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Are there any prescription treatments for nail fungus?

Onychomycosis is a fungal infection of the fingernails or toenails that causes thickened and brittle nails. If your infection is severe, your doctor may prescribe an antifungal medicine. These medicines are taken by mouth, and have the best chance of treating the infection because they enter the nail through the bloodstream. Even with prescription medicine, fungal infections are sometimes difficult to cure, and may return after treatment is complete.

Prescription medicines include griseofulvin (brand name Fulvicin-UF), itraconazole (Sporanox), and terbinafine (>Lamisil). Of these medications, itraconazole and terbinafine are the most effective. They cure 70 to 80 percent of infections with one course of treatment. Griseofulvin cures 30 to 70 percent of infections with one course. Doctors sometimes prescribe another drug, fluconazole (>Diflucan), but it has not been studied as thoroughly as the other antifungal drugs.

Drug treatment usually takes three months. The medicine gets into the nail and remains there as the nail grows out. It can take up to six months to cure a fingernail infection and up to 18 months for toenail infections because this is how long it can take for the healthy nail to grow out.

More recently, the FDA approved ciclopirox (>Penlac) nail lacquer for nail fungus. You apply it like a nail polish once daily to the affected nail(s). While it appears less effective than antifungals taken by mouth, it may be an option for people who want to avoid the risk of side effects from oral antifungals.

Sources:
Scher RK. Journal of the American Academy of Dermatology. June 1999.
Micromedex® Healthcare Series. Thomson Micromedex, 2007
Roberts DT. British Journal of Dermatology. November 1999.
Penlac Product Information, Aventis Pharmaceuticals, December 1999.
Habif. TP. Clinical Dermatology. Mosby Inc. 1996.
Drug Facts and Comparisons. Facts & Comparisons, 2007.
Diseases and Conditions, "Nail fungus." http://www.mayoclinic.com. Mayo Clinic Health. Last accessed 1/9/2007.

This answer prepared 1/9/2001.
This information updated 1/9/2007.