Review of the best according to the editors. About the selection criteria. The the material is subjective, is not advertising and is not serves as a guide to the purchase. Before purchase is needed consultation with a specialist.
Among all fungal infections, the most dangerous are systemic mycoses that affect the internal organs of a person and may cause death. Such serious illnesses often found in HIV-infected patients with AIDS, with deep immunity disorders. But even ordinary, healthy a person with normal immune status can meet fungal skin lesions, and especially nails. These diseases are called onychomycosis, and they can be cured if used correctly antifungal drugs (they are called fungicides, or antimycotics), and with careful observance of the principles of secondary prevention.
The fact is that being located deep in the nail plate, the fungus is protected from all harmful factors. He has the most favorable conditions for growth and reproduction, especially if it is talking about toenails. Man is almost always during the day, especially in winter, is in closed shoes. This gives the fungi the necessary darkness and the absence of ultraviolet harmful radiation, moisture and excess nutrients. Nail plate except Moreover, mechanically protects the fungus. All this makes the treatment onychomycosis is a difficult thing, especially if a nail lesion the plate is significant, but there is no indication to remove the nail yet.
There are various means for both local and internal use for the treatment of onychomycosis. Medicinal funds taken orally must be prescribed dermatologist, taking into account the indications and contraindications. But even local treatment should begin after an initial consultation specialist, and taking the nail for analysis for confirmation of the diagnosis. This rating includes the most modern and popular remedies for the treatment of nail fungus. But before begin a review of fungicidal agents, it is necessary to talk a little about antifungal ointments and creams.
- Ointments and creams do not cure nail fungus
- Rating of the best remedies for nail fungus
- The best fungicidal fluids and varnishes for nail fungus
- Exoderil (Mycoderil, Exostat) – naphthyne
- Advantages and disadvantages
- Lac Batrafen – Cyclopirox
- Advantages and disadvantages
- Lac Loceril (Oflomil, Exolorfinlac) – amorolfine
- Advantages and disadvantages
- Best oral tablets
- Lamisil (Terbizil, Binafin, Termikon, Exiter, Exifin) – terbinafine
- Advantages and disadvantages
- Diflucan (Diflazon, Mikomax, Mikosist, Fangiflu, Flucostat) – fluconazole
- Advantages and disadvantages
- Orungal (Irunin, Canditral, Orungamine, Orunit, Rumikoz) – itraconazole
- Advantages and disadvantages
- The secret to proper nail fungus treatment
Ointments and creams do not cure nail fungus
There is a common misconception that using various ointments and creams can cure the nail fungus. Unfortunately, this far from it. Ointments and creams are intended for application to the skin and on the mucous membranes. Only with the correct use of the product rapid absorption of the active substance occurs, and the creation necessary fungicidal concentration. Therefore the whole rich spectrum creams and ointments for fungus, mainly intended for the treatment of dermatomycosis, or fungal skin lesions, for the treatment of candidiasis vagina and other similar localizations.
Well-known drugs like Nizoral Cream, Lamisil, containing terbinafine, zalain, mifungar, candid, and other soft dosage forms are too weak for the treatment of onychomycosis, and not intended for the treatment of nail fungus. They cannot penetrate through the thickness of the nail, which consists of keratin. Protein keratin is strong enough and disappointment with such improper treatment of onychomycosis will be significant, especially in in the event that large cream or ointment will be spent facilities.
There is another danger. Those are minimal the concentration that will still pass through the nail, and reach the fungus, but not kill him, help him adapt to this active substance, and develop in the fungus resistance to fungicides.
However, antifungal ointments and creams are quite applicable for onychomycosis of nails for application to the skin surrounding the nail, on interdigital spaces, and can be used in complex therapy onychomycosis to prevent the spread of fungus from the nail to nearby soft tissue. This explains the inclusion in official instructions are indications like onychomycosis.
Important! The one exception when shown antifungal creams and ointments, is a situation where the patient the nail is completely removed and the product can be rubbed directly into the naked nail bed. This is done by several once a day until a healthy nail tissue grows.
If we are talking about the popular salicylic ointment, then it it is used as a keratolytic agent for foot fungi, and when nail fungi its task is to soften and remove excess keratinized masses that accumulate in abundance mainly on the heels of individuals middle-aged and elderly, and are a food source for fungus. It is known that crumbling masses released from under the nail, affected by a fungus, contain a large amount of mycelium – “germ” of the fungus.
Distributed on the inner surface of the shoe, on the insoles and slippers, socks, mycelium of the fungus gets on keratinized mass, gradually passes from the subungual space to the skin, first, into the area of the interdigital spaces, and then the foot. therefore the use of salicylic ointment for onychomycosis of toenails shown as a prophylactic that deprives fungi nutrients. But fungicidal, or real antifungal a drug with proven activity, this ointment is not. Now you can go to the ranking of really popular and effective medicines to treat nail fungus.
Rating of the best remedies for nail fungus
|Nomination||a place||Name of product||price|
|The best fungicidal fluids and varnishes for nail fungus||1||Exoderyl||564 rub|
|2||Lac Batrafen – Cyclopirox||2 035 rub.|
|3||Lac Loceryl||828 rub|
|Best oral tablets||1||Lamisil||546 rub|
|3||Orungal||2 855 rub.|
|The secret to proper fungus treatment nails|
The best fungicidal fluids and varnishes for nail fungus
You must immediately explain that the treatment of nail fungus with fluids and varnishing is a regular and daily process. Exist rule: until the nail plate is completely updated, no no guarantee that the fungus is eliminated. Known to be on feet nails are updated much slower than on the hands, and a complete replacement the toenail can range from 9 months to one of the year.
Therefore, in case of damage to the thumb (and this occurs most often), such a treatment duration is needed, and then it takes about 2 weeks to apply the product completely An updated and healthy nail plate to prevent relapse. This applies to liquids; the same can be applied to antifungal varnishes, and even to folk remedies. If a the patient will treat the nail fungus one day, or one month, then all the same, there will be no sense from this. Relapse occurs onychomycosis.
Important! By local means, i.e. liquids and varnishes can be treated nail fungi only if no more than 3 nails are affected, and each of them is no more than 50% by area, counting from the free edge. In case if more nails are affected, there is a fungal infection of the skin, or the reproduction zone of the fungus is localized on the side of the growth of the nail records, it is necessary to combine the application of local funds with taking antifungal drugs inside.
Exoderil (Mycoderil, Exostat) – naphthyne
Exoderil for the treatment of onychomycosis is known Sandoz pharmaceutical concern, and represented by 1% solution naphthyne. This compound belongs to the class of allylamines, and inhibits the synthesis of new elements of the cell wall of the fungus. For treatment for nail fungus exoderil is applied twice daily to the affected nail, trying not to touch the periungual skin.
Before you apply the tool for the first time, you need cut off the free edge of the nail plate as much as possible, and grind the affected part of the nail parallel to its surface a special file to make a nail plate in the area lesions as thin as possible. It is necessary that the concentration of naphthyne under the nail plate was the highest.
The set also includes special disposable files, which serve to polish the surface of the nail for better fluid contact with the nail plate. This light grinding needs carry out before each application. Such treatment is necessary spend at least 4 months, without a pass, but the best time is 6 months old. Exoderil can be purchased in volume vials. 10, 20, and 30 ml. Their average cost is 520, 880, and 1350 rub. in the prices of autumn 2018 for large cities of the Russian Federation Federation.
Advantages and disadvantages
The advantage of exoderil is the proven ability to heal onychomycosis caused by dermatophytes. In the event that the nail affected by yeast, the drug may not kill the fungus, but only prevents its reproduction, that is, act fungistatically. That is why an initial analysis on fungus held in a venereal skin dispensary.
The concentration of exoderil in the thickness of the nail with uncomplicated onychomycosis is considered sufficient to apply the remedy is not more than 2 times a day. Naftifin is contraindicated in individual hypersensitivity during pregnancy and in the period breastfeeding. Sometimes a side effect is manifested, especially if the fluid is accidentally applied to adjacent skin. Then dryness, burning and redness of the skin. But in the event that the medicine is applied according to the instructions without omissions, and all the rules are followed prevention, then the percentage of cure for onychomycosis will be very high.
Important! Each time you apply an antifungal fluid, or any varnish you need to use disposable nail files, shovels, disposable wipes, and other disposable tools. It is strictly forbidden to grind and file the affected nail one nail file, and the more it is forbidden to use this manicure file for processing other nails.
Lac Batrafen – Cyclopirox
Batrafen is a clear varnish that contains active substance cyclopirox olamine. Varnish shows high fungicidal activity against more than 40 varieties fungi. Cyclopirox inhibits the metabolism of fungal cells, and prevents the exchange of their substances with the environment.
The basic principles of preparing a nail for applying varnish are similar to preparation of the above exoderil, as they are single. At first, the nail affected by the fungus is as short as possible cut off, then the remaining nail plate should be sanded with a nail file to create an uneven surface. It will increase the area and durability of applying varnish. It is necessary to apply varnish specially applied with disposable blades in a thin layer, from the thickness of the layer no increase effect will be affected. Application Procedure following:
- during the first month, varnish is applied every other day;
- for the second month – twice a week;
- for the third month – weekly.
During the course of treatment, it is necessary to remove every week all applied varnish with conventional cosmetic products nail polish remover, then shortly cut the nail again and prepare it for applying varnish for the next week.
As prescribed by the attending physician, depending on the type of fungus, other options are possible: for example, within a month and a half varnish is applied every other day, over the next one and a half months – twice a week for the next one and a half months – weekly.
The maximum duration of treatment with Batrafen should not exceed half a year. Batrafen produces a well-known pharmaceutical company Sanofi-Aventis, and a small bottle of varnish with a volume of 3 ml has the average cost is 2200 rubles.
Advantages and disadvantages
Lac Batrafen is one of the most effective remedies for treatment of onychomycosis, as in the form of monotherapy for uncomplicated forms and form of complex therapy in combination with internal the use of drugs. Batrafen is well tolerated practically does not cause intolerance and allergic reactions. Once an open bottle of varnish is stored for 6 months, subject to tight blockage. In that case, if the purchased bottle was kept closed, then its expiration date is not more than 3 years
Of course, the relative disadvantage will be the high price, but at the same time you need to remember that this tool really has a proven efficiency, and still not represented by any analogues or generics. It is known that people with very limited financial opportunities doctors can prescribe cheap drugs, such as Nystatin and Levorin tablets, and recommend smearing the affected fingers tincture of iodine. This type of treatment will be extremely cheap, but its effectiveness is almost close to zero.
Lac Loceril (Oflomil, Exolorfinlac) – amorolfine
Another representative of highly active varnishes against fungus is Loceryl. And, if Batrafen had no analogues or generics, then Loceril has two of them: Oflomil and Exolorfinlak varnish. The first the drug is manufactured by Glenmark, and the second is Sandoz. The original Loceril is produced by a French company Galderma.
The active substance of Loceryl is amorolfine. Loceryl for sale in type of set. Varnish is packaged in bottles of 2.5 or 5 ml. To varnish special wipes with isopropyl alcohol are attached, which clean nails before application, disposable nail files, and also special spatulas for application and uniform distribution varnish. The active substance amorolfin disrupts the synthesis of structural fungal cell components that are represented by sterols. After accumulation inside the fungal cell is abnormal and incorrect synthesized sterols, fungal cell gradually collapses.
The rules for applying Loceryl are simpler than Batrafen. It is necessary to apply varnish either once or twice a week. The sequence of operations is as follows: first, remove the file with a file maximum area of all areas affected by the fungus of the nail plates, cut the free edge as much as possible, then process the surface of the nail with isopropyl alcohol wipes, then applied varnish. Unlike Batrafen, Loceril has no limit duration of treatment. Treat as much as necessary, up to duration of treatment lasting 1 year.
The cost of one small bottle of Loceryl in 2.5 ml 800 rubles. A small bottle of Oflomil – varnish costs 688 rubles, and the cost Exorolfinlac is 798 rubles for the same dosage. how it can be seen that the price range is small. The cost of a large bottle amounts to an average of 1300 rubles.
Advantages and disadvantages
The only drawback of Loceril and its analogues is that side effect, like a temporary slight burning sensation at the site of application varnish. Also, this product is contraindicated for use in children. age, and mean newborns and babies aged up to three years. The manufacturer recommends not to use during treatment with cosmetic varnish, as well as artificial nails, since this may lead to insufficient treatment effectiveness, and relapse of onychomycosis. Loceryl is also highly effective. a means with proven effectiveness, but, unlike Batrafen, it is much more affordable and the consumer can purchase 2.5 ml bottle, or 5 ml, depending on the duration upcoming course of treatment.
Important! The main advantage of all local preparations, used to eliminate nail fungus, is the lack of various side effects and symptoms of intoxication that may arise when prescribing medicines for internal application, and especially with their overdose.
The disadvantage common to this group of means is that that the drug may not always reach the pathogen, especially if the fungus is located in the area of the nail bed, or in the structures of the nail matrix. If the nail is significantly thickened, that is, there are symptoms of hyperkeratosis, then you need to resort to such means as removing the nail plate, cleaning the nail bed. If the nail matrix is affected by the fungus, then local treatment will not reach its goal. Then It is recommended to prescribe systemic drugs prescribed as pills.
Best oral tablets
In the event that a patient with onychomycosis has a fungal infection nails exceeded the maximum permissible limits described above, then the doctor prescribes together with local remedies for treatment onychomycosis and pills. There are a very large number antifungal agents, but since each original There are 5-6 commercial copies of the drug, or generics, other firms and even more then the number of most effective pills for treatment of nail fungus is greatly reduced.
Below are listed the medicines that used to treat onychomycosis. It is very important to understand that if topical nail fungus treatments and may cope with minor manifestations of infection on your own, then tablet preparations alone applied by nail fungus not able to cure. Their task is to create inside, in the blood, high the concentration of antifungal agents. Thus, the fungus does not there will be chances to get rid of adverse conditions existence. The local drug will act outside, and the tissues the subungual space will be saturated with fungicides, coming from the blood.
Lamisil (Terbizil, Binafin, Termikon, Exiter, Exifin) – terbinafine
In modern dermatological practice of the treatment of onychomycosis terbinafine is a first-line drug, or a drug of choice. Terbinafine is a synthetic high allylamine level of antifungal action. Mechanism of action of this substance is a violation of the synthesis of structural elements fungal cells. With prolonged use of Lamisil tablets fungicidal concentration is created not only in the subungual space, but also in the skin and hair.
Take Lamisil for onychomycosis, and any localization, need 250 mg per day (once a day) on average, over one and a half months. We are talking about adults and children weighing more than 10 kg In some cases, treatment can last up to 3 months. The duration of treatment depends on the rate of nail growth, which it is individual.
Lamisil is an original drug and therefore the cost its highest. It is produced by the Swiss company Novartis Pharma, and the minimum cost of a two-week course of treatment, then there are packs of 14 tablets, is 1820 rubles. Average is The cost of this package ranges from 2370 rubles. Sure, It is expensive for the average Russian consumer. After all, the cost the course will already be more than 14 thousand rubles, if you take average market price of packaging.
You can offer more affordable options. So, the drug Teva terbinafine, produced by an Israeli company of the same name, will cost 600 rubles., and for 28 tablets. Perhaps the most affordable the price will be terbinafine produced by a domestic company Vertex. So, 30 tablets of this drug, designed for a monthly course, can be found at a price of 400 rubles and above. But the question of quality of the original substance and treatment results in this case remains open.
Advantages and disadvantages
Lamisil is an international standard for treating more than just onychomycosis, but also fungal diseases of other localizations. But, since this drug is quite serious, it has range of side effects. It is usually well tolerated, but most a common side symptom is a headache, taste disorder sensations, stagnation of bile can rarely occur. Most often loss of appetite, a feeling of fullness in the stomach, and various allergic skin reactions, in the form of urticaria and rash. Some patients complain of joint and muscle pain. Terbinafine may affect the metabolism of other drugs in the body.
That is why it is necessary to carry out treatment only under doctor’s supervision. This drug is contraindicated in breast feeding, and during pregnancy. Terbinafine is not used in children under two years old, and in children over two years of age, a large clinical experience with the use of this tool, and its tolerance good one.
Diflucan (Diflazon, Mikomax, Mikosist, Fangiflu, Flucostat) – fluconazole
Diflucan, aka original fluconazole, is also powerful antifungal drug, and is used not only for onychomycosis, but also with skin lesions, with severe fungal infections with damage to internal organs, including with HIV infection, as well as the development of fungi on the background of a decrease immunity in the treatment of malignant neoplasms.
Fluconazole is available in tablets and capsules, and even in solutions for intravenous infusion. For the treatment of fungal nail damage the most acceptable dosage of Diflucan 150 mg a one capsule. With onychomycosis, it is recommended to take fluconazole one such capsule weekly for 3 to 6 months. By indications, the duration of the course can be changed by the attending physician. The same dosage of Diflucan is used for mycosis of the feet, skin, with inguinal lesions. For comparison, we can indicate that for deep and systemic fungal infections of the internal organs can require the use of fluconazole in a dosage of 2 capsules per day in for up to a year or longer, so the appointment of 150 mg per week may considered very gentle.
Diflucan is produced by the well-known pharmaceutical company Pfizer, and packaging in 12 capsules, designed for 3 months of treatment, which makes a course of minimum duration, on average, costs 2200 rubles. Of course, this can also be considered a large sum, but after all, this is already the cost of the whole course, and it is 6 times lower than when using Lamisil.
There are more affordable options for fluconazole. So, one of the cheapest, if not the cheapest, is fluconazole – verte, domestic manufacturer ZAO Canonfarm Production. Two capsules will cost only 20 rubles, respectively, the exchange rate such domestic fluconazole, designed for 3 months admission will be only 120 rubles. It is 18 times cheaper than cost original drug. Most of the cost of any the drug is the active substance, or substance. Therefore, the question of the ratio of price and quality in the case of the choice of such a cheap drug will also be open.
Advantages and disadvantages
The main advantage of fluconazole in the treatment of fungal nail disease is an excellent ratio price / quality, when it comes to the original drug, about Diflucan, and about the relatively expensive generics (Mikosist). Since you need to take the drug only once a week, then exchange rate compared to the original terbinafine production is much lower. Therefore, a large number of doctors he prefers Diflucan as a first-line treatment for need to prescribe oral drug treatment means.
However, such an excessive enthusiasm for fluconazole entails the risk of insensitive varieties of fungi, according analogies to bacterial resistance, which often develops antibiotics used.
Just like any serious drug, it can cause side effects, although drug tolerance is usually good one. Most often, headache, abdominal discomfort, skin rash, prolonged use in high doses is possible toxic effects on red bone marrow, and toxicity in against the liver. Fluconazole interacts with a number of other drugs, therefore, prescribe and control treatment should only be a doctor. But fluconazole of good quality is always will be necessary in the treatment of fungal infections of the nails, if there are indications for its use.
Orungal (Irunin, Canditral, Orungamine, Orunit, Rumikoz) – itraconazole
Itraconazole is a reserve agent, and is used in cases if there are contraindications to the use of terbinafine and fluconazole, or if to the first two drugs for any the cause develops resistance in the fungus, although such cases in clinical practice is almost never found.
Original Itraconazole, or Orungal, is available in capsules by 100 mg, and is used for fungal infections of the nails immediately after food, and two schemes for its use are known:
- according to the first treatment regimen for fungal nail damage Recommended intake of 2 capsules per day (200 mg daily) for 3 months
- the second scheme involves taking 4 capsules per day (2 in the morning and in the evening), while it is applied at 1 and 5 weeks from the beginning treatment.
The first scheme is characterized by a low constant dosage, and the second scheme – doubled, “shock” dosage, but not in the form a constant but intermittent course. For the treatment of fungal infections nails in children itraconazole is not used. Manufacturer also recommends a longer treatment for nail damage treatment than in case of damage to the nail plates of the fingers. it completely justified, since the causative agents of onychomycosis in the legs more comfortable conditions are created, and they are more protected, more about that It was said in the introduction to the rating.
Produces Orungal famous pharmaceutical company Janssen Silag, Italy. The cost of this drug is also very high. So, a package of 14 capsules costs an average of 3150 rubles. Even if you try and find the lowest price, you can hardly to find Orungal, cheaper than 2200 rubles. And that means that the cost of a three-month course according to the first scheme will be over 28 thousand rubles, and according to the second scheme – about 9 thousand, which much more profitable.
As in all previous cases, there are more affordable and cheap analogues. If you purchase an antifungal drug in a pharmacy Orunit, manufactured by Obolenskoe, then one package in 15 capsules will cost starting from 617 rubles, which means that the cost the monthly rate will be about three times cheaper.
Advantages and disadvantages
Itraconazole is relatively rarely used in treatment onychomycosis, not without reason it is a reserve drug. Therefore to resistance is less likely to develop, and the remedy justifies its high price. But, like any serious means, Orungal has contraindications and side effects. Of the side effects often allergic rash, abdominal discomfort and feeling noted nausea, other side effects such as rapid urination, increased hepatic transaminases, blurred vision are rare. This means – not more often than with a frequency of 0.01%.
Orungal is contraindicated in severe liver damage, with impaired renal function in childhood (up to three years), with pregnancy, and with breastfeeding. Also a contraindication is chronic heart failure as well as gastritis with decreased secretion, because against the background of low acidity gastric juice, absorption of the active substance from capsules. For the same reason, it is recommended to disconnect the reception. Itraconazole with antacids. It means taking Orungal is needed no later than 2 hours before taking Maalox, Almagel, Phosphalugel, omeprazole and other antacids, or after 2 and more than an hour after their application.
With all the pros and cons, treatment of nail fungi with pills in all world medical practice are on these whales – terbinafine, itraconazole, and fluconazole. Of course there are others antifungal pills that do not belong to these names, but their effectiveness is significantly lower, and sometimes completely absent, especially since destroy fungi protected nail plate, fails quickly even modern drugs.
Of those old drugs that appeared in textbooks pharmacology about 50 years ago, but are still being produced, and even prescribed, can include pills Nystatin and Levorin. So, Nystatin in the amount of 20 tablets is sold, starting from 33 rubles, but if you are prescribed Nystatin for onychomycosis – look for another specialist. Even if you have only 33 rubles in your pocket, you simply spend them in vain.
The secret to proper nail fungus treatment
If a respected reader has come to this section, then, rather In total, he is looking for a means for self-treatment. Otherwise case, he would just go to the pharmacy and buy what the doctor prescribed. Therefore, instead of listing folk remedies, you need to know about those treatment conditions, without which the use of any of the most powerful antifungal drugs will give or short-term effect, or will be completely useless. Sure, we are talking about the rules of secondary prevention, which should comply with each person with onychomycosis. We give them for the case fungal infection of the toenails:
- the patient needs after suspecting the presence of nail fungus, and even more so, after confirming the diagnosis, purchase a separate basin for washing feet and baths;
- socks should be changed daily, it is very desirable that after drying they were ironed with steam;
- the skin on the feet must be treated with a special fungal spray;
- insoles should change as often as possible, or their it is necessary to iron with socks just like socks;
- for processing the inner surface of the shoe is necessary use special antifungal sprays for shoes, or regularly irradiate the inside of the shoe with special UV dryers, in the summer you can listen to shoes in the bright sun;
- you should abandon closed slippers, and go to open slippers that are also treated with antifungal compounds for shoes;
- be conscious and not visit during treatment fitness centers, public baths, saunas and pools, even if fungal nail damage exists on a limited site, or you already have a certificate for visiting the pool.
Finally, in the event that the treatment of fungal infection of the legs was ineffective, you need to visit a doctor and make sure that there are no chronic diseases like diabetes, vascular insufficiency of the lower extremities, immunodeficiency, and all those conditions that complicate the fight against fungus.
The treatment of nail fungus is difficult, troublesome and lengthy. business. In the treatment of onychomycosis, not so much is required the use of the most expensive drugs how much careful adherence rules of secondary prevention and discipline, because regular many nails can be taken and medications taken months. Only in this case, the fungal infection will be defeated.
Attention! This rating is subjective, not advertising and does not serve as a guide to the purchase. Before the purchase consultation with a specialist is necessary.