The People's Perspective on Medicine

Pricey Nail Fungus Treatment vs. Inexpensive Home Remedies

Do you ever look at your nails? Are you unhappy with what you see? Do you know how much Rx nail fungus treatment can cost? It's mind boggling! What about home remedies?

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.

  1. Soaking in equal parts Listerine and white vinegar daily for 20 mins
  2. Spraying with white vinegar after shower and during the day when I think of it when I’m at home.
  3. 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.

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    About the Author
    Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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    Jublia worked very well for my father and me. Dad’s podiatrist was wonderful. She helped us get the prescription filled through Canada Pharmacy for $130.00 plus $15.00 shipping instead of $1300 + in the US. The 8 ml bottle lasted Dad over 6 months.

    Full strength bleach for a bit, loose shoes will work. Oxyclean peroxide will do the same.

    I soak my feet in a mixture of Epson Salt and hot water until the water is cold. I do this to soften the nails so I can do a better at cleaning and cutting. Will this help fungus treatment?

    I’ve been struggling with toenail fungus for several years and recently discovered I have Candida overgrowth. Treating the Candida overgrowth has resolved the chronic toenail fungus. I believe many people have Candida overgrowth and don’t know it.

    Just wondering if anyone has had luck using a bleach gel pen for nail fungus?

    There’s a laser treatment that’s pricey – $800 plus a little more if the infection doesn’t completely leave after the treatment, but that’s nothing compared to these crazy drug prices. It takes all of about 20 minutes for the single treatment. My fungus has not returned in four years, but my nails look the healthiest – clear pink – now that I’ve ditched sugar and yeast. The nail tech was amazed when I returned for a checkup.

    I used a name brand callus remover to carefully smooth off the top “woody” ridges of the infected nails and then applied the Vicks. This seems to help the Vapo-rub penetrate the surface of the nail. Seems to be clearing up the fungus nicely!

    I started making and taking pickled garlic (one medium sized clove a day) about six months ago and I swear although I didn’t do it for my nails sake they seem to be losing the under funk and getting thinner and pinker . . . I love the garlic and beings that it is pickled, so does my stomach. The recipe is in Gladstars “medicinal herbs” book.

    Many years ago you suggested Vitamin E oil for toenail fungus. Using one Vitamin E oil capsule and using a common pin I would squeeze a drop out and apply it under my toenail. It took many months. Now, 25 years later I had a bottle of vitamin E oil which I bought to put on my scar from knee surgery and decided to rub some under my toenail. Now 7 months later the fungus is just about all grown out. Vitamin E oil is cheap and it worked very well for me.

    I’ve been using jojoba oil with success. My nail is almost clear and I keep it trimmed as low as it is comfortable for me. Jojoba oil is anti fungal. Before that I had tried these following things with no success: Jublia, Vick’s VapoRub, and apple cider vinegar.

    I read that coconut oil had anti-fungal properties, so I decided to try it on the fungus I had had for many years on my big toe. I rubbed it on and under my toenail and on the skin around it twice daily (AM and PM). In about three weeks, I began to notice a difference in my toenail. In about two more months, the color returned to normal, and the the thick ridge running up and down the nail disappeared. My nail became a normal, healthy nail again. I used organic coconut oil.
    I had only tried over-the-counter fungus remedies before that.

    This may sound crazy but it’s true. I had toenail fungus for a number of years. I had tried one prescription (a topical paint-on type) which didn’t help. Then I tried painting my nails with vinegar with no result. Then I tried Vicks Vaporub. Worked like a miracle!

    I should point out that my case was not severe. However, all I did was rub a bit of Vicks on the affected nails before bed, and put socks on. After two nights, my nails were completely clear. That was two or three weeks ago, and they are still clear… no sign of fungus returning. My result may be uncommon, but I’m a believer! Can’t hurt to try it. Costs next to nothing!

    I had an injury that cascaded into fungus under one great toenail. That was almost a year ago. I have been using a lacquer medication which does well WHERE IT TOUCHES, but the problem is that I see the fungus moving down and continuing to grow under the nail where nothing can reach. I don’t know how anything could help that situation!

    Anyone have experience with laser treatment performed by a podiatrist?

    Has anyone tried the laser fungal ablation as provided by podiatrists. It is costly but if it works. I would like to try it. Thank you. Walter in Florida

    After reading your article on nail fungus a few months ago, I began to use vinegar and baking soda solutions and soaked my foot for about 20-30 min. But I also put bleach on a cotton ball and swabbed it around the toenail. I did it once or twice. I also used the Vick’s Vapor rub at night, and I’ve used peroxide. All of this was done at different times, and it’s all working.

    I can see the difference in the new and old nail. I don’t suggest using bleach too much but I don’t think a couple of times will hurt. I think that the bleach really got me on a quick road to recovery. I will continue to do all of the above except the bleach until my toe is completely healed.

    Why has no one mentioned laser treatments? I did that about 4 years ago, and it completely solved my problem. My big toe was so bad, I had I infection coming from it. The treatment was $500, cheaper than some of the prescriptions. So far the fungus has not returned.

    I’ve been using hydrogen peroxide for several years. It works great for me. I put some is a bowl and use an old tooth brush to work it under the nails. It clears up in 2 to 3 weeks.

    This remedy may sound strange but here it is, I have used Penlac for years, and I do think it helps but it is so costly and insurance does not really help much there. I began to file my toe nails across the nail to reduce the thickness of the nails. I did this to the point they were thin. I use the Penlac on the big toes and one other toe that has been maybe the worst one not a big toe. I used tea tree oil on all the others. I am noticing a great deal of improvement on all the nails. I put the tea tree oil on morning and night. I do keep filing the nails to keep them thin and maybe this allows the treatments to penetrate the nails. I have had no ill effects from doing this just that my toenails do seem to be getting a lot better.

    I completely eliminated my toe fungus of fifteen years with the application of a DMAE & MSM serum, purchased on Ebay, which I use on my face. I wasn’t even trying to get rid of it-I put it on my toes, over opaque nail polish, because it made them look shiny. When I removed the polish I noticed my fungus was on its way out after so many years! I had been applying the serum about once a week, but when I saw what was happening, I started to apply it daily. The fungus disappeared in about two weeks. I had tried many other remedies over the years, such as Listerine and VicksVapo Rub, but was not patient enough to get results. This was truly easy and extremely effective.

    I had success with Kerasal fungal treatment after trying all of the other remedies. I recommend it.

    My podiatrist prescribed an oral medication for toe fungus which I took for a year, but it only did a fair job. This year I asked if there was something else that was more effective and cheaper. He recommended a tea tree skin oil treatment. I found it at a natural foods store at less than $10 a jar. It is a pleasant-smelling and easy to apply ointment. I just dab a tiny little bit on my toe nails before bed. It’s been 2 months since I started this routine. Voila! My toes look 99% better.

    Years ago, through unfortunate circumstances, I was forced to stay overnight at a really nasty hotel. When I took a shower, muddy stuff backed up from the drain and got on my feet. Yuck. Many months later I noticed my toenails thickening and changing color. Doctor put me on expensive medicine that didn’t quite get it. I switched to OTC Kerasal and that started working. It took years to completely heal. The applicator is well made and helps with keeping the medicine off the skin.

    Toenail Fungus – I found I had candida in my system after trying all these home remedies, and they would only work for a few months after finishing them. I also had toenail laser treatment that would work for up to 1 year.

    So I went on a candida diet and started taking an over the counter cleansing pill and eliminated all sugar except for small amounts of honey in my coffee each morning; no dairy, no potatoes or corn or breads. My toenail fungus has gone away. For the cracked heels I did the Listerine/vinegar soak, and it has worked great.

    I used tea tree oil every day using a Q-tip to swab it on.

    Okay, so I’m afraid that this will go into the dumb question category but here goes. I have toenail fungus and want to do the listerine soaks but I also want to wear nail polish since they are so ugly but will the lacquer in the nail polish prevent the listerine from being effective?
    Also as advice to readers I used Vick’s on my toes early one morning I was selected for a random hand swipe at an airport (after multiple hand washings) and it triggered a full private screening with two people. The only thing I can think of was the petroleum in the Vick’s that made me come up positive. Word of warning to frequent flyers.

    Re: toenail fungus. I had fungus in both my big toes for about a year. My primary care Dr basically said nothing would help. On-line gave many thoughts. I started painting my toenails with tea tree oil.

    Then because of its strong odor and quick to rub off, I started putting drops on a bandaid; wrapped around the toe, left on overnight. Then because I was already using CBD oil I started matching a drop of tea tree with a drop of CBD in the morning. Now about 10 months later, the bad toenail is almost grown out.

    I have used gentian violet with great success. It does dye your toe purple, but with nail fungus I was not wearing open toes anyway. You can get this online or the pharmacy. Really cheap – like $2 a bottle, and one will do it.

    $15-20,000 for toenail fungus treatment is beyond insane. And that with a less than 50% chance that it works. No wonder health insurance is over priced by 50% or more. I tried oil of oregano (less that $30) and it helped some. I will likely try some of the remedies mentioned here. How can we expect Big Pharma to find for cancer when they can’t even understand and treat toe fungus?

    Oreganol P73 (wild oregano) worked great for me! Applied it morning and night, just a drop or 2 and rubbed it in.

    I heard a few years ago that Boron is an anti fungal and that we get 1/2 the RDA in our US soils. It’s also supposed to be great for joints as an anti inflammatory and ease joint pain!
    I started taking 3mg Boron/day and using 1Tbsp Borax (laundry additive ) to my Epsom salt & baking soda baths that I take 2-3 x/ week. Here I am a year & 1/2 later with the toenail fungus I’ve had since I was 15yo almost gone. Nothing else had worked so I’m encouraged as I think this process will be over in 6 months .

    Oreganol P73 (wild oregano)…GREAT remedy!

    The Vicks alone worked for me I trimmed as much of the nail away as I possibly could and put it on those nails twice a day within about 6 weeks it was gone my middle toe was totally infected and big toe was about 1/3 rd of the nail. I have heard the corn gluten meal (not regular store bought cornmeal) works but you have to soak your feet in it every night. I don’t have the patience for that. Vinegar soak does work for athletes foot I’ve done that on the advice of my podiatrist I have one foot that gets it for some unknown reason.

    I had severe toenail fungus on all of my toes and two of my fingers. I tried numerous oral prescriptions, topical prescriptions, and otc/home remedies (virtually everything tried and reported by others in this thread) for over 30 years. Finally, I saw a note about a podiatrist who used pinpoint laser treatment on the toenails. Everything cleared up in approximately 12 months. I now go once a year for a “touch up”, i.e. more of a preventive approach for now. I have been “clean” for about 10 years. I am currently 71 years of age.

    I am not sure why this approach is not more indicated by others. However, it is somewhat expensive ($150+/treatment) and is not covered by my insurance (cosmetic). Also, not all podiatrists are certified to use the equipment, so this treatment may be hard to find in all areas.

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