Toenail fungus or onychomycosis as called by doctors, is a nail disorder that describes about half of the total onychopathies. 1 Scientists estimate that onychomycosis is a disorder that affects more than 4% of the population in Europe and North America, but in some countries estimations raise these numbers up to 26%.2-3
Onychomycosis, which is a fungal infection, affecting toenails and to a lesser degree finger nails4, is a public health problem able to cause serious complications.2 Toenails are affected more often because they grow slower than fingernails, providing more time to the fungus in order to act and infect the area. 1 Species of three genera cause onychomycosis to humans: Trichophyton(the most common), Microsporum and Epidermophyton. They invade tissues such as hair and nails.5
Some of the most common risk factors are2,5:
- Age, older individuals- higher risk
- Gender, male- higher risk
- History (family or personal) of previous infection
- Exercise or sports in which chronic minor trauma to the toes is sustained
- Exposure to moist environments. Walking barefoot in places such as swimming pools, gyms increases the possibility of transmission of the causative organisms.
- Peripheral vascular disease, diabetes, psoriasis, HIV patients.
There are serious consequences caused when onychomycosis remains untreated. The most common symptoms include inflammation, swelling, pain, yellow discoloration and thickening of the nail. Moreover, toenail fungus may result to permanent damage to the nail plate and its attachments. In additions there is the possibility of development of secondary infections with bacteria and local spread or spread of the infection to other parts of the body, and transmission to others.6
The diagnosis of onychomycosis is usually based on the clinical examination, signs and symptoms, especially when few nails are involved. In more serious cases, laboratory confirmation is the best option. A definitive diagnosis of the toenail fungus can be done in laboratory using a potassium hydroxide (KOH) preparation.7
Onychomycosis is not usually resolved without treatment. Considering the situation, you can choose the treatment option. Some treatments include oral antifungals, topical antifungals, laser therapy, debridement, alternative home remedies. The cost of modern medicine combined with the tendency of many people to search for alternative ways of treatment, lead more and more patients to try home remedies in order to battle onychomycosis.
Here are some of the most popular Home Remedies against toenail fungus:
Vicks VapoRub: A number of studies showed the antifungal activity of essential oils extracted from Eucalyptus species. Eucalyptus oil is the basic ingredient of the Vick’s VapoRub medicine. According to a study of 18 participants, 83% of them showed a positive treatment effect after the application of Vicks VapoRub. About 1 out of 4 participants had a mycological and clinical cure at 48 weeks and almost half of them had partial clearance of onychomycosis.8
Snakeroot extract. It is produced by a plant that belongs to the sunflower family. A study showed that it was about as effective as a synthetic antifungal agent for topical use. It needs a 3 month application, every third day for the first month, twice a week for the second month and once a week for the third month.9
Tea tree oil. Despite the fact that it is considered as a potential nail fungus treatment, more research should be conducted .9Before using it, you have to clean the infected areas with rubbing alcohol and then apply the tea tree oil to the affected nails and let it soak in. After 10-15 minutes, you have to scrub the nail with a soft bristle toothbrush. It is better to combine tea tree oil application with olive oil. The application should continue up to 2 weeks after the new healthy nail grows out. completely.10
Clove oil. The activity of clove oil was verified and showed powerful activity. When the antifungal activity was tested in onychomycosis the oil was effective. Against some Candida species it proved to be more effective than a commonly used medication.
Thyme oil. Thyme essential oil is a strong antifungal against clinical isolates from onychomycosis. In a study of 39 patients presenting paronychia, the application of thyme essential oil in chloroform was related to a 60 % of relief and 15 % of cure after 3 months of treatment.
Oregano Oil. The most antifungal active chemotypes are those that present carvacrol and thymol as major compounds. Combining 2 drops of oregano oil with 1 drop of olive oil and applying it to the infected area twice a day, may eliminate onychomycosis in 3 weeks.
Essential Oils from Lavandula spp. They show strong antifungal activity, mainly for dermatophytes.4 You need to apply a few drops of lavender oil to the infected area every night and let it soak in until morning.10
Baking Soda and Sodium Borate.It is widely known that fungus needs an acidic environment to flourish. Baking soda creates an environment that doesn’t let toenail fungus to spread. Sodium borate, which is a naturally occurring mineral, is another fungicide, which combined with baking soda, create a mixture able to cure nail fungus efficiently. Mix equal parts of the above 2 ingredients with just enough water to form a paste. Wet feet and gently rub the mixture onto infected nails.10
Apple Cider Vinegar. After onychomycosis occurs, the pH of the surrounding area and nail becomes more basic or alkaline in nature. The fungus thrives in an alkaline environment, so when the pH of the area turns from basic to more acidic, the fungus cannot survive. This is where the apple cider vinegar becomes useful. The vinegar is acidic but still mild enough to not damage the surrounding skin and nail.11Mix equal parts apple cider vinegar and water. Soak the infected nail in the solution for 30 minutes. Remove nail from solution and dry completely. Repeat daily for 4 weeks.12
Listerine Mouthwash. Listerine is widely used to treat toenail fungus infections. It is a much cheaper solution in comparison to drugs to treat toenail fungus infections and it does not cause any side effects. The acceptance of this product as a toenail fungus treatment has no scientific base and provides no medical guarantee that toenail fungus can be improved by the topical application of Listerine. The suggested application to treat toenail fungus is soaking your feet for 30 minutes every day, but only for a few days, take a rest, and back again.13
- Keep your hands and feet clean and dry.
- Wear well-fitting shoes and socks that absorb sweat.
- Replace old shoes that you believe are contaminated with fungi
- Use an antifungal spray or powder
- Wear rubber gloves.
- Don't trim or pick at the skin around your nails.
- Don't go barefoot in public places, instead wear special shower shoes are available to protect your feet.
- Wash your hands after touching an infected nail.11,14
To sum up, patients in some special populations are at higher risk for nail infections. Treatment in these groups of population may be complicated by the presence of systemic illnesses and might require the use of multiple medications. The use of home remedies can cure the onychomycosis, but sometimes it can be supplementary to the medical treatment. If the disease is not limited to the toenails, you should visit a dermatologist for further examination. Even when the nail looks healthy after treatment, it may still be hiding traces of fungus. The best practice is to continue topical treatments for a couple of weeks after the infection disappears.
- 2015 May-Jun;13(3):240. Onychomycosis. Bernhardt M
- J Am Podiatr Med Assoc. 2015 Sep 25. [Epub ahead of print] Diagnosis and Management of Onychomycosis: Perspectives from a Joint Podiatry-Dermatology Roundtable. Markinson BC, Vlahovic TC, Joseph WS, Scher RK, Tosti A, Plasencia J, Pariser DM.
- 2015 May;95(5):E15-21. Onychomycosis treatment in the United States. Taheri A, Davis SA, Huang KE, Feldman SR.
- 2015 Oct 19. [Epub ahead of print] Essential Oils for Treatment for Onychomycosis: A Mini-Review. Flores FC, Beck RC, da Silva CB
- Semin Cutan Med Surg. 2013 Jun;32(2 Suppl 1):S2-4. The epidemiology, etiology, and pathophysiology of onychomycosis. Scher RK, Rich P, Pariser D, Elewski B.
- J Am Acad Dermatol. 1996 Sep;35(3 Pt 2):S2-5. Onychomycosis: a significant medical disorder. Scher RK.
- Semin Cutan Med Surg. 2013 Jun;32(2 Suppl 1):S5-8. Diagnosis, clinical implications, and complications of onychomycosis. Rich P, Elewski B, Scher RK, Pariser D.
- J Am Board Fam Med. 2011 Jan-Feb;24(1):69-74. doi: 10.3122/jabfm.2011.01.100124. Novel treatment of onychomycosis using over-the-counter mentholated ointment: a clinical case series. Derby R, Rohal P, Jackson C, Beutler A, Olsen C.
- https://www.mayoclinic.org/diseases-conditions/nail-fungus/basics/alternative-medicine/con-20019319 [retrieved 6 December 2015]
- https://www.naturallivingideas.com/top-10-natural-remedies-for-toenail-fungus/ [retrieved 6 December 2015]
- https://www.livestrong.com/article/110938-apple-cider-vinegar-toenail-fungus/ [retrieved 6 December 2015]
- https://homeremediesforlife.com/apple-cider-vinegar-nail-fungus/ [retrieved 6 December 2015]
- https://www.healthguidance.org/entry/4950/1/Listerine-Treatment-For-Toenail-Fungus.html [retrieved 6 December 2015]
- https://www.nhs.uk/conditions/Fungal-nail-infection/Pages/Introduction.aspx [retrieved 6 December 2015]