By the way, doctor: Cut off from toenail fungus medicine too soon?

Q. Penlac didn't work to cure my toenail fungus. I took an oral medication, terbinafine, and saw some improvement, but my insurance company won't approve more than a few months of treatment. It's frustrating to finally have a solution and then be cut off.

A. I am not surprised that ciclopirox (Penlac) didn't work. It's painted on like nail polish, so it's nice and easy to use. But toenails are made of a tough, impenetrable protein called keratin, so the medicine doesn't reach fungi growing inside them very well. Penlac is effective less than 10% of the time.