Medications for onychomycosis can be administered topically or orally. A combination of topical and systemic treatment increases the cure rate. Adjunctive surgical measures may also be used. Topical therapy for onychomycosis is as follows: Ciclopirox olamine 8% nail lacquer solution Amorolfine or bifonazole/urea (available outside the United States) Efinaconazole 10% topical solution (the first FDA-approved topical triazole for toenail onychomycosis) Tavaborole 0.5% topical solution, an oxaborole solution (boron-containing compound) Can be used in WSO and DLSO limited to the distal nail Should be limited to cases involving less than half of the distal nail plate or for patients unable to tolerate systemic treatment Topical treatments may be useful to prevent recurrence in patients cured with systemic agents Oral therapy for onychomycosis is as follows: Terbinafine Itraconazole Fluconazole and posaconazole [4] are off-label alternatives Systemic treatment is always required in PSO and in DLSO involving the lunula region Nonpharmacologic approaches include the following: Laser treatment Photodynamic therapy Mechanical, chemical, or surgical nail avulsion Chemical removal with a 40-50% urea compound in patients with very thick nails Removal of the nail plate as an adjunct to oral therapy..consult dermatologist they will do the needful