nail.
Tip: Look for products containing ingredients like terbinafine or ciclopirox. Prescription-strength topical treatments often work better than OTC versions.
2. Oral Antifungal Medications
For more stubborn or widespread infections, oral antifungals can be much more effective.
- How it works: These medications, such as terbinafine (Lamisil) or itraconazole (Sporanox), work systemically to clear the fungus from within.
- Pros: High success rate (often over 70%).
- Cons: Requires a prescription, potential liver side effects, and usually taken for 6–12 weeks.
Important: We’ll typically monitor your liver function with a simple blood test during treatment to ensure safety.
3. Laser Treatment
Laser therapy is a newer, non-invasive treatment option that targets fungal cells beneath the nail without damaging surrounding tissue.
- How it works: The laser generates heat to kill the fungus in the nail bed.
- Pros: Painless, no medications, minimal downtime.
- Cons: Often not covered by insurance, and multiple sessions may be needed.
Bozeman Bonus: This is an increasingly popular option for active individuals who want to avoid oral medications and get back to outdoor activities quickly.
4. Toenail Debridement (Nail Trimming and Thinning)
While not a cure on its own, professionally thinning and trimming the toenail can relieve discomfort and help other treatments work more effectively.
- How it works: Your podiatrist carefully removes thickened or infected parts of the nail.
- Pros: Immediate improvement in appearance and comfort.
- Cons: Needs to be combined with another antifungal treatment for best results.
Ideal for: Athletes and hikers looking for faster symptom relief while undergoing other treatments.
5. Nail Removal (in Severe Cases)
In rare cases where the infection is painful or hasn’t responded to other treatments, removing the toenail may be the best path forward.
- How it works: The nail is surgically removed to allow direct access to the nail bed, where the fungus lives.
- Pros: Allows for aggressive treatment and regrowth of a healthy nail.
- Cons: More invasive, with a longer recovery time.
Toenail fungus is stubborn but treatable—and the sooner you start, the better your outcome. If you’re unsure what treatment is best, we’re here to help. At Montana Foot and Ankle, we’ll assess your nails, discuss your lifestyle and health history, and create a personalized plan to get your feet looking and feeling their best.