People often arrive having spent a year or more on chemist paints and lacquers with nothing to show for it. There are two reasons that happens, and only one of them is about the treatment itself.
Reason one: the treatment cannot reach the infection
A fungal nail infection sits within and beneath the nail plate. The nail is a dense, largely impermeable barrier - which is its job.
Topical treatments have to penetrate that barrier to reach the organism. Many simply cannot get deep enough in sufficient concentration, particularly once the nail is thickened. The treatment is applied faithfully for months to the surface of a shield that is protecting the very thing you are trying to kill.
Reason two: it may not be fungal at all
This is the one that catches people out. Not every discoloured, thickened or crumbling nail is a fungal infection.
Nails change for a range of reasons - old trauma, pressure from footwear, psoriasis, and other conditions that look very similar to the untrained eye. If the problem is not fungal, an antifungal will never work no matter how long you use it.
Confirm before treating
We take a nail sample and confirm what we are dealing with before starting treatment. It sounds obvious. It is skipped constantly, including by people selling treatment.
If it is not fungal we will tell you and treat what it actually is. If it is, you start treatment knowing it is aimed at the right target.
What we can offer
Class 4 laser therapy is used to target the fungal organisms in and under the nail. It is quick, pain-free, and offered by only a small number of clinics in Ireland.
Alongside that, careful reduction of the nail thickness helps considerably. Rotary debridement thins the nail noticeably, often within a single session - which reduces pressure and discomfort, improves the appearance immediately, and gives any topical treatment a far better chance of reaching the nail bed.
Where appropriate we will also discuss oral treatment with your GP, because some presentations genuinely need it.
Honest expectations
This is the part we would rather say at the outset than after six months.
Nails grow slowly. A toenail takes many months to grow out fully, so even with successful treatment you are looking at a long period before the nail looks normal - you are waiting for healthy nail to replace damaged nail, not for the damaged nail to repair.
And even with successful treatment, a nail that has been badly affected may not return exactly to how it looked before. Where the nail bed itself has been damaged, some permanent change in appearance is possible. You deserve to know that before you start, not afterwards.
Reducing the chance of it returning
- Keep feet dry - fungal organisms favour warm, damp conditions.
- Rotate footwear so shoes dry fully between wears.
- Wear something on your feet in communal changing rooms and pool surrounds.
- Treat athlete's foot promptly; skin infection commonly precedes nail infection.
- Do not share nail clippers, and disinfect your own.
If you have been hiding your feet
A great many people put this off for years out of embarrassment. There is no version of this we have not seen, and no reaction from us other than working out what it is and what can be done.
Book directly at Finglas or Mount Merrion - no GP referral needed. The same goes for verrucas.
This article is general information about a common foot condition and is not a diagnosis or a treatment plan for any individual. Foot pain has several possible causes that present similarly, so if something is troubling you, have it assessed in person.
References
- Fungal nail infection - HSE (Health Service Executive, Ireland)
- Fungal nail infection - NHS
This page is for general information and does not replace individual clinical assessment. If symptoms persist, book an appointment with a CORU-registered podiatrist.