The best treatment for fungal infections of toenails is to use an oral agent. In Canada there are two medications that are approved for treating fungal toenail infections. These are terbinafine and itraconazole. Terbinafine is taken once daily while itraconazole is taken for one week each month. Both agents need to be taken for three months.

When the treatment course is complete, the nail will still show dystrophy. It’s very important to inform the patient that the nail will still look unusual for up to 12 months. There’s no indication for treating the nail infection for longer than three months.

If your patient is unable to take any of the oral agents, there’s a topical laquer that can be painted onto the nail. However, the rate of clearance is not as good as the oral medication. Furthermore, this therapy takes at least 12 months to be successful.

Fingernail infections only require two months of therapy. You can use the same medications that are used for treating toenail infections.

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