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Treatment area: nail fungus

Treatment of nail fungus under medical supervision

Nail fungus (onychomycosis) is common, persistent, and rarely heals on its own. Depending on the severity, treatment options include medicated nail polish or oral tablets and capsules. A doctor will determine which treatment is suitable for you.

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Ratgeber lesenRead the guideLire le guideGids lezen
  • online questionnaire
  • Medical examination
  • Discreet Shipping
  • Money back if not suitable

BehandlungsoptionenTreatment optionsOptions de traitementBehandelopties

Preparations against nail fungus

Terbinafine and itraconazole are prescription-only medications, while the nail polish Loceryl is available only from pharmacies. After making your selection, please complete the medical questionnaire in full. A doctor will then decide whether the treatment is suitable for you.

Selbst einschätzenAssess it yourselfFaire le point vous-mêmeZelf inschatten

Which treatment might be suitable?

  1. 1 If only one or two nails are slightly affected and the nail root is free Then a medicated nail polish containing amorolfine may be an option. It is applied once a week, often for a year in the case of toenails. The doctor will decide based on your questionnaire.
  2. 2 If several nails are affected or the fungus extends to the nail root In these cases, nail polish alone is often insufficient, and oral terbinafine or itraconazole may be considered. The results only become apparent with the regrowth of the nail, often months after completing the medication. The doctor will decide based on your questionnaire.
  3. 3 If you have liver, kidney or heart disease, psoriasis, lupus, or if you regularly take medication Terbinafine and itraconazole can put a strain on the liver. Itraconazole is not suitable for patients with heart failure and has many drug interactions; psoriasis and lupus can worsen under terbinafine. A blood test before starting treatment is advisable. List all medical conditions and medications in the questionnaire. The doctor will make the final decision.
  4. 4 Speak to a local doctor beforehand if you have diabetes, circulatory problems, or a weakened immune system. A personal examination of the feet is then important, because skin injuries can become infected more easily. The doctor will decide on the treatment.

Diese Hinweise helfen bei der Orientierung und ersetzen keine ärztliche Beratung. Ob und welche Behandlung für Sie geeignet ist, entscheidet der Arzt anhand Ihres Fragebogens.This guidance helps you get your bearings and does not replace medical advice. Whether a treatment is suitable for you, and which one, is decided by the doctor on the basis of your questionnaire.Ces indications vous aident à vous orienter et ne remplacent pas un avis médical. C’est le médecin qui décide, sur la base de votre questionnaire, si un traitement vous convient et lequel.Deze aanwijzingen helpen u op weg en vervangen geen medisch advies. Of en welke behandeling voor u geschikt is, bepaalt de arts aan de hand van uw vragenlijst.

Active ingredient nail polishes

For mild nail fungus, when only a few nails are affected and the nail root is clear.

Amorolfine RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Loceryl (Amorolfin)

Active ingredient nail polish containing amorolfine for mild nail fungus without involvement of the nail root.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Visible results only after several months
FormFormFormeVorm
nail polish

So wirkt es:How it works:Mode d’action :Zo werkt het: Amorolfine inhibits the formation of ergosterol, a component of the fungal cell membrane, thus damaging the fungi. The active ingredient penetrates the nail from the lacquer film. The healthy nail must then grow back.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If only a few nails are slightly affected
  • If the nail root is not affected
  • If regular use over many months is possible
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: Apply nail polish once a week to filed and cleaned nails. The treatment lasts approximately 6 months for fingernails and 9 to 12 months for toenails.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 5%

In cases of extensive infestation, diabetes, circulatory disorders, or a weakened immune system, consult a doctor beforehand. Apply only to the nails and do not wear artificial nails.

abfromà partir devanaf 100,98 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Oral antifungal medications

For extensive nail fungus, especially when several nails or the nail root are affected.

Terbinafine RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Terbinafin

Tablets containing terbinafine for nail fungus caused by dermatophytes (filamentous fungi).

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Visible results only after several months
FormFormFormeVorm
Tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Terbinafine blocks an enzyme that fungi need to build their cell membrane, thereby killing them. After ingestion, the active ingredient accumulates in the nail and remains there for some time even after the treatment has ended. The healthy nail then needs to grow back.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • You have been diagnosed with nail fungus, ideally through a laboratory test.
  • Several nails or large parts of a nail are affected
  • Treatment with medicated nail polish was not sufficient.
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: Tablets for oral administration, once daily and regardless of meals. For nail fungus, the course of treatment usually lasts 6 weeks to 3 months, sometimes longer.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 250 mg

Not suitable for people with liver disease; a liver function test is recommended before starting treatment. If nausea, loss of appetite, fatigue, upper abdominal pain, yellowing of the skin, dark urine, or pale stools persist, seek medical advice immediately.

abfromà partir devanaf 37,13 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Itraconazole RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Itraconazol

Capsules for treating nail fungus caused by dermatophytes or yeasts, usually as a pulse therapy with breaks.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Visible results only after several months
FormFormFormeVorm
Hard capsules

So wirkt es:How it works:Mode d’action :Zo werkt het: Itraconazole inhibits an enzyme that fungi need to build their cell membrane, thus disrupting their growth. The active ingredient accumulates in the nail and remains there for months after the last capsule. The healthy nail then has to grow back.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If nail fungus is diagnosed, ideally a laboratory test should be performed.
  • If there is no heart failure or liver disease
  • If no medications are being taken that should not be combined with itraconazole
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: Capsules to be taken orally directly after a meal. For nail fungus, the usual course is 1 week of use followed by a 3-week break, depending on the nails, 2 or 3 cycles, or continuous therapy for 3 months.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 100 mg

Do not use if you have heart failure or in combination with many medications such as simvastatin, ergotamine, or domperidone. Seek immediate medical advice if you experience nausea, dark urine, or yellowing of the skin.

abfromà partir devanaf 41,35 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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RatgeberGuideGuideGids

What you should know about nail fungus

Treating nail fungus requires time and consistency. A confirmed diagnosis and appropriate therapy are the first steps.

Causes and signs

Nail fungus is usually caused by dermatophytes (fungi that form threads in the skin), which often spread from athlete's foot to the nails. Toenails are affected much more frequently than fingernails. Typical signs include:

  • whitish, yellowish or brownish discolorations
  • thickened, brittle or crumbling nails
  • Detachment of the nail from the nail bed

Nail fungus is promoted by a warm, humid environment in shoes, walking barefoot in communal showers, older age, diabetes, and circulatory problems. Similar changes can also have other causes, such as psoriasis.

Treatment options

Which therapy is suitable depends on how severely the nails are affected:

  • Light infestation: Medicated nail polish, e.g. with amorolfine or ciclopirox, usually for many months
  • Extensive infestation or nail root affected: Tablets or capsules such as terbinafine or itraconazole, usually for six weeks to three months, with itraconazole also including breaks in treatment.

Before starting oral treatment, the diagnosis should ideally be confirmed by a laboratory test using nail material. Since nails grow slowly, the result is often only visible after many months. For toenails, this can take a year or longer.

Side effects and risks

Possible side effects of terbinafine and itraconazole include gastrointestinal problems, headaches, and skin rashes; terbinafine can also cause persistent taste disturbances. Rarely, both drugs can cause severe liver damage.

  • Liver: A liver function test is recommended before starting; both are not suitable for those with existing liver disease.
  • Heart and interactions: Itraconazole is not suitable for patients with heart failure and should not be combined with many medications; terbinafine also interacts with some medications.
  • Nail polish: Symptoms usually remain limited to the nail and surrounding skin, such as redness, itching, or brittle nails.

Please provide complete information about all illnesses and medications in the questionnaire.

When you should go directly to the doctor

Get a personal medical examination if:

  • If you have diabetes or circulatory disorders and the skin on your foot becomes red, painful, swollen or shows open sores
  • a dark streak or dark discoloration appears in the nail
  • Nausea, loss of appetite, fatigue, yellowing of the skin or eyes, dark urine or pale stools may occur when taking terbinafine or itraconazole.
  • Swollen legs, tingling or numbness in the hands or feet, or worsening hearing may occur while taking itraconazole.

In case of a skin rash with blisters, skin peeling or involvement of the mucous membranes, as well as shortness of breath or swelling of the face, call the emergency number 112 immediately (Switzerland: 144).

Preventing relapses

Proper foot and nail care

Nail fungus often recurs if conditions remain favorable for fungi. Simple everyday habits can reduce the risk of reinfection and support treatment.

  • Dry your feet thoroughly after washing, including between the toes, and wear breathable shoes and washable socks.
  • Wear bathing shoes and do not share towels in swimming pools, saunas and communal showers.
  • Treat any existing athlete's foot at the same time and disinfect shoes if necessary.

Cut affected nails short, using separate scissors or a file that you don't use for healthy nails. A discolored nail won't clear up on its own. The healthy part must grow back from the nail root. This requires patience, even if you've already stopped taking any medication. If you have diabetes, you should check your feet daily for injuries and seek professional foot care (podiatry). Our online doctor answers general questions..

Zu den BehandlungsoptionenView treatment optionsVoir les options de traitementNaar de behandelopties

AblaufHow it worksDéroulementWerkwijze

In vier Schritten zur BehandlungFour steps to your treatmentEn quatre étapes vers votre traitementIn vier stappen naar uw behandeling

Ärztlich geprüft, diskret und ohne Wartezimmer.Reviewed by a doctor, discreet and without a waiting room.Examiné par un médecin, discret et sans salle d’attente.Door een arts beoordeeld, discreet en zonder wachtkamer.

  1. 1Behandlung wählenChoose a treatmentChoisir un traitementBehandeling kiezenWählen Sie Ihr Anliegen und das gewünschte Präparat oder stellen Sie eine allgemeine Anfrage.Choose your concern and the medicine you want, or send a general request.Choisissez votre problème et le médicament souhaité, ou envoyez une demande générale.Kies uw klacht en het gewenste middel, of stuur een algemene aanvraag.
  2. 2Fragebogen ausfüllenFill in the questionnaireRemplir le questionnaireVragenlijst invullenDie medizinischen Fragen beantworten Sie online, vertraulich und in Ruhe.You answer the medical questions online, confidentially and at your own pace.Vous répondez aux questions médicales en ligne, en toute confidentialité et à votre rythme.U beantwoordt de medische vragen online, vertrouwelijk en in alle rust.
  3. 3Ärztliche PrüfungMedical reviewÉvaluation médicaleMedische beoordelingEin zugelassener Arzt prüft Ihre Angaben. Ist die Behandlung nicht geeignet, erhalten Sie Ihr Geld zurück.A licensed doctor reviews your answers. If the treatment is not suitable, you get your money back.Un médecin agréé examine vos réponses. Si le traitement ne convient pas, vous êtes remboursé.Een bevoegde arts beoordeelt uw gegevens. Is de behandeling niet geschikt, dan krijgt u uw geld terug.
  4. 4Diskreter VersandDiscreet deliveryLivraison discrèteDiscrete verzendingNach Ausstellung des Rezepts versendet eine EU-Partnerapotheke Ihr Arzneimittel meist innerhalb eines Werktages.Once the prescription has been issued, an EU partner pharmacy usually sends your medicine within one working day.Une fois l’ordonnance établie, une pharmacie partenaire de l’UE expédie votre médicament généralement sous un jour ouvré.Na het uitschrijven van het recept verstuurt een EU-partnerapotheek uw geneesmiddel meestal binnen één werkdag.

Häufige FragenFrequently asked questionsQuestions fréquentesVeelgestelde vragen

Frequently asked questions about nail fungus

Haben Sie eine andere Frage? Unsere Ärzte und unser Service-Team helfen Ihnen gerne weiter.Have another question? Our doctors and our service team will be glad to help.Vous avez une autre question ? Nos médecins et notre équipe de service vous aident volontiers.Heeft u een andere vraag? Onze artsen en ons serviceteam helpen u graag verder.

Frage an einen ArztAsk a doctorPoser une question à un médecinVraag stellen aan een arts
Why does the treatment take so long?

Terbinafine and itraconazole accumulate in the nail, while the active ingredient from a nail polish penetrates from the outside. However, the already discolored part of the nail will not become clear again; it must grow out. Fingernails take about six months for this to happen, while toenails often take a year or longer. Therefore, a nail polish is applied over many months, and with tablets or capsules, the results are usually only visible months after the medication has been discontinued.

It is recommended to confirm the diagnosis by examining a nail sample before starting oral treatment. Not every nail change is a fungal infection; psoriasis or injuries are also possible causes. Furthermore, terbinafine is primarily effective against dermatophytes, while itraconazole is also effective against yeasts. Please indicate in the questionnaire whether a test has been performed.

Terbinafine and itraconazole are metabolized by the liver and can, in rare cases, cause severe liver damage. Therefore, a liver function test is recommended before starting treatment, and regular checkups are advised during prolonged use. While taking these medications, watch for warning signs such as persistent nausea, fatigue, upper abdominal pain, dark urine, or yellowing of the skin, and seek immediate medical advice if these occur.

In cases of mild infection, where only a few nails are affected and the nail matrix is ​​unaffected, a medicated nail polish may suffice. For more extensive infections, tablets or capsules are more likely, sometimes in combination with a polish. Your doctor will determine the most suitable treatment based on your individual circumstances.

Terbinafine is not recommended during pregnancy and should not be taken while breastfeeding. Itraconazole should not be taken for nail fungus during pregnancy and is not recommended while breastfeeding. Nail polish should only be applied if absolutely necessary. Nail fungus can usually wait. In this situation, consult your doctor.

Medizinische ExpertiseMedical expertiseExpertise médicaleMedische expertise

Jede Anfrage in ärztlichen HändenEvery request in a doctor’s handsChaque demande entre des mains médicalesElke aanvraag in medische handen

Dr. Viktor Simunovic
Medizinischer GutachterMedical assessorMédecin évaluateurMedisch beoordelaarDr. Viktor SimunovicAllgemeinmedizin & digitale GesundheitGeneral medicine & digital healthMédecine générale et santé numériqueHuisartsgeneeskunde en digitale zorg
Dr. Codruta Anca Pandalache
Medizinische GutachterinMedical assessorMédecin évaluatriceMedisch beoordelaarDr. Codruta Anca PandalacheReproduktionsmedizin & FrauengesundheitReproductive medicine & women’s healthMédecine de la reproduction et santé des femmesVoortplantingsgeneeskunde en vrouwengezondheid
Lernen Sie unsere Ärzte kennenMeet our doctorsFaites connaissance avec nos médecinsMaak kennis met onze artsenHintergrund, Erfahrung und FachgebieteBackground, experience and specialismsParcours, expérience et spécialitésAchtergrond, ervaring en vakgebieden

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Treatment of nail fungus under medical supervision

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