Fungal Nail Infection

Fungal Nail Treatment

Effectively treat your fungal nail infection with a variety of antifungal nail treatments, available over the counter. No need for a doctor's appointment. Fungal infections are more common in toenails than fingernails and cause discomfort or pain if left untreated. 

About fungal nail infections

A fungal nail infection, also known as onychomycosis, is a common condition where fungus infects one or more nails. They can become discoloured, easily break, or appear thicker than usual. An infection is more likely if you wear shoes for a long time, share footwear or clothing, have poor nail hygiene, or have hot, sweaty feet.  

What causes fungal nail infections?

Fungal nail infections are usually caused by various types of fungi, such as yeasts and moulds. Frequent exposure to moist environments can cause fungus to develop, because it thrives in warm and moist conditions. You are more likely to have a fungal nail infection due to:  

• Ageing 
• Poor circulation 
• Weakened immune systems 
• Diabetes  
• Trauma to the nail
• Poor nail hygiene
• Walking around barefoot in areas such as changing rooms, swimming pools and shared shower

What are the signs and symptoms of a fungal nail infection?

You may not notice the infection at first. As it develops, you may experience the following symptoms: 

• Discolouration – the nail may appear green or yellow in colour 
• Change in thickness – it may be difficult to clip your nails 
• Painful when applying pressure 
• Foul odour 
• Brittle or crumbly nails 
• Nail separation from the nail bed

How to diagnose a fungal nail infection

A fungal infection is diagnosed by visual examination. This typically involves a healthcare professional looking at the affected nails for signs of a fungal infection, such as a change in colour, crumbling, thickening or distortion of the nail shape, as well as signs of inflammation or infection in the surrounding skin. In some cases, clippings may be taken and sent to a laboratory for testing to confirm the presence of fungi. Early intervention can help prevent complications.  

Fungal Nail Treatments

Treating a fungal nail infection takes time, but it is possible. It can sometimes require a combination of approaches from topical treatments to surgical removal or laser therapy, as well as addressing any underlying health conditions and improving nail hygiene. You should visit your GP or pharmacist if the appearance of an affected nail is bothering you or causing you pain or discomfort. 

Fungal nail lacquer  

Fungal nail lacquers work by killing the fungal infection that causes the infection and have a high success rate when used correctly. Treatments such as Amorolfine or Curanail should be applied once or twice a week over a period of several months. Curanail is recommended for milder fungal infections in up to two nails and amorolfine 5% treats multiple nail infections at once.  

Fungal nail tablets  

Antifungal tablets can be prescribed by a GP if over the counter treatments have not worked. Antifungal tablets should be taken once or twice a day for up to 6 months. People who are pregnant, breastfeeding or have underlying health conditions, such as liver or kidney disease, cannot take antifungal tablets.  

Fungal nail cream  

Antifungal cream works by softening the infected part of the nail, so that it can be scraped off. This makes way for the growth of a healthy nail. This process is carried our every 2-3 weeks, until a healthy nail has grown over.

Laser treatment  

Laser treatment uses laser energy to heat and destroy the fungus while protecting the surrounding tissue. It can be an expensive procedure and is not covered by the NHS.  

What is the best treatment option?   

Antifungal tablets are most effective; however, they can be harsh on your liver, and you will need to have regular liver function tests. Usually, they are reserved for very severe cases. For mild to moderate cases, lacquer is the best fungal nail treatment as it is safest. Whilst laser treatment is the most effective treatment, it is expensive, so overall, the recommended treatment option will always be lacquer.  

How to prevent fungal nail infections

The risk of developing a fungal nail infection can be prevented by: 

• Regularly washing your hands and feet and keeping them clean and dry 
• Wearing clean cotton socks 
• Wearing shoes that allow your feet to “breathe” 
• Not walking around barefoot in public places such as swimming pools, changing rooms, or public showers 
• If you get athlete’s foot, you should treat it immediately to avoid spread of the infection to your nails 
• Keeping nails short and avoiding sharing nail clippers with other people

Sources

NHS. (Year). Fungal Nail Infection. NHS. Available at: https://www.nhs.uk/conditions/fungal-nail-infection/ (Accessed: May 2, 2024).