Let’s be honest. Nail fungus looks disgusting. When your nails get thick and misshapen, yellow, brown and crumbly, they are not nice to look at. Why do some people develop fungus and others don’t? How does the fungus get under the nail in the first place? Why are older people more susceptible? Such questions don’t have good answers. Dermatologists often point a finger at genetics, immune function, circulation, athlete’s foot infection, nail injury or something mysterious. The question most people want answered: What is the most effective nail fungus treatment?
Is There an Effective Nail Fungus Treatment?
The answer to this frequent question is maybe, but success varies from individual to individual. We are constantly amazed at the reports of success and failure from visitors to this website. Some people report great benefit from a particular prescription drug. Others say it is virtually worthless.
Home remedies produce equally varied reactions. What works incredibly well for one person may totally flop for another. We have no explanation for this unpredictability. All we can say is that trial and error is an effective strategy for finding what will work best for you.
Pricey Prescription Nail Fungus Treatment:
Are medication costs out of control? One woman in Washington, DC, would likely answer yes to that question. Ms. Anne Soloviev’s story is described in detail on Kaiser Health News and NPR.
Tavaborole (Kerydin):
She went to her dermatologist’s office for a routine skin check. The physician assistant diagnosed toenail fungus even though it wasn’t bothering her. The PA prescribed a topical antifungal solution called tavaborole (Kerydin).
Ms. Soloviev didn’t think to ask how much it would cost. The bill was $1,496.09. That was for a one-month supply. She was supposed to treat her nails for 11 months.
Because the pharmacy took most of the payment from her Health Reimbursement Account (HRA), she didn’t realize quite how much she was really paying for this medicine. When she got to the pharmacy to pick up her cholesterol-lowering medicine she learned to her dismay that her annual HRA of $1500 had been wiped out.
Pegg in New Jersey wrote to us about her Kerydin bill:
“I just got a a prescription filled for 10 ml of Kerydin 5%. They billed the insurance company $1605.09. What is going on here? Thank goodness I have insurance, but really. Is anybody watching the store?
PS. I can get up to 10 refills: $16,050.”
Efinaconazole (Jublia):
This isn’t the first time we have heard about high prices for nail fungus treatment. A competing drug called efinaconazole (Jublia) could cost over $600 for one 4 ml bottle. People with infected nails are supposed to apply at least one drop per infected nail per day. Big toes get two drops.
There are approximately 80 drops in a 4 ml bottle. We calculate that if all nails were affected, one bottle would last about a week. Because the treatment takes 48 weeks, the cost could be over $20,000. All this to clear a nail fungus that does not have serious health consequences for most people.
Kevin in New Jersey performed some interesting mathematical analyses. We have not verified his calculations, so cannot vouch for his conclusions:
“I have had toe nail fungus for 20+ years. I tried itraconazole (Sporonox) and home remedies with marginal success. I figured I would try Jublia due to the ubiquitous commercials shown on TV.
“Once I received a coupon waiving the copayment I asked my doctor to prescribe it. He agreed and when I went to the pharmacy they informed me it would take a day to get the “large” size and get pre-approval from my prescription plan. When I picked up the Jublia it was in a tiny bottle and the large size was only 8 ml. There are only 20 drops in a ml and therefore the entire bottle should only have 160 drops.
“Reviewing the literature indicating the need for 1 drop per toe, per day, that’s 10 drops a day. Therefore the 160 drop bottle should last about 16 days. Figure 2 bottles per month. If the treatment time frame is 10 months, then one would need about 20 refills.
“Then I looked up the pricing for Jublia and the cost ranged from $1082 at Walmart to $1187 at my RiteAid. So, it would cost about $22,000 for the 10 month treatment that only shows a complete cure rate of 17.8%. That’s absolutely ridiculous!
“I then calculated the cost of the efinaconazole active ingredient. Estimating the active ingredient at 10% solution and 8ml in my bottle at $1187 the active ingredient is only .8ml for that price and converting that to cost per ounce I get roughly $35,000/oz. (32 X the price of gold/oz.). Let’s get crazy and calculate the cost per gallon of active ingredient and you get $4.5 million per gallon.
“The Canadian online pharmacies charge roughly $20/ml so my 8 ml bottle would cost $160. Here in the US we pay 7.4 times as much. I am almost embarrassed that I cost my drug plan that kind of money. I will NOT be refilling this prescription.”
Al in Oakley, California has had good success with Jublia:
“Jublia has been amazing for me. It cleared up 4 of 5 toes. The 5th one was almost completely cleared when insurance stopped paying. Only after taking about 8 months. Now that nail is getting worse. All other treatments have serious side effects. Waiting for appeal approval.”
Saki was disappointed:
“I have used Jublia for over a year. It did not work for me. Just a waste of time and money.”
Susan in Hawaii is happy with Jublia and her cost is manageable:
“I developed a very deep fungal infection in a toe nail that was injured when a paint can fell on it. I tried oral medications and laser treatments. Miraculously, the Jublia is working. There is only about a 1/8th inch area of discolored nail at the tip left. I purchase the 4 oz bottle for $75 a month. Steep in price, but it is working.”
Do Doctors Know What Their Prescriptions Cost?
Prescribers don’t always know how much the prescriptions they write actually cost. According to Kaiser Health News & NPR, the practice manager at Ms. Soloviev’s dermatology clinic said:
“When our providers are treating patients, we’re not treating them based on what the cost’s going to be. We look for what’s the best care for the patient. If the patient calls and says that’s too expensive, then we’ll look for alternatives.”
Perhaps patients should ask their health professionals how much a prescription will cost before they leave the office. When the providers don’t know, they should inquire so that patients will not be surprised by an outrageous bill in the pharmacy.
Home Remedies for Nail Fungus Treatment:
If a medicine is too pricey, a patient should ask about alternatives. Sometimes a home remedy can suffice, especially for a minor problem like toenail fungus.
Listerine and Vicks VapoRub for Nail Fungus Treatment:
A retired physician wrote:
“I’ve looked into popular suggestions such as Listerine or Vicks VapoRub to treat my own toenail fungus. Both have fungicidal ingredients, albeit at low concentrations.
“My thinking focused on two critical factors: treating for the total growth time of the toenails, about 12 months, and exposing the tissue to the medication for hours at a time. This appears to be working! For three months, I’ve spent two or three hours a day several times a week with my feet in plastic garden clogs. I pour a little Listerine into the toes and wear them with no socks.
“A year is a long time to do anything, but so far I’m sticking with this, usually when I’m sitting around in the evening. At this point the nails are growing in pink and healthy.”
Spring in Spokane, Washington experienced surprisingly fast results:
“Amber Listerine worked for me. I tried it mixed 50/50 with vinegar, but the smell was terrible. I switched to straight amber Listerine. I put it in a squeeze bottle and poured it over my toenails each morning right before drying off from the shower.
“The results were amazing and quick. Within a week I could see healthy toenail growth. After a couple of months I had fungus free toenails. I know it sounds crazy, but it worked. It is affordable and doesn’t cause kidney damage like the oral prescription products do!”
The Listerine and White Vinegar Nail Fungus Treatment:
Therese in Australia offered this report:
“I have had toenail fungus for years and nothing would budge it. I found this website re vinegar and Listerine. Am now hitting it from three directions.
- Soaking in equal parts Listerine and white vinegar daily for 20 mins
- Spraying with white vinegar after shower and during the day when I think of it when I’m at home.
- I purchased a small machine which zaps my shoes with uv light for 15 minutes to kill bacteria or fungus after each wear. It cost about $30.
“This 3-pronged approach is working. My new pink nails are half grown. The nails always look clean, although still yellow on the old growth.”
Janet’s husband got no benefit from this approach:
“My husband soaked in that Listerine/vinegar for 14 months with no help at all. He is now trying the Vaporub and hope it works. We use the same bathroom, barefoot so yes, he’s given it to me.”
Sherry gave up on Vicks VapoRub
“I’ve had fungus under my toenails for years. OTC ointments didn’t work. Vicks might work if it wasn’t so messy. At the time I tried it, I wore dress shoes to work with nylons. It ruined more than one pair of shoes.
“I bought a heated footbath. I keep it filled with 1/2 white vinegar and 1/2 yellow Listerine. Then I sit for about 30 minutes reading a book with my feet in the footbath. Seems to be working fine and the cracks in my heels have also gone away.”
Hydrogen Peroxide (H2O2) as a Nail Fungus Treatment:
Annilu in Tuscaloosa obtained unexpected success from hydrogen peroxide:
“Fungus had hideously darkened both my big toenails. Even several coats of the special polish that my doctor prescribed didn’t hide the discoloration. It was very embarrassing.
“I began applying tea tree oil daily. It appeared to be helping, but given the glacial pace of toenail growth, this was taking forever.
“Then a dog bit my right foot. To avert infection, the doctor recommended that I soak my foot daily in hydrogen peroxide. Lo and behold, the H2O2 bleached out the discoloration on my toenail!
“I started soaking both feet, and in a few days I could wear pale pink polish again. With vanity soothed, I’m now soaking my toes in Listerine for the duration. My toenails look and feel better than they have for years. I highly recommend this two-pronged approach to treating toenail fungus. P.S. The dog bite healed cleanly, too.”
Many people report that peroxide helps while others say it is worthless. This proves once again how variable the response can be.
Cornmeal Foot Soaks As Nail Fungus Treatment:
Heidi tried a LOT of things until cornmeal made a difference:
“I have longstanding fungus on both big toes and a couple of smaller toes. I used Kerydin for more than a year with only limited success. Before the Kerydin, I also tried Vicks, Listerine soaks, and tea tree oil, all of which improved the situation but did not resolve it.
“Right now, I’m trying cornmeal soaks with better progress than any other method I’ve tried. After about four months of weekly soaks, the small nails look completely normal. One big toenail looks pretty close to normal and the other is only discolored near the top and a little on the sides. I cover the bottom of a plastic box with a thin layer of white corn meal then just cover that with water and let it soak for an hour. Then I soak my feet in it for an hour.”
Hank uses cornmeal for his feet and his roses:
“I soak my feet in cornmeal mush from time to time. For me it does work against both plantar warts and toenail fungus. Afterwards I pour the water and mush over my rose bushes to prevent blackspot and other fungus diseases. Multitasking, so to speak.”
The People’s Pharmacy Perspective on Nail Fungus Treatment:
Whatever treatment you select, patience is essential. It takes a very long time for nails to grow out, which is why eight months to a year is not considered excessive.
Even the pricey prescription products require months and months of daily applications to be moderately effective. Do not expect a home remedy to work any faster Such an approach requires patience and dedication, but at least it won’t tax your bank account.
If you would like to learn more about other nail fungus treatment you will find our book, The People’s Pharmacy Quick & Handy Home Remedies of interest. Not only do we offer a variety of options for nail fungus, we cover topics like allergies, canker sores, coughs, gas, heartburn, hemorrhoids, hot flashes, plantar fasciitis, sinusitis, and warts.
Share your own experience with nail fungus treatment in the comment section below.
