I'm currently dealing with this. My podiatrist prescribed Jublia in conjunction with an OTC Urea-based compound. The Urea compound softens the nails and makes them more porous, thus more receptive to the medicine. My understanding is that Jublia is considered a standard, safe and effective treatment. But, the downside is that it can take 4-6 months for results. This is due in part to the slow growth of toenails. Prior to trying this treatment I did try an oral course of Sporanox. I did this to avoid the daily hassle of the application of medication to my toenails. Sporanox is taken 1 week per month for several months. BUT - bad reactions to oral anti-fungals are common. Some people have serious liver issues and the doctor will do some blood work for this. For me, the oral medication caused a bad rash and severe GI upset after one week and I had to stop it. FWIW - you can't drink alcohol at any time while on the oral medicine. So if you like the occasional cocktail or brew with your BBQ - forget it for as long as you are on the pills (including between the weeks you are actually taking the pills).

One thing my podiatrist told me too - and this is easy to forget - is that the fungus is very hardy. It will hang out in your favorite shoes if you don't clean them. I spray the OTC Lamisil spray in my Crocs (don't judge - I love Crocs) and bike shoes, etc.

Good luck.
-Doug

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It is the mind itself which builds the body.
-Joseph Pilates

Did 12 weeks of Lamisil (terbinafine) this spring, had great results. Didn’t need any liver tests and alcohol is fine to drink with Lamisil. Was very effective and I would recommend this route. Got a doctor on the Push Health app and never even saw them in person. We had a podiatrist on here (ST) a few years ago saying the liver threat on Lamsil is much, much less than what was originally thought.

Hi, I finally threw in the towel and went all in on oral Terbinafine after trying every over the counter recommendation I found on the internet, with zero success.

I had zero issues with terbinafine. I had my liver checked via bloodwork after the first 30 days and had no issues. I did dial back the drinking a bit. I could see the nail already growing out healthy after about 7 weeks, so I stopped taking it at that point.

9 months later, my nails are 100% again. I would do it again in a heartbeat.

My wife had a laser treatment that did wonders and seems to be working.

The fungus is really hard to beat it seems and now she really keeps up with it.

OTC stuff (have tried a few) has worked for me. It just works slowly. Months.

Another important thing is that you want to keep up the treatment (at least for OTC topical stuff) for a few more months after all sign of fungus is gone. I've made the mistake of stopping as soon as my nails look OK, then it can pop right back up.

It took a while, but I eventually had good luck with full strength tea tree oil.

i am only using the Jublia. It took maybe 3 months to notice anything and then both toes started growing out. i lost track of when I started, but I reckon Im finally almost done the 48 weeks. i cant tell you if it works long term but short term reviews are good.

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Dan Mayberry
Amateur a lot of things, professional a few things.

I had it only on one big toe. I damaged the nail at a big, long distance race and thought I was going to lose it. Twice before I damaged that nail and the new one just grew under the old one making it look really thick, then finally the old one would fall off but this time it didn't.

So after several months I discovered that it was a fungus. I wanted to do everything I could before I sought medical treatment, this is what I did:

I cut the nail back as far as I could, I did it in several stages and each time I showered I scrubbed it trying to get underneath it as much as possible. I think I was fortunate that the fungus didn't reach the nail bed.

After scrubbing it in the shower (with a marked toothbrush) I applied an anti-fungal cream. There were two types I had on hand, clotrimazole and terbinafine hydrochloride, I alternated between the two of them. In hindsight I think the clotrimazole worked better.

I did this for about 12 weeks and kept cutting the nail back whenever I could. I stopped for a few months because I thought it was gone but it wasn't and had to start over, now 18 months later it's nearly all gone. I've had to work hard on it.

I don't think this will work for everyone but it seems to be working for me.

If I got it again I would seek medical attention as soon as my training allowed it.

Wait a minute, Terbinafine is a jock-itch cream, right?

I've been dealing with this issue (toe fungus) for years, and haven't had any success with OTC applications. Would love to find a guaranteed solution!

Another downside to Jublia is it is extremely expensive (in excess of $1k per bottle) and a lot of insurances don’t cover it or require a prior authorization. I would go with oral terbinafine over itraconazole as it is easier on the liver. BTW I’m a pharmacist.

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Let food be thy medicine...

i took A PILL, hence the word oral. I don't know what jock itch cream is, I'm a chick.

Wanna get rid of it in 2 months? take the terbinafine (lamisil) pill.

so Jack, so do you share your women and your wine? are you from Wichita? ha!

Yes, same medication, different delivery method. Topical treatments are less effective because the root of the infection is often internal.

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"They're made of latex, not nitroglycerin"

Yes!

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Let food be thy medicine...

My wife usually has some cockamamie statements fly out of her mouth, and in light of the recent posts about sharing wives and how I sometimes want someone to take mine, I'll share something she was actually kinda right about.

Propolis

https://www.ncbi.nlm.nih.gov/...articles/PMC5996904/

For those who want the conclusion instead of reading the full article

Conclusion
The findings of the present study suggest that the ethanol PE is a promising natural compound for onychomycosis treatment. Our results confirmed the in vitro antifungal activity of PE, against both the planktonic cells and the biofilm formed by species of Trichophyton, which are the most common agents of onychomycosis and are usually resistant to conventional antifungals. Furthermore, PE was able to penetrate through the nail by itself, a good property for topical medications, and was not cytotoxic to the cell lines tested. Patients with onychomycosis treated topically with PE twice a day showed excellent clinical improvement within 6 months. Therefore, the extract of propolis is a potential new therapeutic agent for the topical treatment of Trichophyton onychomycosis.

Here is the important part...

The results of the current study indicate that PE represents a very promising alternative for treatment of onychomycosis, including cases caused by the genus Trichophyton. The cure rate after 6 months of topical treatment (total recovery of the anatomical appearance of the nails and absence of fungi in direct mycological examination) was 56.25% (Table ​Table44). A systematic review of topical therapies for toenail onychomycosis showed that FDA-approved topical drugs such as ciclopirox, tavaborole, and efinaconazole produced clinical and mycological cure with reasonable clinical improvement, but with variations according to the treatment plan and combinations used (Gupta et al., 2014). Another, more recent review by the same group (Gupta et al., 2017) showed complete cure with topical treatment using these medicines, at rates from 6–9% for ciclopirox and tavaborole and 15–18% for efinaconazole. The present study found that PE provided a complete cure in 9 of 16 treated patients (56.25%), a higher rate than those obtained with approved medicines. Thus, PE was as efficient as or better than these medications for the treatment of onychomycosis. Tavaborole and efinaconazole, two new topical agents, have demonstrated good nail penetration and high negative culture rates in clinical trials of patients with onychomycosis (Zane et al., 2016); however, they are not available in some countries, including Brazil. If the above rate of complete cures is added to the 31.25% rate of partial cures (patients who are still being treated and will be followed for a longer period of time, 12 months), we could report an 87% index of clinical improvement, a superior performance to the results attained with several other natural products (Halteh et al., 2016) for onychomycosis topical treatment. This efficacy may be related to the cumulative effect of the different properties of propolis, such as antimicrobial, biofilm reducer, anti-inflammatory, and scarring effect (Oryan et al., 2018).

What is propolis? According to Wikipedia it is...
"Propolis or bee glue is a resinous mixture that honey bees produce by mixing saliva and beeswax with exudate gathered from tree buds, sap flows, or other botanical sources. It is used as a sealant for unwanted open spaces in the hive. "

A great thing is that it is unlikely that bee spit isn't going to cause you to need a liver transplant.

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The more people I encounter the more I love my cats.