Fungal Nail Infection Treatments

A fungal nail infection, medically known as onychomycosis, develops when fungi invade the nail bed and surrounding skin, causing the nail to become discoloured, thickened and brittle over time. It most commonly affects the toenails, particularly the big toe, though fingernails can also be affected. Fungal nail infections tend to develop gradually and rarely resolve without treatment, so most people need an antifungal treatment such as a medicated nail lacquer to clear the infection fully.

Fungal nail infections are caused by fungi that thrive in warm, moist environments. You are more likely to develop one if you regularly walk barefoot in communal areas such as swimming pools, gyms or changing rooms, wear tight or damp footwear, or have sweaty feet. Other risk factors include having a weakened immune system, diabetes, poor circulation, psoriasis, a nail injury, or an existing case of athlete's foot, which can spread from the skin to the nail if left untreated.

Fungal nail infections are usually picked up through direct contact with fungi in warm, moist environments, such as swimming pool floors, gym changing rooms and communal showers. They can also spread through sharing towels, socks, shoes or nail clippers with someone who has an infection. If you already have athlete's foot, the fungus can spread from the skin on your feet to your toenails if it is not treated promptly.

Yes, fungal nail infections are contagious and can spread to other nails on the same hand or foot, to the skin (causing athlete's foot), or to other people through shared surfaces, footwear or nail tools. To reduce the risk of spreading it, use a separate nail file and clippers for infected nails, dry your feet thoroughly after washing, wear flip-flops in communal showers and changing rooms, and avoid sharing towels or socks. Starting antifungal treatment promptly also helps limit how far it spreads.

A fungal nail infection typically causes the nail to become discoloured (yellow, white or brown), thickened, brittle or crumbly, and sometimes distorted in shape. Debris can build up underneath the nail, and in some cases, the nail may start to lift away from the nail bed. It is not usually painful in the early stages, but as the nail thickens, it can become uncomfortable, especially in tight-fitting shoes. If your nail is very painful, swollen, red or you have diabetes, speak to a pharmacist or GP rather than treating it yourself.

Medicated antifungal nail lacquers, such as Amorolfine, Curanail and Loceryl, are the most widely used treatment for fungal nail infections. All three contain the same active ingredient, amorolfine hydrochloride 5%, which penetrates the nail plate and disrupts the fungal cell membrane to stop the infection growing. Clinical studies show it clears or significantly reduces symptoms in over 77% of toenail infections and 83% of fingernail infections after three months of consistent use. The affected nail is filed down, cleaned, and the lacquer applied one to two times a week.

Mild to moderate fungal nail infections can usually be treated at home with an over-the-counter medicated nail lacquer, without needing to see a GP first. Home remedies such as tea tree oil or vinegar are popular online, but there is limited scientific evidence that they clear a fungal nail infection, so they should not be relied on in place of a licensed antifungal treatment. If several nails are affected, the nail is very thick, or the infection keeps coming back, a pharmacist can advise whether a stronger option, such as an oral antifungal tablet from your GP, would be more suitable.

Fungal nail infections rarely clear up without treatment, as the fungus can persist within the nail for a long time if left untreated. With a medicated nail lacquer such as Amorolfine, it typically takes around 6 months to clear a fingernail infection and 9 to 12 months to clear a toenail infection, as treatment needs to continue until the infected nail has fully grown out and been replaced by healthy nail. Applying the lacquer consistently, as directed, gives the best chance of clearing the infection within these timeframes.

The clearest sign your fungal nail infection is healing is new, healthy nail growth appearing at the base of the nail, near the cuticle, which should look clear and free from discolouration. As this healthy section grows outwards, it gradually replaces the infected nail, which is why treatment needs to continue for several months rather than stopping once symptoms improve. Some people also take a nail-supporting supplement, such as OneVit Biotin, alongside treatment to support nail strength as new nail grows. If you see no improvement after a few months of consistent use, speak to a pharmacist.

Most fungal nail infections can be treated safely with an over-the-counter antifungal nail lacquer, but it is worth speaking to a pharmacist or GP if the nail is painful, red, swollen or warm to the touch, as this can indicate a bacterial infection rather than a fungal one. You should also seek advice if you have diabetes or a weakened immune system, as fungal nail infections can be more serious in these cases, if several nails are affected, or if there has been no improvement after several months of consistent treatment. A GP can take a nail clipping to confirm the diagnosis if it is unclear, or prescribe an oral antifungal tablet for more severe infections.