I’ve been fighting a fungal infection in my toenails. I took medication that seemed to clear the infection at first, but now it’s back. Any suggestions? K.L.

You are not alone. Statistically, fungal nail infections return at least 65% of the time, perhaps more frequently. The problem is that the fungi grow in your shoes as well as in your nails. Each time you put on your shoes you are re-infecting the nails.

Fungi prefer a moist environment so it is important that you wear the same pair of shoes no more often that every other day. This allows them to dry out more completely. It is also very helpful to treat the lining of the shoes with an antifungal powder or spray before and after wearing them.

If you do not wish to take medication again topical agents such as tea tree oil may be tried.  Many people have reported success applying Vicks VapoRub once or twice a day.  The most effective topical treatment I know is use of Herbal Nail Fungus Soak from www.longcreekherbs.com. Recognize that the goal is to keep infection out of the new portion of the nail as it grows.  Treatment often needs to be continued until the diseased portion of the nail has completely grown out.  This may take 6 to 9 months for fingernails and 12 to 18 months for toenails.  -Dr. Peterson