What do doctors prescribe for a toe infection?

October 12, 2025 •

3 min read

According to the American Academy of Family Physicians, ingrown toenails are one of the most common causes of toe infections, and if left untreated, they can lead to complications. Understanding what do doctors prescribe for a toe infection is crucial for effective treatment and preventing the spread of the condition.

Quick Summary

Doctors prescribe various medications for toe infections, depending on the underlying cause, which is most often bacterial or fungal. Treatment can involve topical ointments for mild surface infections or oral antibiotics and antifungals for more severe or deep-seated issues.

Key Points

Diagnosis is Key: The correct medication for a toe infection depends entirely on whether the cause is bacterial or fungal, which a doctor must diagnose.
Oral Antibiotics for Severity: For moderate to severe bacterial infections, such as an infected ingrown toenail, doctors prescribe oral antibiotics like cephalexin or clindamycin.
Topicals for Mild Cases: Mild, superficial infections may be treated with topical antibiotics like mupirocin or antifungal creams like clotrimazole.
Oral Antifungals for Nails: Persistent or severe toenail fungus (onychomycosis) often requires long-term oral antifungal medication, such as terbinafine.
Long-term Topical Antifungals: For milder nail fungus, prescription topical lacquers or solutions, like ciclopirox or efinaconazole, are applied daily for several months to a year.
Underlying Issues Require Procedures: When an infection stems from an ingrown toenail, medical procedures to remove the ingrown portion may be needed alongside medication.
Red Flags for Doctor Visit: You should see a doctor immediately for symptoms like intense pain, spreading redness, pus, fever, or if you have diabetes.

Understanding the cause: Bacterial vs. fungal

Before any medication can be prescribed, a doctor must determine the cause of the toe infection. Infections typically fall into two main categories: bacterial and fungal.

Bacterial infections

Bacterial toe infections often result from trauma, such as a cut or an ingrown toenail, that allows bacteria like Staphylococcus aureus or Streptococcus to enter the skin. An infected ingrown toenail is also known as paronychia. For superficial infections, topical antibiotics may be recommended. Deeper or spreading infections often require oral antibiotics.

Fungal infections

Fungal toe infections, such as toenail fungus (onychomycosis) or athlete's foot (tinea pedis), are caused by dermatophytes (skin fungi) or yeasts. Mild cases or athlete's foot can be treated with topical antifungal creams or lacquers. Severe or extensive infections, particularly those involving the nail matrix or resistant to topical treatments, typically require oral antifungal medication.

Medications for bacterial toe infections

Doctors commonly prescribe the following medications for bacterial infections of the toe:

Oral antibiotics: For mild-to-moderate infections caused by Staphylococcus and Streptococcus, common prescriptions include Cephalexin, Dicloxacillin, or Amoxicillin-clavulanate. Clindamycin may be used for patients with penicillin allergies or more severe cases. Trimethoprim-sulfamethoxazole (TMP-SMX) or Doxycycline are options if a community-associated MRSA infection is suspected.
Topical antibiotics: Mupirocin ointment is a prescription option for superficial bacterial skin infections. Over-the-counter creams containing neomycin, polymyxin B, and bacitracin can also be used for minor cuts.

Medications for fungal toe infections

Treatment for fungal infections of the toe can involve topical and oral options:

Oral antifungals: Terbinafine (Lamisil) is a common and effective oral antifungal for toenail fungus, typically prescribed for a period of several weeks to months. Itraconazole (Sporanox) is another option, sometimes used in pulse-dosing, but it has potential drug interactions. Fluconazole is used less often for nail fungus and typically for longer durations. Liver function monitoring may be necessary with oral antifungals.
Prescription topical antifungals: Ciclopirox nail lacquer is applied for an extended period, often up to a year, for mild to moderate nail fungus. Newer solutions like Efinaconazole and tavaborole are also applied and can be used for several months. Urea cream can help soften thickened nails to improve penetration of other topical medications.

Comparison of common toe infection medications


Medication Type	Typical Use Case	Efficacy	Duration	Key Side Effects
Oral Antibiotics	Moderate to severe bacterial infections, often with ingrown nails or trauma.	High, systemically effective against specific bacteria.	Varies depending on the specific antibiotic and severity of infection.	GI upset, rash, antibiotic resistance.
Topical Antibiotics	Mild, superficial bacterial infections of the skin.	Moderate, depends on penetration and wound prep.	Varies, use until infection clears.	Skin irritation, itching.
Oral Antifungals	Severe or stubborn nail fungus (onychomycosis).	High, but requires a long course of treatment.	Varies, can range from weeks to months depending on the medication.	Liver issues (rare but serious), GI upset, headaches.
Topical Antifungals	Mild fungal infections, athlete's foot, or mild nail fungus.	Lower than oral for nail fungus, good for skin infections.	Can take several months to a year for nail solutions.	Skin irritation, stinging.

Beyond medication: Additional considerations

For conditions like an ingrown toenail, medication is often only part of the solution. Doctors may perform minor procedures to facilitate healing and prevent recurrence. This can include partial or complete removal of the ingrown portion of the nail or draining an abscess. Laser therapy may also be recommended for stubborn fungal infections.

When to see a doctor

While warm soaks can help with mild issues like early-stage paronychia, it is essential to see a doctor if symptoms are severe or worsening. Seek medical attention if you experience intense or throbbing pain, pus or discharge, increasing redness or swelling, fever or chills, or red streaks on the skin. Individuals with diabetes or compromised immune systems should also seek immediate care for any toe infection.

Conclusion

Doctors prescribe various medications for toe infections, depending on whether the infection is bacterial or fungal and its severity. Oral antibiotics are typically used for more serious bacterial infections, while oral antifungals are often necessary for severe or persistent toenail fungus. Topical medications are suitable for milder infections. For conditions like infected ingrown toenails, medical procedures may be needed alongside medication. Prompt medical diagnosis and treatment are crucial for effective management and preventing complications, especially for individuals with underlying health conditions. For reliable information on managing common nail and skin conditions, consult trusted resources such as the American Academy of Dermatology.

Frequently Asked Questions

For an infected ingrown toenail, doctors commonly prescribe oral antibiotics such as cephalexin, dicloxacillin, or amoxicillin-clavulanate for mild-to-moderate cases. In patients with a penicillin allergy or more severe infections, clindamycin or trimethoprim-sulfamethoxazole may be used.

You can use over-the-counter creams for very mild, superficial infections, but they are often not strong enough for moderate to severe cases. Topical antibiotics like mupirocin or antifungal creams require a prescription for stronger versions, and seeing a doctor is recommended for persistent symptoms.

Doctors treat toenail fungus with either oral or topical antifungals. Oral medications like terbinafine are highly effective for severe cases but require monitoring. Topical prescription lacquers and solutions like ciclopirox and efinaconazole are used for milder infections, though they often take a long time to work.

Signs of a more serious toe infection include a fever, redness or swelling that spreads away from the toe, intense or throbbing pain, pus or drainage, and red streaks on the skin. These symptoms require immediate medical attention.

If home remedies fail or the infection is severe, a doctor or a podiatrist should be consulted. A podiatrist specializes in foot and ankle conditions and can accurately diagnose and treat complex toe infections, especially those involving ingrown toenails or the nail matrix.

Individuals with diabetes should seek medical care for any foot problem immediately. Poor circulation and nerve damage (neuropathy) can make even minor infections serious, and a doctor can provide prompt, specialized care.

Oral antifungals like terbinafine can, in rare cases, affect liver function. Before starting treatment, and sometimes during, a doctor will perform blood tests to ensure your liver is healthy enough to handle the medication. People with pre-existing liver disease may not be candidates for these medications.