Toenail fungus, also known as onychomycosis, is a common fungal infection of the toenails that can be stubborn to treat. When left untreated, the infection can spread and persist for years. The toenails become discolored, thickened, and brittle over time. Fortunately, there are several effective treatments that can help clear up toenail fungus. However, getting rid of the infection takes time and patience.
What causes toenail fungus?
Toenail fungus is caused by various fungal organisms, such as dermatophytes, yeasts, and molds. The most common culprits are the dermatophyte fungi Trichophyton rubrum and Trichophyton mentagrophytes. These fungi thrive in warm, moist environments like swimming pools, locker rooms, and showers. Fungal spores can enter through tiny cuts or breaks in the nail and set up an infection in the nail bed. Once it takes hold, the fungus slowly spreads and digs deeper into the nail tissue.
Several factors put you at higher risk for toenail fungus:
- Sweaty feet
- Injuries to the toe or nail
- Poor circulation
- Weakened immune system
- Diabetes
- Older age
- Nail trauma from tight shoes
- Using public showers or pools
- Family history of toenail fungus
How long does it take to treat toenail fungus?
Unfortunately, toenail fungus is not a quick fix. It can take anywhere from 6 months to several years for the infection to be completely cured and the nail to grow back healthy. Here are some general timelines:
- Mild to moderate cases: 9-12 months
- Severe or longstanding cases: 12-18 months
- Toenails with matrix involvement: 18 months to several years
These timeframes account for the slow rate at which nails grow and the time it takes to grow out infected parts. Toenails only grow around 1 to 2 millimeters per month. It can take 9 to 12 months to completely replace a big toenail. Second and smaller toenails grow faster at around 3 to 4 months for full regrowth.
Factors that affect treatment duration
Several factors influence the speed and success of getting rid of toenail fungus:
- Severity – Mild infections clear up faster than severe, chronic infections.
- Number of nails involved – Treating one nail is faster than multiple infected nails.
- Extent of infection – If the fungus has spread to the nail matrix, it takes longer to eradicate.
- Method of treatment – Some treatments work faster than others.
- Consistency with treatment – It’s vital to use treatments regularly and as directed.
- Nail trimming – Keeping nails trimmed short helps topical treatments penetrate.
- Underlying conditions – Diseases like diabetes slow healing time.
- Reinfection – Preventing reinfection helps cure times.
With mild to moderate infections limited to the nail plate, patients who stay diligent with topical treatments or oral medications often see improvement in about 3-6 months. Severe or recurring cases take longer due to the extent of infection and difficulty accessing it in the nail bed.
Treatments for toenail fungus
There are several effective options for treating toenail fungus. The most common standard treatments include:
Medications
- Oral antifungals – Prescription medications like terbinafine (Lamisil) and itraconazole (Sporanox) taken for 6-12 weeks.
- Topical antifungals – Solutions like ciclopirox (Penlac) 8% nail lacquer applied daily for 48 weeks.
Nail removal
- Partial removal – Trimming out the infected part of the nail.
- Complete removal – Permanently removing the entire nail.
Laser treatments
- Clearanail device – A laser that shines light through the nail to directly kill fungus.
- Pinpointe laser – Focused laser pulses applied directly to the nail bed.
Photodynamic therapy
- Laser or light + photosensitizing agent – A chemical called methyl aminolevulinate (MAL) is applied and activated by light.
Studies show the quickest treatment for toenail fungus is oral terbinafine, clearing infection in about 80% of cases after 12 weeks. Topical treatments take longer, needing daily application for 48 weeks to penetrate nails and eradicate fungus. Laser treatments like Pinpointe or Clearanail also have relatively quick treatment times of 1-2 sessions.
Home remedies
There are also some home remedies claimed to help treat toenail fungus. However, there is limited evidence on their effectiveness. Some options include:
- Tea tree oil – Applied 2x daily for 3-6 months
- Apple cider vinegar – Used as a daily foot soak
- Vicks VapoRub – Rubbed on nails daily
- Baking soda – Mixed into a paste and applied to nails
- Coconut oil – Applied liberally over nails 1-2x daily
- Garlic – Crushed to make antifungal paste
- Hydrogen peroxide – Used as daily 5-minute soaks
- Ozonated oils – Applied daily for 3-6 months
There is very limited evidence that these home remedies work. Any effects likely depend on the individual and persistence with application. They should not replace standard treatments.
Lifestyle and prevention tips
Practicing good foot care and hygiene can help prevent recurrence and speed healing:
- Wear clean, dry socks and rotate shoes daily
- Wash and fully dry feet daily
- Trim nails short and avoid picking at nails
- Wear shower shoes in public pools, showers
- Disinfect home pedicure tools after use
- Avoid sharing shoes, socks, towels
- Apply antifungal powder to feet and shoes
- Treat athlete’s foot promptly
Does toenail fungus go away on its own?
In rare cases, toenail fungus resolve spontaneously without treatment. However, most cases persist for years and gradually worsen over time without proper antifungal treatment. Left untreated, the infection can spread to other toenails and even fingernails in some instances.
Seeking timely medical treatment provides the best chance for clearing toenail fungus. With oral medications or laser treatments, many patients see improvements within a few months. However, it takes 6 to 12 months or longer to cure the infection, replace the damaged nail, and prevent recurrence.
When to see a doctor
It’s a good idea to see a podiatrist or dermatologist if you suspect toenail fungus instead of self-treating. A doctor can confirm it’s fungal infection and not another condition. They will also determine the type of fungus and best treatment options to eradicate it for good.
See a foot doctor promptly if you have:
- Thick, discolored nails
- Brittle, crumbly nails
- Debris building up under nails
- Nail detachment from bed
- Foul nail odor
- Family history of toenail fungus
Treating toenail fungus at early stages leads to faster recovery times. Severe infections that run deeper into the nail bed are harder to tackle.
Conclusion
Toenail fungus is a challenging infection that can take nearly a year or longer to fully cure. The toenails grow slowly, so it takes time to outgrow damaged parts and replace the nail. With oral antifungals or laser treatments, it may take about 3-6 months to see significant clearing and growth of new nail. Milder cases resolve faster in 9-12 months, while severe infections can persist for 12-18 months or longer.
Staying diligent with proper treatments speeds the healing process. However, the most important thing is patience and persistence. With regular care, the healthy nail can fully regrow and fungal infection will eventually resolve. Seeking treatment early leads to better outcomes. Be sure to follow preventive steps to avoid recurrence once the nail fungus clears.