Q & A Library

Nail fungus can be a persistent and sometimes embarrassing problem, and occasionally can be so painful that it becomes difficult to walk. It develops when fungi called dermophytes burrow under nails causing them to become crusty, thick, discolored and distorted. You can pick up the infection while walking barefoot at a swimming pool, in a gym locker room or shower or even when having a pedicure under less than sanitary conditions. Susceptibility may be heightened among those who have diabetes, an immune-deficiency condition, a history of athlete's foot, or who are prone to excessive perspiration.

Although I've seen no scientific studies showing that Vicks VapoRub works, a lot of anecdotal evidence suggests that it can get rid of nail fungus. The trouble is, these reports are all over the place. Some people say it took only a few days to see improvement, others say they used it faithfully twice daily for four to six months before they got results. I'm not sure why this remedy would work, other than the fact that it contains camphor, which has antifungal properties. If you want to try it, rub a small dab of the ointment into affected nails twice a day.

I have always recommended using tea tree oil, a natural disinfectant sold at health food stores, for nail fungus. Here, too, you won't get speedy results. Paint the oil on affected nails twice a day for at least two months. The nail has to grow out for the fungus to be eradicated, so you may not see results for a year. An alternative remedy is grapefruit seed extract used the same way as tea tree oil - twice a day for at least two months. Eating 1-2 cloves of raw garlic a day may also be helpful over time.

The oral antifungal drugs for treatment of nail fungus seem to be effective but are expensive and not as safe. While cases of toxicity are rare, I see no reason to take even a small risk for a problem that usually is cosmetic. In painful cases, podiatrists may temporarily remove infected nails so that a topical antifungal medication can be applied directly to the nail bed. In stubborn cases, an infected nail can be permanently removed.

Whatever treatment you choose, take these precautions to prevent recurrences:

• Keep your feet as clean and dry as possible
• Wear waterproof sandals at swimming pools or other wet public areas
• Change your socks or hose daily
• Clip toenails straight across and keep them shorter than the tips of your toes
• Avoid tight hosiery, which promotes moisture retention; wear synthetic fabric socks that wick moisture away from feet better than cotton or wool

Andrew Weil, M.D.