Nail fungus treatments: lacquers, creams, or tablets

You noticed a discolouration on your nail. Yellowish, slightly thickened. "Probably just banged my toe, it'll pass," you thought. But it didn't pass. After a month, the nail became thicker, more yellow, brittle. And then it hit you: it's nail fungus.

Nail fungus isn't the end of the world. But it's a problem that won't go away on its own. And one that requires patience - because treatment lasts months, and sometimes over a year. But the good news is: it can be beaten. You just need to know how.

Let's talk honestly about nail fungus - without embarrassment, without scaremongering. About how to recognise it, what treatment options exist, and what actually works.

What is nail fungus and how do you recognise it?

Nail fungus (onychomycosis) is an infection of the nail plate by fungi - most commonly dermatophytes, yeasts, or moulds. It's one of the most common dermatological problems - affecting up to 10% of the population, and after age 60, one in three people.

Typical symptoms of nail fungus:

• Discolouration - white-yellow, brown, sometimes greenish spots
• Nail thickening - difficult to trim
• Brittleness, crumbling - the nail chips and breaks
• Nail separation - the nail lifts off the nail bed
• Shape change - the nail becomes curved or deformed
• Unpleasant odour (sometimes)

Nail fungus most commonly starts on one nail (often the big toenail) and can spread to others.

How did you catch it?

Nail fungus isn't a hygiene issue - it's an exposure issue. Fungi love warmth and moisture.

Most common places of infection:

• Swimming pools, saunas, public baths
• Gyms, changing rooms
• Pedicure salons (poorly sterilised tools)
• Walking barefoot in public places

Risk factors:

• Age (over 60)
• Diabetes
• Weakened immune system
• Circulation problems (e.g., varicose veins)
• Excessive foot sweating
• Tight, poorly ventilated shoes
• Nail injuries

Antifungal lacquers - when are they enough?

Lacquers are the first line of defence. They're applied directly to the infected nail.

Popular lacquers:

• Amorolfine (e.g., Loceryl) - 5% lacquer, once or twice weekly
• Ciclopirox (e.g., Batrafen) - 8% lacquer, initially daily, then less frequently (application schedule)

How do they work?

The lacquer penetrates the nail plate and kills the fungi. It forms a protective layer that keeps the medication in place.

When is lacquer enough?

• Fungus covers less than 50% of the nail plate
• No involvement of the nail matrix (base of the nail)
• Maximum 2-3 nails infected
• No contraindications to systemic treatment (can be combined)

How to apply the lacquer?

1. Disposable nail file - file down the diseased part of the nail (as much as possible). Discard the file after use (fungi remain!).
2. Degrease the nail - with an alcohol swab (often included in the kit).
3. Apply the lacquer - in a thin layer over the entire nail.
4. Let it dry - a few minutes.
5. Consistency is key - once or twice weekly (read the leaflet!).

How long? Minimum 6 months for fingernails, 9-12 months for toenails. Yes, that's a long time. But the nail must grow out healthy.

Effectiveness:

About 50-60% in mild cases. Lower than tablets, but without systemic side effects.

Advantages:

• No systemic side effects (works locally)
• No monitoring tests required
• Available without prescription (some products)

Disadvantages:

• Requires consistency - easy to forget
• Long treatment time
• Lower effectiveness than tablets
• Doesn't work in severe cases

Price: Lacquers cost 12-35 EUR. One bottle lasts several months. Check CheaperForDrug - differences can reach 8-10 EUR.

Creams and ointments - support or primary treatment?

Antifungal creams (e.g., with clotrimazole, terbinafine, ketoconazole) work well on skin but penetrate the nail plate poorly.

When to use creams?

• Fungal infection of the skin around the nail (often accompanies nail fungus)
• Athlete's foot - prevents spread to the nails
• As support - alongside lacquer or tablets

Creams are NOT enough:

If the fungus is in the nail plate (not just around it), cream won't penetrate deeply enough. You need lacquer or tablets.

However: If you have nail fungus + athlete's foot - treat both simultaneously. Otherwise, it will recur.

Tablets - most effective, but not for everyone

Systemic (oral) treatment is the most effective method. The medication reaches the nail from the inside through the blood.

Popular oral medications:

• Terbinafine (e.g., Lamisil) - 250 mg daily, 6-12 weeks (fingernails) or 12-16 weeks (toenails)
• Itraconazole (e.g., Sporanox) - pulse therapy (1 week treatment, 3 weeks break, repeat 2-3 times)
• Fluconazole - less commonly used, usually once weekly for several months

When are tablets needed?

• Fungus covers more than 50% of the nail plate
• Nail matrix is involved
• Multiple nails infected
• Lacquer treatment failed
• Diabetes, weakened immunity (higher risk of complications)

Effectiveness:

About 70-80% cure rate (better than lacquers). But requires consistency and patience.

Advantages:

• Highest effectiveness
• Convenient (once daily, swallow a tablet)
• Works even in severe cases

Disadvantages and side effects:

• Can strain the liver - monitoring liver enzymes required before and during treatment
• Interactions with other medications - check with your doctor (e.g., statins, heart medications)
• Possible side effects: stomach upset, headache, rash, taste disturbances (rarely)
• Not for everyone: liver disease, pregnancy, breastfeeding

Important: Tablets are prescription medications. They require a medical consultation and monitoring.

Lacquer + tablets combination - the best results

Research shows that combining systemic and topical treatment gives the best results - effectiveness reaches 80-90%.

Approach:

• Tablets daily (e.g., terbinafine for 12 weeks)
• Lacquer 1-2 times weekly (continue for 9-12 months)
• Cream on the skin around nails (if needed)

This delivers a two-pronged attack - from the inside and from the outside. The fungus has fewer chances.

How long does treatment take - the hardest truth

Prepare for a marathon, not a sprint.

Fingernails: 6-9 months (they grow faster)

Toenails: 9-18 months (they grow 3 times slower than fingernails)

Why so long? Because the nail must grow out healthy, from the base. And a big toenail grows about 1 mm per month. A full big toenail takes 12-18 months to regrow.

How to know it's working?

• The new nail growing out is pink and healthy
• No new discolouration
• Gradual shrinking of the diseased area

Don't stop too early! That's the most common mistake. "It looks better already, I'll stop taking the medication." And the fungus comes back.

Home remedies - what works and what's a myth?

The internet is full of "miraculous" home remedies. Let's check the facts:

Vinegar - partially true

Vinegar soaks (1:2 with water, 15-20 minutes daily) can inhibit fungal growth, but won't cure nail fungus. Can be used as support, not as the main treatment.

Tea tree oil - weak effect

It has antifungal properties, but penetrates the nail poorly. Effectiveness comparable to placebo.

Garlic, baking soda, Listerine - myths

No convincing evidence. Garlic can irritate the skin, baking soda has no antifungal action, Listerine is a mouthwash, not a medication.

Laser treatment for nail fungus - promising but expensive

The laser destroys fungi with heat. Several sessions may help, but:

• Costs hundreds to thousands of euros
• Effectiveness 50-70% (similar to lacquers)
• Not covered by insurance in most countries
• Often requires combination with other methods

Prevention - the key to success

Nail fungus tends to recur. Even after cure, the risk of reinfection is 20-50%. That's why prevention is essential.

How to prevent nail fungus?

• Foot hygiene - wash daily, dry thoroughly (especially between toes)
• Breathable shoes - leather, not rubber. Change daily (let shoes "rest" for 24 hours)
• Cotton socks - change daily, wash at high temperature
• Don't walk barefoot in public places - pool, gym, sauna - always wear flip-flops
• Your own pedicure tools - don't use unknown tools at salons (unless you see sterilisation!)
• Trim nails properly - straight across, not too short (avoid injuries)
• If you have athlete's foot - treat it! - it's the main source of nail infection
• Shoe disinfection - antifungal sprays, powder, UV irradiation

For people with diabetes:

• Control blood sugar levels - high sugar promotes fungal growth
• Have regular foot check-ups with a podiatrist
• Moisturise foot skin (but not between toes - keep that area dry!)

When to see a doctor?

Always. Seriously.

Why?

• Nail fungus can resemble other conditions (psoriasis, lichen, nail inflammation)
• The doctor can take a clipping for testing (confirming diagnosis)
• Treatment will be tailored to the severity
• Prescription medications can be prescribed (if needed)
• They'll check whether systemic medications can be used (liver tests)

Especially see a doctor if:

• You have diabetes
• Weakened immunity
• Pain, swelling, redness around the nail (could be bacterial infection)
• Fungus is spreading despite treatment

Frequently asked questions about nail fungus

Will nail fungus go away on its own?

No. Nail fungus doesn't resolve spontaneously. Without treatment, it will worsen and spread.

Can I paint my nails with cosmetic nail polish during treatment?

It's not recommended. Cosmetic polish seals the nail, makes medication penetration harder, and creates a moist environment (fungi love that). If you absolutely must - use antifungal lacquer, and cosmetic polish only briefly (e.g., for an event).

Is nail fungus contagious?

Yes, but moderately. You won't infect someone by shaking hands. But you can transfer fungi through:

• Shared towels
• Shared flip-flops, shoes
• Shared bathtub, shower (if poorly disinfected)

How to remove an infected nail?

Sometimes the doctor recommends nail removal (surgically or chemically - urea ointment). This is a last resort, used when:

• Fungus is very advanced
• The nail is ingrown
• Treatment isn't producing results

A new nail regrows in 6-12 months.

Will nail fungus come back after cure?

It might. The recurrence risk is 20-50%. That's why prevention (see above) is key.

Summary - key takeaways

Nail fungus is a marathon - treatment takes 6-18 months. Patience and consistency are needed.

Lacquers are sufficient for mild cases (less than 50% of the nail affected) - amorolfine, ciclopirox.

Tablets are most effective (70-80% cure rate), but require medical supervision and liver tests.

Lacquer + tablets combination = best results (80-90% effectiveness).

Creams work on skin, not nails - use as support, not the main treatment.

Home remedies (vinegar, oils) won't cure it - they can support treatment but won't replace medication.

Prevention is key - hygiene, breathable shoes, no barefoot walking in public places.

Compare medication prices - check CheaperForDrug. Lacquers, creams, and tablets can differ in price by 8-12 EUR between pharmacies.

Disclaimer

This information is for educational purposes and does not replace a medical diagnosis. Nail fungus should be confirmed by a dermatologist (sometimes with mycological testing). Do not start tablet treatment without consulting a doctor. Every case is individual and requires a tailored approach.

Remember: Nail fungus is nothing to be ashamed of. It's a problem that affects millions of people. It can be beaten - provided you have patience, consistency, and proper treatment. Don't give up after a month - the nail needs time to grow out healthy.

Fight the fungus wisely and affordably - check CheaperForDrug and find the best prices on antifungal treatments.