Fungal nail infections are common and although not life threatening, they can increase your risk of developing skin or wound infections on your feet, which can be a serious concern for
people with diabetes. Fungal nail infections are obviously unsightly too and annoyingly take a long time to treat. But, are you sure it's a fungal infection? Since starting work as a podiatrist I've had many clients attend for treatment of fungal infection when actually the nail has suffered trauma and is looking thickened or perhaps off colour but after a simple test, no fungal infection is found. For example, the first image below is actually bruising and not a fungal infection. It is easy to confuse the two conditions especially when a bruise or nail damage is taking some months to resolve. Read on to find out more...
Firstly, confirm that it's a fungal nail infection
Fungal nail infections are most common on your toenails, but you can get them on your fingernails too. Sometimes infection is obvious and can be identified with a visual check (see images below), but not always. So, before starting any treatment for fungal nails it's best to have them tested. Your GP can arrange this for you, they'll need to take a nail sample and send it to microbiology for testing. A common mistake you see with this process though is the use of clear containers when collecting the sample. It's usually best to use a 'blackout envelope' to collect some of your nail, it remains in this envelope on the way to microbiology so that the fungal spores don't die before they are tested (often bright light is enough to ruin a sample). Alternatively on the spot fungal nail testing is now available at the Find Your Stride podiatry clinic in Edinburgh, it costs £40 and you get an immediate result.
Over the counter treatments
If the look of your nail bothers you or it's painful and a test has confirmed fungal infection, you could see a pharmacist to explore your options before booking in at the podiatry clinic. They may suggest:
'Antifungal' nail cream/lacquer – it can take up to 12 months to cure the infection and does not always work
Nail-softening cream – it's used for 2 weeks to soften the nail so the infected part can be scraped off
Remember! The infection is cured when your nail looks healthy again, don't stop the treatment until the entire nail is clear/free from infection. If you're not sure, consider getting in touch and booking a free call with one of our podiatrists for some advice.
Treatment for a fungal nail infection from a GP
A GP can prescribe antifungal tablets once fungal infection is confirmed. They should also review your current medication and discuss the side effects of the drug before writing your prescription because you may need to take anti-fungal tablets for up to 6 months and you should know what to expect. The medication is called Terbinafine and can have side effects, including:
Headaches
Itching
Loss of taste
Feeling sick and diarrhoea
You cannot take anti-fungal tablets if you're pregnant or have certain medical conditions. They can also damage your liver.
Other treatments
Badly infected toe nails sometimes need to be removed. It's a small procedure done while the toe is numbed (under local anaesthetic). Some podiatry clinics now offer laser treatment to destroy the fungus. There's little evidence to show that this is a long-term cure as most studies only follow patients for 3 months, meaning your fungal infection could return.
Preventing fungal nail infections
Prevention is always better than cure! If you can avoid this problem then you'll never need to treat it. Fungal nail infections develop when your feet are constantly warm and damp, because fungus loves these conditions. You're more likely to get an infection if you wear shoes for long periods every day and have hot, sweaty feet. To prevent fungal nail infections:
Do
Treat athlete's foot as soon as possible, it can spread to the nails
Keep your feet clean and dry
Wear clean socks every day (change your socks at midday if really sweaty)
Wear flip-flops in showers at the gym or pool
Throw out 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
Get in touch if you have any questions... Find Your Stride!
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