Fungal Nail Infection

What is a fungal nail infection?

A fungal nail infection happens when germs called fungi get into your nails. These infections are not dangerous, but they can make your nails look different and sometimes feel uncomfortable. They take a long time to get better - often many months.

What does it look like?

Fungal nail infections usually start at the edge of your nail. You might notice:

• Your nail becomes thicker than normal
• The colour changes to white or yellow
• The nail becomes brittle and crumbly
• Sometimes the whole nail can lift away from your finger or toe
• The skin around the nail might become swollen and sore

These infections happen more often in toenails than fingernails.

When to get help

See your pharmacist if:

• The way your nail looks bothers you
• Your nail is painful

You must speak to your GP if:

• The infection is bad and pharmacy treatments haven't worked
• The infection has spread to other nails
• You have diabetes (foot problems can be more serious if you have diabetes)
• You have a weak immune system (for example, if you've had an organ transplant or are having chemotherapy)

What treatments are available?

Pharmacy treatments

Your pharmacist might suggest a special nail medicine that you paint onto the affected nail. These medicines:

• Need to be used every day or once a week
• Must be used for 6 to 12 months
• May take several months before you see any improvement
• Might not be right for you if you're under 18, pregnant or breastfeeding

The infection is cured when you see healthy nail growing back at the bottom.

GP treatments

If pharmacy treatments don't work, your GP might give you antifungal tablets. Before prescribing these, they will:

• Take a sample of your nail to test what type of infection you have
• Possibly arrange a blood test to check your liver is working properly

You might need to take these tablets for up to 6 months. They can cause side effects like:

• Headaches
• Itchy skin rash
• Stomach pain
• Feeling sick and loose bowel movements

These tablets aren't suitable for everyone, especially if you have liver or kidney problems, or if you're pregnant or breastfeeding.

In very bad cases, the infected nail might need to be removed in a small procedure using local pain relief.

How to prevent fungal nail infections

Fungi love warm, damp places. You're more likely to get an infection if you wear trainers for long periods and your feet get hot and sweaty.

Do:

• Treat athlete's foot quickly to stop it spreading to your nails
• Keep your nails short
• Keep your feet clean and dry
• Wear clean socks every day
• Wear flip-flops in gym showers or around pools
• Choose shoes that fit well without high heels or narrow toes
• Throw away old shoes

Don't:

• Wear shoes that make your feet hot and sweaty
• Share towels
• Wear other people's shoes
• Share nail clippers or scissors

Remember, fungal nail infections are common and treatable. Speak to your pharmacist first, and see your GP if the infection doesn't improve or if you have other health conditions.

---

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.