Fluconazole has a certain therapeutic effect on gray nails, but the cure rate is relatively low, and the clinical data on the treatment of gray nails is relatively small, and is not currently used as a first-line treatment drug for gray nails. Fluconazole is a drug for fungal infections, mainly used for the treatment of candidiasis, which occurs mostly in the oral cavity, intestines, and near the vagina, and needs to be used in strict compliance with the doctor’s instructions, because the side effects may cause gastrointestinal adverse reactions, manifested as nausea, vomiting, abdominal pain, or diarrhea, etc., and may also cause allergic reactions manifested as skin rashes, and occasionally, severe exfoliative dermatitis. Patients with serious underlying diseases, such as AIDS and cancer, may have abnormal renal function and need to be used with caution. Currently, terbinafine and itraconazole are often recommended for the treatment of gray nails in the clinic, and glacial acetic acid solution can also be chosen for topical treatment. In addition, it can be combined with cyclopirox and amorolfine, which should be used under the guidance of dermatologists. In addition, nail extraction or nail removal is indicated in cases of distal nail plate involvement, macular streak nails, ingrown nails, or nail plate thickness >2 mm. Laser and photodynamic therapy can also be used as adjunctive and alternative treatments for gray nails.