Fungal Nail Treatments
Fungal infections in the toenails can be difficult to diagnose and treat. In cases where the infection has gone unnoticed for a long period of time, at-home treatments have not been successful, or for those with a compromised immune system, treatment can be particularly difficult and further at-home care is seldom successful.
What does a fungal nail appointment involve?
Assessment of the nail
Your podiatrist will assess the nail, and as you to report a bit of a history of the presentation. This will include questions like:
How long has it been noticed for?
Do you have any idea what may have caused it?
Have you significantly damaged the nail previously?
​
Your podiatrist may also ask to take a clipping of the nail to be tested to confirm presence of a fungal infection. In some cases, significant, or repetitive nail trauma can cause changes to the appearance of the nail, similar to that of a fungal infection. It is important to be able to distinguish between changes due to nail trauma, and changes due to a fungal infection. To find more information on how to compare nail trauma to a fungal infection at-home, read my blog post here!
​
commonly available in most chemists), provide appropriate advice around protecting your other nails, and then check-in with you periodically to ensure the treatment is tracking successfully and provide nail and skin treatments to decrease the fungal load along the way.
​
Establishment of treatment method and expectations
Read some of the options below!
Treatment Options Available
In-clinic A.R.C. laser treatment
This involves a trained, experienced podiatrist cutting back some of the detached and devitalised nail, then using a clinical, hot laser to kill the remaining fungal spores on the nail bed and surrounding skin. The treatment feels warm to hot, and is a very tolerable treatment. Your podiatrist can discuss your suitability based on the amount of nail affected by the infection, and by your medical history on the same day.
​
Targeted at-home topical treatment
This treatment may be a suitable option to treat a fungal toenail infection at-home. Your podiatrist will recommend the medicated topical treatment most suited to your presentation (which are commonly available in most chemists), provide appropriate advice around protecting your other nails, and then check-in with you periodically to ensure the treatment is tracking successfully and provide nail and skin treatments to decrease the fungal load along the way.
​
Referral pathways for oral medication (if eligible)
Your podiatrist can communicate with your General practitioner or family doctor to explain the methods of treatment for your fungal nail infection that have been explored as well as the level of success of those treatments.
Then, your doctor can assess your medical history and health status before prescribing an oral anti-fungal medication, or advising against the use of that medication in your case.
​
Oral anti-fungal medication (commonly oral Terbinafine) can have many side effects and is commonly a 'last resort' treatment in most cases. It is not a suitable treatment for everyone. It is particularly unsuitable for those with a history of organ failure, those who are pregnant, conceiving or breastfeeding and for young children. Your General practitioner or family doctor is the most suitable professional to ensure these medications are used effectively and only as required.