Toenail Fungus

The medical term for toenail fungus is “Onychomycosis”

What does it Look Like?

The toenails have a yellow discolouration underneath. If just mild, it may just be near the end of the nail, but can start to involve most of the nail if severe. The toenail can even become brittle.

Is it Harmful?

People can be self-conscious because of the appearance.

Generally, it is not harmful. However, if the nails and skin become cracked, this can be a source for bacterial infections. The bacteria infections would definitely be harmful, especially for patients with diabetes or weak immune systems.

Can it be Treated?

Toenail fungus is very stubborn. It can often take 6-12 months. That’s how long it takes toenails to fully grow too.

Sticking with the treatment every day as prescribed is key.

Treatment Options:

Topical Cream (i.e. Lamisil)

  • This is a cream you rub all over the nail and skin every night.
  • The benefit of topical option are that no risks and no side effects.
  • This is an option people way wish to try only because it’s only topical option (not an pill) that is covered by Ontario Drug Benefits.
  • However, it is rarely effective.

Vicks VapRub Ointment

  • This is the over-the-counter product you’ve already heard about. You can rub all over the nail and skin every night.
  • It’s relatively inexpensive and safe. 
  • Many people swear it works.
  • There is one small study that showed it was very effective.

Topical Jublia (efinaconazole)

  • This is like a nail polish. You apply it every night.
  • The benefit of topical option are that no risks and no side effects.
  • One drawback is that it is not covered by Ontario Drug Benefits. It’s expensive and costs over $100 per bottle. Each bottle will last a few months.
  • Most private drug plans will cover the mediation.
  • It doesn’t always work. Some studies estimate that only 22% of people are completely cured after 36 weeks. Though, maybe a little higher success after 1 year.

Oral Anti-Fungal Pills (i.e. terbinafine)

  • This is a pill you take every day. Again, it can often take 6-12 months.
  • Side effects are rare, but there is a rare chance of liver injury from these pills (maybe 1 in 100,000 people will get this).
  • This medication is covered by all drug plans, including Ontario Drug Benefits.
  • This is the most effective option. But again, it has some risks and it involves taking a pill every day for many months.

Which Option Should You Choose?

You should consider the pros and cons to each of these options.

If the toenail fungus is more severe, like involving at least half the nail, then the oral medications is generally suggested.