Diagnosis of toenail fungus is relatively straightforward, based on clinical signs and laboratory tests. While the toenail appearance may indicate a toenail fungus infection, laboratory tests are necessary for confirmation. Symptoms of toenail fungus can appear to be other medical conditions, such nail psoriasis or yellow nail syndrome.

Fungi in the nail can be detected with a microscope; however, this does not identify exactly which type of fungi is causing the infection. Nail samples are either treated in the laboratory with a special solution to identify the fungus or crushed and put in a container to allow the fungi to grow. Both of these procedures will establish the form of fungi.

Toenail fungus treatment is long, up to as much as one year, expensive and some medications may have side effects. As well, there is no guarantee the treatment will be successful. There exists, unfortunately, the possibility of relapse after completion of treatment or a different form of fungi may invade to cause another infections.

Pharmacological medications offer two routes for treatment of toenail fungus: oral and topical.

There are two main oral anti-fungal medications currently available. These are itraconazole (Sporanox) and terbinafine (Lamisil). In studies, terbinafine appears to have a higher success rate and is tolerated easier than itraconazole. Terbinafine has a 60 to 80 percent effectiveness estimate and a 15 percent recurrence rate. The major benefit to oral anti-fungal medications is they are able to penetrate the nail via the body.

Both medications can cause several side effects, including digestive upset, rash, headache and dizziness. Blood tests for liver function are usually given before prescribing either of these medications, as they are not safe for people with liver or heart disease

Fluconazole (Diflucan) is sometimes used as an alternative to itraconazole and terbinafine, but it is not approved by the Federal Drug and Administration for treatment of toenail fungus.

Topical medications are not as effective as oral anti-fungal medications. As a rule, they cannot cure toenail fungus, as they are not able to infiltrate the nail enough to eradicate the fungi. Topical medications available in the United States include Penlac (a nail polish), Nizoral Cream and Lamisil Cream. Side effects are minimal and rare.

Topical treatments are considered beneficial as part of a treatment regime that includes anti-fungal medications.

Natural remedies, which profess to cure toenail fungus, consist of Australian tea tree oil, grapefruit seed extract, bleach and Vic’s VapoRub. It should be noted there is currently no scientific proof for success of these remedies and the effectiveness rate is probably less than ten percent. You should always consult your doctor before trying home remedies.

It can take up to one year for an infected nail to grow back healthy after successful treatment.