Typically no, because there is about a 6% success rate for a topical preparation on the toenail after one year. This means that after one year of daily use, 6% of patients using a topical shellac on the nail can expect to have a clear toenail. This is the reason why we oftentimes need to resort to oral antifungal medications for toenail fungus or onychomycosis. Oral medications have a success rate closer to 86% to 90% after two to three months.
Although there are very low risks of liver inflammation when using these medications, it is something to still be aware of prior to initiating therapy with an oral antifungal. Typically, your doctor will draw a set of baseline labs to ensure that your liver is healthy prior to initiation of an antifungal tablet.