6 best remedies for nail fungus
Among all fungal lesions, the most dangerous are systemic mycoses, which affect the internal organs of a person and can lead to death. Such serious diseases are often found in HIV-infected patients in the AIDS stage, with profound impaired immunity. But even in a normal, healthy person with a normal immune status, there can be fungal infections of the skin, and especially of the nails. These diseases are called onychomycosis, and they can be cured with the proper use of antifungal drugs (they are called fungicides, or antimycotics), and with careful observance of the principles of secondary prevention.
The fact is that, located in the depth of the nail plate, the fungus is protected from all harmful factors. It has the most favorable conditions for growth and reproduction, especially when it comes to toenails. A person is almost always during the day, especially in winter, in closed shoes. This gives the fungus the necessary darkness and the absence of harmful ultraviolet radiation, moisture and excess nutrients. The nail plate, in addition, mechanically protects the fungus. All this makes the treatment of onychomycosis difficult, especially if the damage to the nail plate is significant, but there is no indication to remove the nail.
There are various means, both for local and for internal use for the treatment of onychomycosis. Drugs taken orally must be prescribed by a dermatologist, taking into account indications and contraindications. But even local treatment must begin after the initial consultation of a specialist, and taking the nail discharge for analysis to confirm the diagnosis. This rating includes the most modern and popular means for the treatment of nail fungus. But before we begin the review of fungicidal agents, it is necessary to tell a little about antifungal ointments and creams.
Ointments and creams do not cure nail fungus
There is a common misconception that with the help of various ointments and creams you can cure nail fungus. Unfortunately, this is far from the case. Ointments and creams are designed for application to the skin and mucous membranes. Only with the correct use of the agent, the active substance is quickly absorbed and the necessary fungicidal concentration is created. Therefore, the entire rich range of creams and ointments from the fungus, mainly intended for the treatment of ringworms, or fungal infections of the skin, for the treatment of vaginal candidiasis and other similar localizations.
Such well-known drugs as Nizoral-cream, Lamisil, containing terbinafine, Zalain, Mifungar, Candide, and other soft dosage forms are too weak to treat onychomycosis, and are not intended to treat nail fungus. They will not be able to penetrate the thickness of the nail, which consists of keratin. Keratin protein is strong enough, and frustration from such an incorrect treatment of onychomycosis will be significant, especially if large amounts of money are spent on the cream or ointment.
There is another danger here. Those minimal concentrations that will still pass through the nail and reach the fungus, but not kill it, will help it to adapt to this active substance, and develop fungicide resistance in the fungus.
However, antifungal ointments and creams are completely used in nail onychomycosis for application to the surrounding nail skin, on the interdigital spaces, and can be used in the complex therapy of onychomycosis to prevent the spread of the fungus from the nail to the nearby soft tissue. This explains the inclusion in official instructions of such indications as “onychomycosis.”
Important! The only exception when antifungal creams and ointments are shown is when the patient has already completely removed the nail, and the tool can be rubbed directly into the bare nail bed. This is done several times a day until healthy nail tissue grows.
If we are talking about the popular salicylic ointment, then it is used as a keratolytic agent for foot fungi, and for nail fungi, its task is to soften and remove excess keratinous masses that accumulate in abundance mainly on heels, in middle-aged and elderly people, and are a food source for fungus. It is known that the crumbling masses released from under the nail affected by the fungus contain a large amount of mycelium - the “embryos” of the fungus.
Spreading along the inner surface of the shoe, along the insoles and slippers, socks, the mycelium of the fungus enters the cornified mass, gradually moving from the subungual space to the skin, first into the zone of interdigital spaces, and then the feet. Therefore, the use of salicylic ointment for onychomycosis of toenails is shown as a prophylactic agent, depriving fungi of nutrients. But this ointment is not a fungicidal or real antifungal drug with proven activity. Now you can go to the rating of really popular and effective drugs for the treatment of nail fungus.
Rating of the best remedies for nail fungus
| Nomination | a place | Name of product | price |
| The best fungicidal fluids and varnishes from nail fungus | 1 | Exoderil | 564 ₽ |
| 2 | Lac Batrafen - ciclopirox | 2 035 ₽ | |
| 3 | Lac Loceryl | 828 ₽ | |
| The best tablets for oral administration | 1 | Lamisil | 546 ₽ |
| 2 | Diflucan | 412 ₽ | |
| 3 | Orungal | 2 855 ₽ | |
| The secret of the correct treatment of nail fungus | |||
The best fungicidal fluids and varnishes from nail fungus
Immediately you need to explain that the treatment of nail fungus with fluids and varnishes is a regular and daily process. There is a rule: until the nail plate is completely refreshed, there is no guarantee that the fungus is eradicated. It is known that the nails on the legs are updated much more slowly than on the hands, and the complete replacement of the big toe nail can be from 9 months to one year.
Therefore, in the event of a lesion of the thumb (and this occurs most often), it is precisely this duration of treatment that is needed, and then you need about 2 more weeks of applying the remedy to a fully updated and healthy nail plate, in order to avoid relapse. This applies to fluids, it can also be applied to antifungal lacquers, and even to the means of folk therapy. If the patient treats the nail fungus for one day, or one month, there will still be no sense from it. There will be a relapse of onychomycosis.
Important! Only local means, that is, fluids and varnishes, can treat nail fungi only if a person has no more than 3 nails affected, and each of them is no more than 50% in size, counting from the free edge. In the event that more nails are affected, there is a fungal infection of the skin, or the fungus's breeding area is localized on the growth side of the nail plate, then it is necessary to combine the application of local agents with the intake of antifungal drugs.
Exoderil (Micoderil, Exostat) - Naftifine
Rating: 4.9
Exoderil for the treatment of onychomycosis is produced by the well-known pharmaceutical concern Sandoz, and is represented by a 1% solution of naftifine. This compound belongs to the class of allylamines, and inhibits the synthesis of new elements of the fungal cell wall. For the treatment of nail fungus, Exoderil is applied twice a day to the affected nail, taking care not to touch the periungual skin.
Before you apply the tool for the first time, you need to cut the free edge of the nail plate as much as possible, and sand the affected part of the nail parallel to its surface with a special file to make the nail plate in the affected area as thin as possible. It is necessary that the concentration of naftifine under the nail plate was the highest.
The kit also includes special disposable files, which serve to grind the surface of the nail for better contact of the liquid with the nail plate. This light sanding should be done before each application. Such treatment must be carried out for at least 4 months, without a permit, but the best period is 6 months. Exoderil can be purchased in 10, 20, and 30 ml bottles. Their average cost is 520, 880, and 1350 rubles, respectively. in autumn 2024 prices for large cities of the Russian Federation.
Advantages and disadvantages
The advantage of Exoderil is a proven property to cure onychomycosis caused by dermatophytes. In that case, if the nail is affected by yeast fungi, then the drug can not kill the fungus, but only prevents its reproduction, that is, to act fungistatic. That is why the primary analysis of the fungus, held in the skin and venereal clinic.
The concentration of exoderil in the thickness of the nail with uncomplicated onychomycosis is considered sufficient to apply the agent no more than 2 times a day. Naftifine is contraindicated in case of individual hypersensitivity, during pregnancy and during breastfeeding. Sometimes a side effect occurs, especially if the liquid is accidentally applied to the surrounding skin. Then dryness, burning and redness of the skin may occur. But in the event that the medicine is applied according to the instructions without gaps, and all the rules of prevention are observed, then the percentage of cure for onychomycosis will be very high.
Important! Each time you apply antifungal fluid, or any varnish, you must use disposable nail files, paddles, disposable wipes, and other disposable tools. It is strictly forbidden to grind and file the affected nail with one nail file, and all the more it is forbidden to use this nail file for processing other nails.
Lac Batrafen - ciclopirox
Rating: 4.8
Batrafen is a clear varnish that contains the active ingredient ciclopirox-olamine. Varnish exhibits high fungicidal activity against more than 40 varieties of fungi. Cyclopyrox inhibits the metabolism of fungal cells, and prevents their metabolism with the external environment.
The basic principles of preparing nails for applying nail polish are similar to those of the above described Exoderil, since they are the same. At first, the nail that is affected by the fungus is cut as short as possible, then the remaining nail plate should be sanded with a nail file to create an uneven surface. It will increase the area and durability of drawing a varnish. It is necessary to apply varnish with specially applied disposable paddles with a thin layer; the effect will not depend on the layer thickness. The order of application is as follows:
- during the first month the varnish is applied every other day;
- for the second month - twice a week;
- on the third month - weekly.
During the course of treatment, it is necessary to remove every applied lacquer every week with the usual cosmetic nail polish remover, then shortly trim the nail again and prepare it for applying the varnish for the next week.
According to the prescribing physician, depending on the type of fungus, other options are possible: for example, for one and a half months the varnish is applied every other day, for the next one and a half months - twice a week, for the next one and a half months - weekly.
The maximum duration of Batrafen treatment should not exceed six months. The famous pharmaceutical company Sanofi-Aventis produces Batrafen, and a small bottle of lacquer with a volume of 3 ml has an average cost of 2,200 rubles.
Advantages and disadvantages
Lac Batrafen is one of the most effective means for the treatment of onychomycosis, both in the form of monotherapy in uncomplicated forms, and in the form of complex therapy in combination with the internal use of drugs. Batrafen is well tolerated, practically does not cause intolerance and allergic reactions. Once opened, a bottle of varnish is stored for 6 months, provided it is tightly sealed. In the event that the purchased bottle was kept closed, then its shelf life is not more than 3 years.
Of course, the relative disadvantage is the high price, but it must be remembered that this tool really has proven effectiveness, and it has not yet been represented by its counterparts or generics. It is known that physicians with very limited financial resources may prescribe cheap medications, such as Nystatin and Levorin in pills, and recommend smearing iodine tincture on the affected fingers. This type of treatment will be extremely cheap, but its effectiveness is almost nil.
Lac Lotseril (Oflomil, Ekzolorfinlak) - amorolfin
Rating: 4.7
Another representative of highly active varnishes from the fungus is Loceryl. And, if Batrafen had no analogues or generic drugs, then Loceryl had two of them: Oflomil and Ekzolorfinale Lac. The first drug is manufactured by Glenmark, and the second is Sandoz. The original Lotseril is produced by the French company Galderma.
The active ingredient of Lotseril is amorolfine. Sold Lotril in the form of a set. The varnish is packaged in 2.5 or 5 ml bottles. Special wipes with isopropyl alcohol are used to clean the nails before applying, disposable nail files, as well as special spatulas for applying and evenly distributing the varnish. The active ingredient amorolfin disrupts the synthesis of structural components of the cell of the fungus, which are sterols. After the accumulation of abnormal and incorrectly synthesized sterols inside the fungal cell, the fungal cell is gradually destroyed.
The rules for applying Lotseril are simpler than those of Batrafen. It is necessary to apply varnish either once or twice a week. The sequence of operations is as follows: first, the nail file removes all areas of the nail plate that are affected by the fungus, cut off the free edge as much as possible, then treat the surface of the nail with napkins with isopropyl alcohol, then apply a varnish. Unlike Batrafen, Lotseril does not have a limit on the duration of the course of treatment. Treat as much as necessary, up to the duration of treatment for 1 year.
The cost of one small bottle of Lotseril in 2.5 ml 800 rubles. A small bottle of Oflomil - lacquer costs 688 rubles, and the cost of the Ekzolfolfak is 798 rubles for the same dosage. As you can see, the price range is small. The cost of a large bottle is, on average, 1300 rubles.
Advantages and disadvantages
The only drawback of Lotseril and its analogues is such a side effect as a temporary slight burning sensation in the place of application of varnish. Also, this tool is contraindicated for application in children, and refers to newborns and babies under the age of three years. The manufacturer recommends not to use during the treatment of cosmetic varnish, as well as artificial nails, as this may lead to a lack of effectiveness of treatment, and to a relapse of onychomycosis.Loceryl is also highly effective with proven efficacy, but, unlike Batrafen, it is much more affordable and consumers can buy a bottle of 2.5 ml, or 5 ml, depending on the duration of the upcoming treatment.
Important! The main advantage of all local preparations used to eliminate nail fungus is the absence of various side effects and symptoms of intoxication that may occur when prescribing drugs for internal use, and especially overdosing.
The disadvantage that is common for this group of agents is that the drug may not always reach the pathogen, especially if the fungus is located in the region of the nail bed, or in the structures of the nail matrix. If the nail is significantly thickened, that is, there are phenomena of hyperkeratosis, then you need to resort to such means as removing the nail plate, cleaning the nail bed. If the fungus is affected by the nail matrix, then treatment with local means will not reach its goal. Then it is recommended to prescribe systemic drugs prescribed in the form of tablets.
The best tablets for oral administration
In the event that a patient with onychomycosis has a fungal infection of the nails beyond the maximum permissible limits described above, then the doctor will prescribe along with local remedies for the treatment of onychomycosis and tablets. There are a very large number of antifungal agents, but since each original drug has 5-6 commercial copies, or generics, other companies, and even more, the number of the most effective tablets for the treatment of nail fungus is significantly reduced.
Below are listed medicines that are used to treat onychomycosis. It is very important to understand that if local remedies for the treatment of nail fungus can cope with minor manifestations of infection on their own, then the tablets of nail fungus used alone cannot be cured. Their task is to create from the inside, in the blood, a high concentration of antifungal substance. Thus, the fungus will not have a chance to get rid of adverse conditions of existence. A local preparation will act outside, and the tissues of the subungual space will be saturated with fungicides coming from the blood.
Lamisil (Terbizil, Binafin, Thermicon, Exiter, Exifin) - terbinafine
Rating: 4.9
In modern dermatological practice of treating onychomycosis, terbinafine is a first-line drug, or drug of choice. Terbinafine is a synthetic allylamine with a high level of antifungal action. The mechanism of action of this substance is a violation of the synthesis of structural elements of fungal cells. With long-term use of Lamisil tablets, the fungicidal concentration is created not only in the subungual space, but also in the skin and hair.
Take Lamisil with onychomycosis, and any localization, it is necessary to take 250 mg per day (once a day), on average, for one and a half months. These are adults and children weighing more than 10 kg. In some cases, treatment can last up to 3 months. The duration of treatment depends on the growth rate of the nails, which is individual.
Lamisil is an original drug, and therefore its cost is the highest. It is produced by the Swiss company Novartis Pharma, and the minimum cost of a two-week course of treatment, that is, a pack of 14 tablets is 1,820 rubles. The average cost of this package ranges from 2370 rubles. Of course, this is expensive for the average Russian consumer. After all, the cost of the course will already be more than 14 thousand rubles, if we take the average market price of packaging.
You can offer more affordable options.Thus, the drug terbinafine Teva, produced by the eponymous Israeli firm, will cost 600 rubles, and for 28 tablets. Perhaps the most affordable price will be terbinafine, produced by the domestic company Vertex. So, 30 tablets of this drug, calculated on a monthly course, can be found at a price of 400 rubles and above. But the question of the quality of the original substance and the results of treatment in this case remains open.
Advantages and disadvantages
Lamisil is an international standard for the treatment of not only onychomycosis, but also fungal diseases of other localizations. But, since this drug is quite serious, it has a range of side effects. It is usually well tolerated, but the most frequent adverse symptom will be headache, taste disturbance, rarely bile stasis may occur. Most often there is a loss of appetite, a feeling of fullness in the stomach, and various allergic skin reactions, such as urticaria and rashes. Some patients complain of joint and muscle pain. Terbinafine may affect the metabolism of other drugs in the body.
That is why it is necessary to carry out treatment only under the supervision of a physician. This drug is contraindicated in breastfeeding and during pregnancy. Terbinafine is not used in children under two years of age, and children older than two years have accumulated extensive clinical experience with this drug, and its tolerability is good.
Diflucan (Diflazon, Mikomax, Mikosist, Fanfiflu, Flucostat) - fluconazole
Rating: 4.8
Diflucan, also known as original fluconazole, is also a powerful antifungal drug, and is used not only for onychomycosis, but also for skin lesions, for severe fungal infections of the internal organs, including HIV infection, as well as for the development of fungi on the background reduced immunity in the treatment of malignant neoplasms.
Fluconazole is available in tablets and capsules, and even in solutions for intravenous infusions. For the treatment of fungal nail infections, the dosage of Diflucan 150 mg in one capsule is most acceptable. For onychomycosis, it is recommended to take fluconazole in one such capsule weekly for 3 to 6 months. According to the testimony of the duration of the course can be changed by the attending physician. The same dosage of Diflucan is also used for mycoses of the feet, skin, and inguinal lesions. For comparison, you can specify that with deep and systemic fungal lesions of the internal organs, it may be necessary to use fluconazole at a dosage of 2 capsules per day for up to a year or longer, so the prescription of 150 mg per week can be considered very benign.
Diflucan is produced by the well-known pharmaceutical company Pfizer, and a package of 12 capsules for 3 months of treatment, which is a course of the minimum duration, on average costs 2,200 rubles. Of course, this can also be considered a large amount, but still it is already the cost of the whole course, and it is 6 times lower than when using Lamisil.
There are more available options for fluconazole. So, one of the cheapest, if not the cheapest, is fluconazole - Verte, a domestic manufacturer of ZAO Kanonpharma Production. Two capsules will cost only 20 rubles, respectively, the exchange rate The cost of such a domestic fluconazole, calculated on 3 months of admission, will be only 120 rubles. This is 18 times cheaper than the cost of the original drug. Most of the cost of any drug is the active ingredient, or substance. Therefore, the question of the ratio of price and quality in the case of choosing such a cheap drug will also be open.
Advantages and disadvantages
The main advantage of fluconazole in the treatment of fungal nail diseases is the excellent ratio of price / quality, if we are talking about the original drug, Diflucan, and relatively expensive generics (Mikosist).Since it is necessary to take the drug only once a week, the exchange rate cost is significantly lower compared to the original production of terbinafine. Therefore, a large number of doctors prefer Diflucan as a first-line drug, if necessary, to prescribe treatment with oral medications.
However, such an excessive enthusiasm for fluconazole entails the risk of low-sensitivity varieties of fungi, by analogy with the resistance of bacteria, which develops to commonly used antibiotics.
Like any serious drug, it can cause side effects, although tolerability is usually good. The most common headache, abdominal discomfort, skin rash, with prolonged use in high doses may have a toxic effect on the red bone marrow, and toxicity to the liver. Fluconazole interacts with a variety of other drugs, so only a doctor should prescribe and control treatment. But a good quality fluconazole will always be necessary in the treatment of fungal nail infections, if there are indications for its use.
Orungal (Irunin, Kanditral, Orungamin, Orunit, Rumikoz) - itraconazole
Rating: 4.7
Itraconazole is a reserve agent, and is used in cases where there are contraindications to the use of terbinafine and fluconazole, or if the first two drugs for some reason develop resistance to the fungus, although such cases in clinical practice almost never occur.
The original Itraconazole, or Orungal, is available in 100 mg capsules, and is used for fungal nail infections immediately after eating, and two schemes of its use are known:
- according to the first treatment regimen of fungal nail infections, the administration of 2 capsules per day (200 mg daily) for 3 months is recommended;
- The second scheme involves taking 4 capsules per day (2 in the morning and evening), while it is applied at 1 and 5 weeks from the start of treatment.
The first scheme is distinguished by a low constant dosage, and the second scheme is doubled, the “shock” dosage, but not in the form of a constant, but an intermittent course. For the treatment of fungal nail infections in children, itraconazole is not used. The manufacturer also recommends a longer treatment for the treatment of lesions of the nails of the toes than in the case of lesions of the nail plates of the fingers. This is completely justified, since the causative agents of onychomycosis in the legs are more comfortable and more protected, said in the introduction to the rating.
Produces Orungal famous pharmaceutical concern Janssen Cilag, Italy. The cost of this drug is also very high. So, packing in 14 capsules costs, on average, 3150 rubles. Even if you try, and find the minimum price, it is hardly possible to find Orungal, cheaper than 2,200 rubles. This means that the cost of a three-month course on the first scheme will be more than 28 thousand rubles, and on the second scheme - about 9 thousand, which is much more profitable.
As in all previous cases, there are more affordable and cheaper counterparts. If you buy an anti-fungal drug Orunit, manufactured by Obolensky, in a pharmacy, one pack of 15 capsules will cost from 617 rubles, which means that the cost of a monthly course will be cheaper by about three times.
Advantages and disadvantages
Itraconazole is relatively infrequently used in the treatment of onychomycosis, it is not for nothing that it is a reserve drug. Therefore, resistance to it develops less frequently, and the product justifies its high price. But, like any serious remedy, Orungal has contraindications and side effects. Of the side effects, an allergic rash, abdominal discomfort and feeling of nausea, other side effects such as frequent urination, increased hepatic transaminases, blurred vision are rare. This means - no more often than with a frequency of 0.01%.
Orungal is contraindicated in severe liver damage, in renal dysfunction, in children (up to three years), in pregnancy, and in breastfeeding. Also a contraindication is chronic heart failure, as well as gastritis with reduced secretion, since the background of low acidity of gastric juice worsens the absorption of the active substance from the capsules. For the same reason, it is recommended to separate the administration of itraconazole with antacid preparations. This means that it is necessary to take Orungal no later than 2 hours before taking Maalox, Almagel, Phosphalugel, omeprazole and other antacids, or 2 or more hours after their use.
With all the pros and cons, the treatment of nail fungi with the help of tablets in the whole world medical practice stands on these whales - terbinafine, itraconazole, and fluconazole. Of course, there are other antifungal pills that do not belong to these names, but their effectiveness is much lower, and sometimes completely absent, especially since it is not possible to quickly destroy fungi protected by the nail plate even with modern preparations.
Of these old drugs, which appeared in the textbooks of pharmacology about 50 years ago, but are still available, and even prescribed, can be attributed tablets Nystatin and Levorin. So, Nystatin in the amount of 20 tablets is sold starting from 33 rubles, but if you are prescribed Nystatin for onychomycosis, look for another specialist. Even if you have only 33 rubles in your pocket, you just spend it in vain.
The secret of the correct treatment of nail fungus
If a dear reader has reached this section, then, most likely, he is looking for tools for self-treatment. Otherwise, he would just go to the pharmacy and buy what the doctor ordered. Therefore, instead of transferring folk remedies, it is necessary to know about those treatment conditions, without which any application of the strongest antifungal drugs will give either a short-term effect, or it will be completely useless. Of course, we are talking about the rules of secondary prevention, which must be followed by every person suffering from onychomycosis. We give them for the case of fungal infections of the toenails:
- the patient needs after suspected the presence of nail fungus, and even more so, after confirming the diagnosis, purchase a separate basin for washing the feet and for the baths;
- socks should be changed daily, it is highly desirable that after drying they are ironed with steam;
- skin on the feet must be treated with a special spray from fungi;
- insoles should be changed as often as possible, or they should be the same as socks, ironed with steam;
- for the treatment of the inner surface of the shoe, you must use special antifungal sprays for shoes, or regularly illuminate the inner surface of the shoe with special dryers with ultraviolet radiation, in summer you can listen to shoes in bright sun
- you should abandon the closed slippers, and go to the open slippers, which are also treated with anti-fungal compositions for shoes;
- one should be conscious and not visit fitness centers, public baths, saunas and swimming pools during treatment, even if the fungal nail disease exists in a limited area, or you already have a certificate to visit the pool.
Finally, if the treatment of fungal lesions of the legs was ineffective, you need to visit a doctor and make sure that there are no chronic diseases such as diabetes mellitus, vascular insufficiency of the lower extremities, immunodeficiency, and all those conditions that complicate the fight against fungus. .
The treatment of nail fungus is not easy, troublesome and lengthy. In the treatment of onychomycosis, it is not so much the use of the most expensive medications that is needed as the careful observance of the rules of secondary prevention and discipline, because regular treatment of nails and taking drugs can last for many months. Only in this case, the fungal infection will be defeated.
Attention! This rating is subjective, is not advertising and does not serve as a guide to the purchase. Before buying, you should consult with a specialist.
