Struggling to treat an embarrassing fungal toenail and feeling frustrated at your lack of progress?

Updated: Apr 17, 2021

What is toenail fungus?

Known in the medical profession as Onychomycosis, fungal nail infections can make your toenails thick, crumbly, and with a yellow /brown discoloration. 

If you are able to cut or file the nail there may be a distinctive smell.

However, the affected nail/nails can become so thick they are difficult to cut and left un-managed can cut into the skin of adjacent toes. 

The pressure from shoes pressing down on the thick nail can also be a source of pain, and in severe cases may prevent you from wearing footwear and unable to get out of the house. 

The nail we see infected the most is the big toenail and the infection starts at the free edge, advancing down the nail, towards the cuticle.  

The commonest form affects the nail bed, which can therefore make any treatment challenging as any treatment has to get through the nail to the site of infection.

How do I get toenail fungus?

If the integrity of your toenail is compromised, in other words, if it has had some previous damage to it, this will allow the fungus to penetrate the nail where it thrives on the keratin that your nail is made of. 

It is also common in those people who suffer from athlete's foot, which is a fungal infection of the skin.

According to the National Institute for Health and Care Excellence (NICE) guidelines on treating fungal nail infections, you may be more at risk if:

  • You are older in age:

  • You are immuno-compromised, have peripheral arterial disease,  Raynaud’s Phenomenon, suffer from Psoriasis.

  • If you have Diabetes Mellitus you are 3 times more likely to contract a fungal nail infection.

Can I prevent toenail fungus?

There are some steps you can take to reduce your risk of contracting a fungal infection of the toenail:

  • Avoid damage to your toenails by wearing well-fitting footwear, avoiding high heels and shoes  with a narrow, pointed toe box,

  • Keep nails trimmed and filed.  Don’t share nail clippers with family members.

  • Have a good foot hygiene regime and treat any Athletes foot infections promptly.

  • If you use communal changing rooms, wear protective footwear.

  • Try to avoid prolonged or frequent exposure to warm, damp conditions.

  • Look for socks made from breathable, natural materials, such as Bamboo.

Stepwise Podiatry can help you by:

  • Cutting the affected toenail or nails to stop the nail from getting too long and cutting into the adjacent toe.  Cutting the nail also stops you from getting holes in your tights and socks!

  • Thinning down the affected nail or nails, which will not only make the nail look better but will make any treatment with an anti-fungal nail paint more effective.

  • Take a sample of the affected nail and use our quick 5 minute fungus test to get you the correct diagnosis.

  • Use The Lacuna Method

How will the 5-minute fungus test help me? 

If you are distressed by the look of your nails, one or more nails are affected or they are painful,  and you’re wondering what the best course of action to take is, then this is a test that we can do in clinic.

There's no need to wait weeks whilst the nail sample is analysed by the microbiology lab as this test develops to give a result before the end of your appointment.

It has been reported that up to half of all nails that look like they have a fungal infection don’t. So, before you work your way through the vast array of treatments available in your local pharmacy let us use our quick diagnostic test to save you time and money.

If the test is positive we can discuss the possible treatment options that you may wish to consider.

Treatment options for a fungal nail infection

If you are not worried about the look of your nail, or the nail is not causing you any pain you may wish to do nothing to treat the infection. However, you may like to consider:

Anti- Fungal Nail Paint

Topical treatments, that are painted on to the affected toenail or nails, are popular because they are easy to use, and avoid the risks that can be associated with medicines that are taken internally in a tablet form.

NICE suggests a topical agent containing 5% Amorolofine as the treatment of choice.  This is an off the shelf treatment in the form of Curanail.

Treatment may be needed for between 9 and 12 months to be effective,  so dedication will be the key to your success!

Oral Anti-Fungal tablet

Now you have a quick, confirmed diagnosis of a fungal nail infection another treatment option to consider is the possibility of an oral antifungal tablet.  

We can write a letter to your doctor so you can discuss this treatment option further, and if it would be suitable for you.  

The prescription for this will depend on your general state of health and is at the discretion of your doctor.


The Lacuna Method

We offer a treatment for fungal toenails that is unique to Podiatrists and Foot Health Practitioners. It's called The Lacuna Method.

Once a diagnosis is confirmed, with our in-house fungus test, this would be another treatment option.

Performed over 6 months, in a series of treatments approximately 6 weeks apart, Lacuna Method involves making multiple small holes in the nail plate, followed with the application of an antifungal treatment into the holes, where it reaches the infected nail bed below.

If you are interested to find out more about The Lacuna Method, you can click here to read the blog

It is also worth treating any fungal skin infections, like athlete's foot, with an appropriate anti-fungal cream or spray, as this is a common cause of re-infection of the nail. 

Step Towards Better Foot Health


Step Into Our World


Thank you for taking the time out of your busy schedule to read to the end of our blog on fungal toenail infections.

The fact that you have made it this far probably means you have a fungal toe nail and are considering some treatment options that could help.

If you would like to work with us to help improve your foot health please get in touch.

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