Treatment options ranging from monitoring to over the counter treatments to prescription medications and nail surgery may be considered in the treatment of nail fungus. Over the counter topical solutions, creams and ointments, may be used. Prescription medications are available in both topical and oral forms. Which treatment is best suited for each individual patient with regards to prescription medication is discussed and decided on based on patient goals, review of lab work, fungal nail culture results and any coexisting medical conditions. In some cases, nail surgery is discussed. The most common cases in which nail surgery is considered when treating toenail, fungus is in the case of extreme pain due to the thickness of the nail plate, a coexisting ingrown toenail, the desire of the patient for a permanent solution or a patient who would like to avoid the use of prescription oral or topical medications. Toenail fungus can reoccur in as many as 50% of patients who have previously treated for onychomycosis.