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Welcome to Dr. Bob's Anti-Fungal Blog

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Anti-fungal Nail Treatment: Lamisil Pills vs. Topical Lacquer


Which anti-fungal nail treatment options work? 

There are a multiple antifungal nail treatment options out there but not all of them work and  each have advantages and disadvantages.  I decided to write this article to discuss the options available and what I believe is good and bad with each.

In general, fungus lives in the nail matrix behind the nail and this is what needs to be treated.  Many products treat the matrix and nail and clear the fungus but only a few products continue to treat the nail to prevent fungus return.  If the nail is not protected after the fungus clears, the fungal nail will reoccur.

Here is a list of common products and advantages/disadvantages.

Lamasil and Sporonox Pills


  1. Excellent response and fungal treatment working 70-80% of the timedescribe the image
  2. Easy to use


  1. Health risks and troublesome to the liver and need blood test
  2. Stays in the body for about 1 year and when out of body fungus can return
  3. No long term protection

Penlac Nail Lacquer (Terbinafine)


  1. Very little risk to the body with minimal side affects. 
  2. Local treatment without full body affects


  1. Needs to be applied for about a year to clear the nail
  2. When you stop the treatment, the nail is not protected and the fungus can return
  3. Clinical trials showed only a 10% or so positive response
  4. Shiny lacquer coating is thick and very visible
  5. Cannot place nail polish on area

The Other 30 OTC Nail Products

There are a number of other OTC (over the counter) nail products.  Ingredients that are commonly used include Terbinafine, Urea, Tea Tree Oil, Undecylenic Acid and Menthol. 

All of these products have been shown to be antifungal but they need to penetrate the nail to get to the matrix to work.  Many of the OTC products sit on the nail or just slide off the nail and therefore don’t get into the nail.

PediMD Antifungal Nail Treatment System 


  1. 70-80% clearing of the nail in clinical trials
  2. Local treatment with no full body involvement or risk
  3. Can wear nail polish on top of it
  4. Can be used to prevent nail fungus alone or as a base coat under nail polish
  5. Is combined with a antifungal foot cream to also treat the skin and prevent cross contamination
  6. Can be used after the fungus is cleared to prevent return of nail fungus
  7. Cannot be seen on the nail
  8. Can wear nail polish on top at any time


  1. Needs to be used for about one year to clear the nail


I hope this information helps clear up some of the misconceptions about nail fungus treatment systems.  It is essential to realize that a nail on the foot takes about 1 year to fully grow out and a nail on the hand takes about 6 months to grow out.  It is critical to treat the nail until it fully grows out clean and then continue to protect the nail with some form of defense to protect the nail against re-infection.



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