Understanding fungal nail infection
A fungal nail infection causes the nail to thicken, discolour and become brittle or crumbly. It usually starts at the free edge and spreads back towards the base.
Several other conditions look similar, including nail trauma, psoriasis and other skin conditions. Getting the diagnosis right before committing to months of treatment saves considerable time.
Signs you might notice
- Yellow, white or brown discolouration of the nail
- Thickening that makes cutting difficult
- Crumbly or brittle nail edges
- Nail lifting away from the bed
- Sometimes an associated odour
Common contributing factors
- Fungal organisms acquired in warm, moist environments
- Nail trauma allowing entry
- Reduced circulation or immunity
- Occlusive footwear worn for long periods
- Athlete's foot spreading to the nails
How we assess and treat it
We examine the nail and consider whether testing is worthwhile before starting treatment, because confirming the diagnosis changes what we recommend.
We are honest about timescales. Nails grow slowly, and a toenail takes roughly nine to twelve months to fully replace itself, so improvement is measured in months rather than weeks.
- Diagnosis and, where useful, sampling before treatment
- Reduction of thickened nail to relieve pressure
- Topical treatment applied effectively
- Advice on footwear, hygiene and preventing reinfection
- Referral for oral treatment discussion where appropriate
Common questions
How long does treatment take?
Expect nine to twelve months to see a fully healthy nail grown through. Anyone promising a quick fix is not being straight with you.
Do over the counter treatments work?
They can, particularly on early or partial infections, though they often fail on thickened nails because the product cannot penetrate. Reducing the nail first makes a real difference.
Will it come back?
It can, which is why footwear and hygiene advice is part of the treatment rather than an afterthought.