Do Topical Over-the-Counter Nail Fungus Medicines Work?
I had a patient ask me recently if over the counter topical medications were effective. In general there is no good evidence that topical OTC anti-fungal medications are effective. More important, for less money you can get a much better topical medication.
Video: Are Topical Over-the-Counter Nail Medications Effective?
This video focuses primarily on Tea Tree Oil as a treatment for nail fungus but the same points made about tea tree oil apply also to other OTC medications.
Do Prescription Topical Nail Fungus Medicines Work?
In fact, there is are three topical medications on the market that has been shown in reputable studies to actually help kill the fungus AND make infected nails look better. It is important to note, however, that while they have been shown to help, none of them work particularly well. The best ones only work about 15% of the time.
The oldest one is the medication Ciclopirox. Ciclopirox Nail Lacquer (trade name – Penlac®) is a topical nail solution that actually has been studied and found to be effective at clearing the nail in some patients. In addition, Ciclopirox is much cheaper than many OTC topicals. I’ve seen in available for under $12 for a 3 month supply. You can read more detailed information here about Ciclopirox.
But here is the kicker – even Ciclopirox only works about 8% of the time.
The reality is that no topical medication works well to clear nail fungus in most cases. None of them penetrate deep enough to make a difference in most people with the fungal infection.
We often use Ciclopirox to help prevent reinfection of the nail after treating the fungus with oral medication or laser, but do not consider any topical as an effective treatment on their own.
New Topical Medications for Fungal Nails – Jublia® and Kerydin®
There are two new medications on the market that are used topically to kill nail fungus. Both of these medications, Kerydin® and Jublia®, work better than Ciclopirox and also work better than OTC medicines. But again, the fact that they work better doesn’t mean they work well.
Kerydin® and Jublia® both work about 15% of the time. So again, better, but not great.
The other problem with Kerydin® and Jublia® is that they are very, very expensive. Close to $500 per month and you will need at least a 12 month supply for best results.
So, Should you use Topical OTC Anti-fungal Medications?
In our opinion there are no OTC anti-fungals that work as well as the prescription medications and the prescription topicals don’t work that well either. In particular, avoid any OTC topical medications if they make any of the following claims:
- They claim to have the “most effective” fungus treatment.
- They claim that they have the best ingredients (the best ingredients, according to the best research, are available by prescription only)
- They claim that their product will “cure” nail fungus
If you are going to try a topical medication for nail fungus, get a prescription from your doctor for Ciclopirox, Kerydin or Jublia. They are all more effective than any OTC topical. And Ciclopirox is both more effective and less expensive than OTC anti-fungals.
You can read more here about cures for fungal toenails.