Fungal Nail Infection: Signs, Treatments That Work and How Long They Take

Fungal nail infections are common, stubborn and slow to clear. They’re not dangerous for most people, but they can be uncomfortable and embarrassing. The key is patience: nails grow slowly, so treatment takes months, not days.

Imagine noticing that your big toenail has turned yellow at the edge. Over a year it thickens, becomes crumbly and starts lifting from the nail bed. You hide your feet in sandals season. You’ve tried a cream from a market stall for two weeks with no change, and given up. The truth is, two weeks was never going to be enough.

Signs of a fungal nail infection

• Discolouration: white, yellow, brown or green, often starting at the edge
• Thickened, brittle or crumbly nails
• The nail lifting away from the nail bed
• Discomfort in shoes, and sometimes a smell
• Often athlete’s foot on the skin nearby

Other conditions, such as psoriasis or nail injury, can look similar, so a nail clipping test is sometimes done before tablets are prescribed.

Treatments

• Antifungal nail paints or solutions from a pharmacy: best for mild infections affecting part of one or two nails. They need to be used for many months, often 6 to 12, or until a healthy nail grows out.
• Antifungal tablets such as terbinafine, prescribed by a doctor: more effective for widespread infection, usually taken for about 3 months for toenails. They need checks for side effects and interactions.
• Nail softening kits and podiatry care to remove thick nail
• Laser treatment is offered privately in some places, but the evidence is limited.

Even after successful treatment, the nail can take 12 to 18 months to look normal, because toenails grow slowly.

Preventing it coming back

• Treat athlete’s foot promptly
• Dry feet well, especially between the toes
• Wear clean cotton socks and alternate shoes
• Wear flip-flops in communal showers and pool areas
• Don’t share nail clippers or towels

But who should see a professional first?

If you have diabetes, poor circulation or a weakened immune system, see a nurse, doctor or podiatrist rather than self-treating, because foot infections can become serious. Get prompt help if the skin around the nail becomes red, hot, swollen or painful.

Sources: NHS (Fungal nail infection), American Academy of Dermatology, US Centers for Disease Control and Prevention (Fungal nail infections), British Association of Dermatologists. This guide is for general information and does not replace advice from your own nurse, doctor, podiatrist or pharmacist.