• Fungal Nail

Fungal Nail Infections (Onychomycosis)

Fungal infection of nails is common. The infection causes thickened and unsightly nails which sometimes become painful. Medication often works well to clear the infection, but you need to take medication for several weeks.

Who gets fungal nail infections?

Between 3 and 8 out of 100 people in the UK will have a fungal nail infection at some stage of their lives. Toenails are more commonly affected than fingernails. It is more common in people aged over 55, and in younger people who share communal showers, such as swimmers or athletes.

How do you get a fungal nail infection?

Spread from a fungal skin infection. For example, athlete's foot is a fungal skin infection of the toes.  This may spread to the toenails if the skin infection is not treated early. Fingernail infection may occur after a toenail infection has become established. The fungus may spread to a finger if you scratch your itchy toes and toenail.  Fingernail infections are also more likely to occur if you wash your hands frequently, or have them in water a lot. For example, if you are a cook or a cleaner.  Constant washing may damage the protective skin at the base of the nail. This may allow fungi to enter.

A nail that has recently been damaged is also more likely to become infected.

You have an increased risk of developing a fungal nail infection if you have various other conditions.

For example: diabetes, psoriasis, poor circulation, a poor immune system (for example, if you have AIDS or are on chemotherapy), or a general poor state of health.

Nail infections are more common in people who live in hot or humid climates.

Smoking also increases the risk of developing a nail infection.

In some cases there is no apparent reason. Fungus germs (fungi) are common and an infection can occur 'out of the blue'.

What are the symptoms of a fungal nail infection?

Often the infection is just in one nail, but several may be affected. At first the infection is usually painless. The nail may look thickened and discoloured (often a greeny-yellow colour). Commonly, this is all that occurs and it often causes no other symptoms. However, it can look unsightly.  Sometimes the infection becomes worse. White or yellow patches may appear where the nail has come away from the skin under the nail (the nailbed). Sometimes the whole nail comes away. The nail may become soft and crumble. Bits of nail may fall off. The skin next to the nail may be inflamed or scaly. If left untreated, the infection may eventually destroy the nail and the nailbed, and may become painful. Walking may become uncomfortable if a toenail is affected.

Fungal Nail Treatment


Are all Laser treatment methods the same?


With few exceptions our method is the same as that used by other laser companies offering this type of treatment. With its precision handpiece, the Gentle Max Pro Nd:YAG Laser raises the temperature under the nail to a level that's inhospitable to fungus in order to increase the appearance of clear nails, allowing Aestheticians to treat onychomycosis symptoms locally without the systemic effects of oral medications. Most infectious agents can be killed by heat, which makes laser therapy an extremely promising new option for onychomycosis sufferers.


How many treatments will I need?


Usually between 3 and 5 treatments at monthly intervals. In general if the fungal infection is more than 5 years old, then 5 treatments will probably be required but if less than 5 years old, then 3 treatments will probably be required. The prognosis is good if only 1 out of 10 toenails infected but less if all 10 toes are infected.

The fungi that are killed with treatment remain in the nail until the nail grows out. Fresh, healthy nail growing from the base of the nail is a sign that treatment is working. After you finish a course of treatment, it will take several months for the old infected part of the nail to grow out and be clipped off. The non-infected fresh new nail continues growing forward. When it reaches the end of the finger or toe, the nail will often look normal again. Fingernails grow faster than toenails, so it may appear they are quicker to get back to normal. It may take up to a year after starting treatment before toenails look completely normal again and six months for fingernails to look completely normal.


How should I prepare the area to be treated?


All treatment areas should be clean. Remove all creams, lotions, nail polish, and jewellery and clean the area. Shave the areas of hair if necessary. Patients with thicker nails may need to have the nails pared to allow for better light absorption below the nail. A visit to the chiropodist before treatment, to get the nail filed down as thinly as possible, ideally a minimum of at least 2 days before the laser procedure (so that the laser can penetrate through the nail to the infected nail bed more efficiently) coud also help. Also have the nails cut down as close as possible, again a minimum of 2 days beforehand. Nails will cut better/easier if feet are soaked in saline solution for 30 minutes before cutting them.


What happens during the treatment?


Once the nails have been cleaned a non-alcoholic spray will be applied and then the laser beam will be passed across each nail in a 'painting' technique, both horizontally and vertically, including the cuticles and sides of the nailbed. This will be done several times over each toe and the patient will be required to wear protective glasses.


Is the treatment painful?


The procedure can feel uncomfortable usually towards the end of each dose and is usually felt more in the infected area. However, the discomfort subsides relatively quickly once the procedure is over and patients seem able to tolerate the treatment pretty well.


Can the Aesthetic Practioner use a numbing cream or other anaesthetic to make the procedure more comfortable for the patient?


Topical or local anaesthetics are not advised due to the need for patient feedback during the procedure. However a painkiller (eg Codamol) can be taken a couple of hours before the procedure if necessary.


What aftercare is advised?


• Keep the area cool for 24 hours
• patient needs to throw away all their socks
• and where possible, all their shoes, in order to stop the infection re-occurring (there is now a device called SteriShoe that can be bought for as little as £80 to sterilize shoes if it is not possible to throw them away).
• aftercare is LAMISIL anti-fungal agent daily (as per prescribing recommendations)
• with application of almond oil on all toes (helps soften cuticles and prevents nails from splitting and breaking, and can help the nails grow faster and healthier)
• use a clean dry towel and hair dryer to dry your nails after washing
• if new nail growth is observed after several treatments, then the procedure has been a success
• may take 4-6 months for clear nails to push through


Can the Aesthetic Practioner just treat the big toe if that area is the most affected?


No, the practioner should treat all the nails on the foot for best results. This is because the fungus that causes onychomycosis, and its opaque yellow nails, can remain on the untreated toes and re-infect the treated nails.


Does the patient have to wait for results or will they seem them immediately?


It often takes the big toe nail a full year to completely grow out. Patients may see noticeable results after 3 months, but some cases may take longer due to slow nail growth.


What can the patient do to make sure they get the best possible outcome?


The patient should follow the practioner's recommendation closely. Patients should keep their feet clean and dry while wearing clean socks and shoes. They should also apply prescribed anti-fungal creams as directed.


Why do some Practioners recommend the patient throw away their shoes?


It is not uncommon for a Practioner to recommend that the patient buy new shoes or make use of a device or service they provide to disinfect the patient's current shoes. This is because the fungus that causes the condition can linger in shoes and socks that are not properly disinfected and re-infect the treated nail.


Any Other Questions?


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Kingston Laser Clinic
31 High Street
Hampton Wick
Kingston Upon Thames
Surrey KT1 4DA

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