Fungal nail infections (onychomycosis) are one of the most common nail conditions we treat in podiatry — affecting up to 10% of the Australian population. The nail becomes thickened, discoloured (yellow, white or brown), brittle, and in advanced cases, crumbly and distorted. It's stubborn, it doesn't resolve on its own, and it spreads to other nails if left untreated.
The right treatment depends on how severe the infection is, how many nails are involved, and whether you're dealing with a surface-level infection or one that's penetrated deep under the nail plate. Here's what actually works.
How fungal nail infections start
Fungal nail infections are most commonly caused by dermatophyte fungi — the same organisms that cause tinea (athlete's foot). The infection typically starts at the free edge of the nail and works its way back toward the cuticle, gradually thickening and discolouring the nail plate as it progresses.
Risk factors include age (nails grow slower and thicken as we age), poor peripheral circulation, diabetes, immunosuppression, communal showers and pools, and pre-existing tinea on the skin of the feet. Treating any active tinea on the surrounding skin is essential — otherwise the fungus reinfects the nail during treatment.
Over-the-counter fungal nail treatments
1. Topical antifungal nail solutions
Topical treatments are applied directly to the nail and are the first-line option for mild to moderate infections affecting less than half the nail plate. They work by delivering antifungal medication through the nail surface to the infection underneath.
Our picks:
- Solveasy Tinea Spray — a broad-spectrum topical antifungal effective against dermatophytes, yeasts, and moulds. Easy spray application makes it practical for daily use on nails and surrounding skin.
- Browse all fungal nail treatments →
2. Nail softeners (used alongside antifungals)
Thickened, fungal nails are harder for topical treatments to penetrate. A nail softener applied before or alongside your antifungal treatment helps thin the nail plate, allowing the medication to reach the infection more effectively.
Our pick: Gehwol Med Nail Softener — currently our #1 ranking nail care product. Apply daily to soften the nail, then follow with your antifungal treatment for better penetration. It also makes the nail easier to file down, which further improves treatment effectiveness.
How to get the best results from topical treatments
- File the nail first. Use a disposable nail file to thin the nail surface before applying treatment. This removes the damaged outer layer and allows the antifungal to penetrate deeper. Don't share the file — dispose of it or dedicate it to the affected nail only.
- Treat the surrounding skin. If you have tinea (athlete's foot) between the toes or on the sole, treat it simultaneously with an antifungal cream or spray. The skin infection will reinfect the nail if left untreated.
- Be consistent and patient. Toenails grow slowly — it takes 12–18 months for a big toenail to fully grow out. You won't see a clear nail until the healthy nail has grown from the cuticle to the tip, pushing out the infected portion. Continue treatment for the full recommended duration, even when it looks like nothing is happening.
- Keep feet dry. Fungi thrive in warm, moist environments. Wear moisture-wicking socks, rotate shoes to allow them to dry between wears, and use an antifungal foot powder or spray to keep the skin dry.
When topical treatment isn't enough
If the infection involves more than half the nail plate, multiple nails, or the nail matrix (the growth area at the base), topical treatments alone are unlikely to clear the infection. At this point, your GP or podiatrist may recommend oral antifungal medication (typically terbinafine or itraconazole), which treats the infection systemically from the inside. Oral antifungals require a prescription and liver function monitoring.
Laser treatment for fungal nails is also available through some podiatry clinics and has growing evidence for effectiveness, particularly for infections that haven't responded to topical or oral treatment.
Preventing reinfection
- Treat tinea on the feet and between the toes — it's the most common source of reinfection
- Disinfect shoes with an antifungal spray
- Wear thongs in communal showers and around pools
- Keep nails trimmed short and filed thin
- Don't share nail clippers, files, or towels
- Wear moisture-wicking socks and rotate shoes daily
When to see a podiatrist
If your nails have been discoloured or thickened for more than a few months, it's worth getting a professional assessment. Not all thickened or discoloured nails are fungal — trauma, psoriasis, and other conditions can look similar. A podiatrist can confirm the diagnosis (sometimes with a nail sample), reduce the thickness of the nail professionally, and recommend the most appropriate treatment plan for your situation.