Q: I have read about remedies that cure toenail fungus using means other than prescription medications. We now need that information in...

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Q: I have read about remedies that cure toenail fungus using means other than prescription medications. We now need that information in our family. Could you please help us with this frustrating and embarrassing problem?

A: Toenail fungus, known as “onychomycosis” in medical circles, can be a frustrating problem. It usually shows up as a white, yellow or brown color change in one part of the nail, which can then spread to involve the entire nail bed. Sometimes, part of the nail breaks or flakes off, leaving irregular edges, and it can persist indefinitely if it isn’t addressed.

However, most of the time medicine considers it more of a cosmetic issue rather than a “medical issue” because it doesn’t usually cause any long-term problems. Of course, there are always exceptions to that rule — including people with diabetes, for example.

The trouble with toenail fungus is that it is hard to treat, even with prescription drugs. The two medications that are most commonly used are terbinafine and itraconazole. They are usually taken orally for about six to 12 weeks.

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The downside is that they interfere with other medications, and can also tax your liver. Another downside is that some insurance companies won’t cover the drugs because they also consider toenail fungus a cosmetic issue — though that depends on the individual case as well.

Because of that, many people turn to holistic medicine for ideas. Applying tea tree oil topically has helped some patients I have worked with. In one study, researchers had people apply a 100-percent tea tree oil solution on their nail twice a day for six months. This cured 18 percent of participants and improved the appearance of the nail in 60 percent.

But if you are going to try this, make sure you are using 100 percent tea tree oil, because lower concentrations do not seem to work.

As for side effects, some people are allergic to tea tree and get skin inflammation when they put it on the nail. If that is the case, then don’t use it. Also, keep in mind that you should never take tea tree oil orally because it is toxic.

Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish/Cherry Hill hospitals. Send questions to apujari@seattletimes.com for possible use in future columns. All information is intended for education and not a substitute for medical advice. Consult your doctor before following any suggestions given here.