Fungal Nail Infections

Fungal nail infections which are known medically as Onychomycosis or Tinea Unguium are most commonly spread from fungal skin infections such as Athlete’s Foot. They can also occur from opportunistic bacteria that migrate under a damaged nail plate.

The nail plate is sealed tightly to the nail bed and this seal must be broken in order for bacteria to enter. The nail bed provides bacteria with sugary warm blood to survive while your shoe and sock provide a favourable environment for the fungus to thrive.

Fungus beneath the nail plate prevents the nail from attaching to the nail bed which leads to thickening of the nail plate. Infection usually begins at the free edge travelling down the side of the nail. During the early stages of the infection, nails may appear yellowish with white powder-like lines. In a more established infection, the nail may appear varying shades of brown.

Fungal infections are usually diagnosed on clinical examination however, your GP may decide to take clippings of the nail for laboratory testing.

Fungal nails will not resolve themselves but not all infected nails need to be treated. If the fungal nail infection is not distressing or painful it can be left alone. However, patients should take steps to prevent the infection from spreading.

Topical treatments can be painted on the nail such as Amorolfine, Tioconazole, and Ciclopirox. These treatments work best in the very early stages of infection as they cannot reach the nail bed. They may be used for months to years but cure rates are low.

Oral treatments include Terbinafine, Itraconazole, Fluconazole, and Griseofulvin which are available from your GP. Some of these treatments may have unwanted side effects and liver function tests may be carried out.

@britishdermatology recommends Terbinafine should be considered as a first-line treatment for Athlete’s Foot and fungal nail infections.

At Feet First Podiatry we use the Lacuna Method also known as fenestration. Fenestration treatment introduces tiny holes through the nail plate so that antifungal solution can be applied and reach the point of infection directly to clear the infection as the nail plate grows.