Nail fungus, medically called onychomycosis, is caused by the same dermatophyte fungi that cause skin ringworm, but embedded under and within the nail plate — making it far harder to treat than skin infections.
It's more common in toenails than fingernails, since toenails sit inside shoes for long periods and receive less blood flow, slowing the body's ability to clear the infection.
Nail separating from the skin underneath (onycholysis)
Some cases have an unpleasant odor from the infected nail
How Nail Fungus Differs From Other Nail Problems
Not every abnormal nail is caused by fungus:
Nail trauma bruising: a localized dark purple-black spot, not spreading or progressively thickening like fungus
Nail psoriasis: small pitting on the nail surface, usually with psoriasis skin patches elsewhere
Brittle nails from nutrient deficiency or chemical exposure: cracking without the yellow/cloudy discoloration typical of fungus
If unsure whether a nail problem is fungal, have a doctor or pharmacist check before starting treatment, since fungal treatment takes much longer than other causes.
Why Doesn't Topical Cream Work Well for Nail Fungus?
Because the nail plate is hard and thick, topical cream cannot penetrate deep enough to reach the fungus embedded underneath — unlike skin, where cream reaches the infected layer directly.
Topical nail lacquers have a much lower cure rate than oral medication, especially when more than 50% of the nail is affected or the infection extends to the nail base.
How to Treat Nail Fungus — Oral Medication Is the Main Option
Oral Itraconazole — Itraconazole (Spornar 100) — is the primary option doctors use for nail fungus because it accumulates in nail tissue, penetrating the whole nail far better than cream.
Precautions
Must be used only under a doctor's or pharmacist's prescription
Disclose liver conditions or other regular medications before starting, due to potential drug interactions
For longer courses, the doctor may schedule periodic liver function monitoring
For skin around the nail that may also be infected, a cream such as Canesten Cream can be used as an adjunct, but does not replace oral medication for the nail itself
Fingernails take several weeks or more, while toenails take much longer since they grow many times slower than fingernails. Treatment isn't complete when the nail merely looks better — it continues until the entire nail has grown out fungus-free.
A doctor or pharmacist determines the appropriate duration based on each case's severity and location, with periodic follow-up.
Nail Care During Treatment
Keep nails trimmed short, gently file down thickened areas
Wear breathable shoes, avoid prolonged use of closed, non-ventilated footwear
Keep nails trimmed short and consistently maintained
Dry hands and feet thoroughly, especially after bathing
Don't share nail clippers, files, or shoes with others
Treat athlete's foot or nearby skin fungus at the same time to prevent it from re-infecting the nail
Choose a nail salon that properly sterilizes tools, or bring your own personal set
Frequently Asked Questions
Almost all cases need oral medication (e.g. Itraconazole) combined with keeping nails trimmed and dry. Treatment continues per the doctor's instructions until a new fungus-free nail fully replaces the old one.
Usually not enough — cream cannot penetrate the hard, thick nail plate to reach the fungus. It only works for mild infections not reaching the nail base; most cases need oral medication too.
Much longer than fingernails since toenails grow more slowly. A doctor or pharmacist determines the appropriate duration based on severity, with periodic follow-up.
A bruised nail from trauma is a localized dark purple-black spot that doesn't spread or thicken. Nail fungus progressively thickens, turns yellow/cloudy, and spreads if untreated.
Yes, it can spread through shared nail clippers, shoes, or damp communal areas like shower rooms. Avoid sharing personal items while infected.
Use only under a doctor's or pharmacist's prescription. Disclose liver history or other regular medications before starting due to potential interactions, and liver function may need periodic monitoring for longer courses.
Most nails return to normal once a new nail fully grows out. In severe or delayed cases, the nail shape or texture may show minor permanent changes.
Left untreated, the fungus can spread to nearby nails or surrounding skin, the nail becomes progressively more thickened and misshapen, and may cause pain when walking or wearing shoes — especially important to treat early in people with diabetes to reduce infection risk.
⚠️ Disclaimer
The information on this page is for general informational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment from a qualified doctor or pharmacist. If you have any questions about your symptoms or medication, always consult a doctor or pharmacist first.
Myda-B
Tonaf Cream
Travogen Cream (Isoconazole Nitrate 1%) 10 g
Nizoral Cream (Ketoconazole 2%) Antifungal Cream 15g
Canasone-CB
Spornar
Canesten Vaginal Tablet 100mg, 6 Tablets — Yeast Infection Treatment
Zema Cream Antifungal Cream 10 g
Zema Lotion Antifungal Skin Treatment 15 ml
Canesten Cream Antifungal Clotrimazole 1% 10g
