[My Flight Surgeon]

The oral antifungal medications work well. You have to take them long enough for the nail to grow out to a normal nail. Sometimes the fungal infection is hard to eliminate. We then remove the toenail and treat with oral medications to totally eliminate the fungus.

These drugs can cause problems with the liver but it is relatively uncommon. I can't remember the last time I had to stop one because of liver problems.

Topical treatment is tried but is essentially worthless when it comes to fungus under the nails.