Toe Nail Fungus

We are asked all the time about Toe Nail Fungus. Please make an appointment if you are concerned as good treatments are available

Canadian guidelines suggest topical efinaconazole if <20% nail involvement, efinaconazole +/- oral terbinafine for 20-60% involvement (or for >3 nails), oral terbinafine for >60% involvement

  • Risk of terbinafine-induced liver injury: ~1 in 50,000-120,000 prescriptions.

Bottom Line: Up to 45-60% of patients on oral treatments (terbinafine best), 6-23% on topicals (efinaconazole best), and <10% on placebo will be "cured" after ~1 year. Topicals should be reserved for cases with minimal (=20-40%) nail involvement.

Charlotte Gallant