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What Makes an Effective Topical Antifungal?

What Makes an Effective Topical Antifungal?

Toenail fungus is a problem that many people deal with at some point in their life. Not only is fungus unsightly and embarrassing, but it can also be extremely difficult to get rid of. There are a lot of over-the-counter topical antifungals available at virtually every pharmacy and even on Amazon, but how do you know what is product is actually going to work? Don’t waste one cent more on products that won’t yield results. I’ll tell you exactly what you need to look for in an effective antifungal.

If you are in the beginning stages of a nail fungus infection, then you might be able to clear it up with just a topical antifungal. The beginning stages of nail fungus is called superficial white onychomycosis and looks like little white dots on your nail. You’ll often see this after removing nail polish. If you have toenail fungus, you want to catch it at this stage because it is a lot easier to treat.

What Is The Major Ingredient in Most Topical Antifungals?

There is a plethora of topical antifungals out there to choose from which can be very overwhelming. I did a quick search on Wal-Mart and Amazon for topical antifungals for onychomycosis and found that the active ingredient is tolnaftate in the majority of products. Tolnaftate is an antifungal agent, but it is mostly used for skin infections such as athlete’s foot. While tolnaftate is effective for athlete’s foot, studies have found that it is not recommended for the treatment of onychomycosis because it does not penetrate the nail bed well. So those antifungals that have the active ingredient as tolnaftate are less likely to be effective in treating fungus.

What Ingredient Should You Be Looking For in a Topical Antifungal?

So, what ingredient should you be looking for? Our topical antifungal, Repair, contains clotrimazole as its active ingredient. We have found this to be much more effective when treating our patients for fungus. Repair also contains tea tree oil which is a natural antifungal. A lot of people try tea tree oil at home before seeking professional help and it can be effective depending on the severity of your condition. Combining clotrimazole with tea tree oil on increases the efficacy of the product. Applying Repair daily and taking a prescription strength nail vitamin, called Theranail, should clear any superficial onychomycosis.

Repair also has a key ingredient to help thin the nail: urea. There are no over-the-counter antifungals that offer both powerful ingredients.

Laser Therapy

If you have a progressed case of fungus, topical antifungals alone will not clear it up. When I say progressed fungus, I am talking about nails that are thick, yellow and/or crumbly. For nails like these, the best course of action to do a combination of treatment. I recommend using topical antifungals in conjunction with laser treatment. Laser therapy promotes healthy nail growth by increasing circulation to the affected toes. Our FDA cleared is painless and has no harmful side effects. Laser treatment is approximately 90% effective and, combined with the use of a topical antifungal, will significantly increase your chances of having a healthy toenail.


If you are not interested in topical solutions or laser treatment, there is an oral medication called Lamisil that is used to treat toenail fungus. Lamisil was long considered the gold standard for treating toenail fungus, but in recent years it was discovered that this medication is harsh on the liver. If you have problems with your liver or take medications that already affect your liver, such as cholesterol medication, you are not a candidate for this medication. If you have circulation problems, you are not a candidate for this medication either. Lamisil has to travel through the blood stream and if you are not getting circulation to your feet, how much of the medication is actually getting to your toes?

If you are a candidate for Lamisil, we obtain blood work before prescribing the medication to make sure your liver function is good. We will continue to monitor your bloodwork while you take Lamisil.

Treating toenail fungus is simple and straight forward, but it is a slow process. It can be a frustrating and time-consuming endeavor, but we’re here for you. Stay patient! If it’s treatment options that make your brain hurt (or other related problems) then don’t hesitate to get in touch with us at or schedule an appointment online.