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Fungal Toenail Treatments

5 Minute Fungus Dermatophyte Test 

Some nail conditions can mimic or look like a fungal nail infection. We recommend a test to accurately diagnose in clinic if your toenail has a fungal infection with results in just 5 minutes.

Lacuna Fenestration 

Micro holes are burred through the nail plate to allow for the fungicide treatment to reach and penetrate the nail bed. This treatment needs to be repeated on an 8 week basis so the clinician can re-burr the holes which become blocked with new nail and debris. The patient must commit to spraying the toenail once a day with the treatment advised. Please note it can take a year or more for the infection to grow out and the nail to be clear of infection.

Toe nail removal 

Removal of the toe nail with phenolisation (under a local anaesthetic)

This is the permanent removal of the infected nail under a local anaesthetic. It can take approximately 6 weeks for the toe to heal completely. Patients can drive the next day and go to work as normal.

The Podiatrist will discuss which treatment is advised for your personal situation.


Treatment depends on the severity of the infection, the spread of infection and how long the infection has been present.  There is no one treatment guaranteed to get rid of the fungal infection and treatment must be viewed as a long term therapy with commitment by the patient and the clinician. It can take up to a year or more to clear a fungal infected big toenail. 

Some medical conditions such as psoriasis or poor peripheral circulation may cause the nail to thicken and look like a fungal nail infection when actually there is no fungal infection present. Other medical conditions such as diabetes can make the patient more likely to have a fungal nail infection as does trauma to the nail plate.

Nail polish and gels can damage the nail plate especially if worn over several weeks. The nail plate weakens and micro cracks develop through which fungal spores can enter and infect the nail bed. It is advised not to wear nail polish during treatment.

It is advised to have a test to confirm the presence of dermatophytes which cause the infection so that appropriate treatment can be discussed and recommended. We offer the test at a small charge or you can ask your GP to test your nail on the NHS.


If the nail infection is very severe, oral treatment may be the only course of treatment. Tablets may be prescribed by the GP but be aware there are possible side effects which may affect the liver and regular blood tests may be necessary.

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