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What is a fungal nail infection?

A fungal nail infection, or onychomycosis, is when the hard material that makes up the nail (keratin) is infected by fungi – normally dermatophyte fungi. The infection can affect any part of the nail including the nail itself, the nail bed or the nail root. Toenails are more commonly infected than fingernails and the result is a discoloured (white, black, yellow or green), thickened and distorted nail. The main problem for most is that the infected nail looks unsightly, but some people may experience pain or discomfort due to the distortion of the nail shape.

What are the symptoms of a fungal nail infection?

Fungal infections of the nails, especially the toenails, are very common and can be unsightly. There are four classifications of a fungal nail infection, which all look slightly different. The most common is called 'distal lateral subungual onychomycosis' (DLSO), in which the underside of the nail appears a green-yellow colour, starting at the top of the nail and working down. The nail also becomes thicker and flaky.

Other types of nail infection can appear as crumbly white 'islands' on the top surface of the nail, or as white areas underneath the nail at its base, close to the toe. If any of these infections are left untreated, the whole nail may become affected and may become very uncomfortable as it thickens and distorts. The infection will not go away on its own, and could eventually lead to loss of the nail.

Pharmacy2U offers a convenient and confidential Online Doctor consultation if you’ve got a fungal nail infection, which could lead to prescription-strength treatments being recommended where appropriate.

What are the causes of fungal nail infections?

The nail becomes infected by a dermatophyte fungi, which also causes athletes foot. Athletes foot is a fungal infection of the skin between the toes, and it can spread to the nails. Fungi thrive in a damp environment, so you will be more at risk of a fungal nail infection if your shoes make your feet hot and sweaty. Damage to the nail through stubbing your toe or biting your nails can also increase the risk of infection. Finally, there are some medical conditions that can increase your risk of fungal nail infection including diabetes, psoriasis and anything that diminishes your immune system.

Once one nail is infected, it’s very easy to spread it to other nails when cutting or filing your nails. You should always use separate nail files or scissors for the infected nail, preferably cleaning them with alcoholic wipes after each use and discarding disposable nail files after use.

Fungal nail treatments

Treatment of fungal nail infection is possible, but it can take 12 months to completely remove the infection from a toe nail. If the infection is minor (involving only the upper half or sides of one or two nails) then a non-prescription treatment is available to buy from Pharmacy2U called Curanail.

For more serious infections, antifungal tablets can be prescribed by a doctor. This is more effective than nail lacquers, as the antifungal medicine is carried in the blood and does not have to penetrate the nail to be effective. The Pharmacy2U Online Doctor can prescribe terbinafine if it suitable for you. As with all antifungal treatments, it may take six to nine months for the infection to be completely eradicated and early cessation of treatment could result in the infection returning.

Like all medicines, terbinafine can have some side effects – one of the rare side effects is liver toxicity. Whilst this is rare, it is important that when you're taking terbinafine, we monitor your liver. When the doctor prescribes terbinafine, you will also be sent a blood test that checks your liver is functioning correctly. The blood test can be conducted from the convenience of your own home and is performed by collecting finger prick blood into a small vial. This will need to be done each time we send you a new supply of medicine.

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In very severe cases, the infected nail could be removed surgically and laser treatments are also available. However, Pharmacy2U does not offer surgical or laser treatments.

If you think you may have an infected nail and need prescription treatments, act now and start a convenient and confidential consultation with one of our UK registered GPs.