Fungal Fingernail Treatment
A fingernail that has gone thick, yellow, crumbly or lifted away from the nail bed is difficult to ignore, because unlike a toenail it is on display in every handshake, every meeting and every photograph.
Fungal infection of the fingernails is much less common than of the toenails. That is exactly why the first thing we do is establish whether it is actually fungal at all.
Start with the diagnosis, not the treatment
Plenty of fingernails that look fungal are not. Psoriasis affects nails and can look almost identical. So can damage from an old injury, from repeated gel or acrylic application, from chronic inflammation of the nail fold, and from a number of other conditions. Bacterial infection produces its own distinct discolouration.
This matters for a simple reason: antifungal treatment does nothing at all for a nail that does not have a fungal infection. People spend months on creams, lacquers and tablets for a nail that was never going to respond to any of them.
So we look at the nail properly first, and if the diagnosis is not clear we will say so and tell you what would settle it.
Worth knowing. A single dark or discoloured fingernail with no history of injury should always be assessed by a doctor rather than treated as fungal. In the overwhelming majority of cases it is harmless. It is checked because of the small number of cases where it is not.
Laser therapy
Where the nail is confirmed as fungal, we offer laser therapy through our sister clinic, The LaserCare Clinic. The laser passes through the nail plate and heats the tissue beneath it, targeting the fungus in the nail bed that topical treatments struggle to reach through a thickened nail.
It is non-invasive. There are no tablets, no liver function tests, and no interaction with other medication, which is the usual reason people are steered away from oral antifungals in the first place. Most people describe it as a sensation of warmth.
You should expect a course of sessions rather than a single visit, and we will tell you how many at the consultation, based on what we are looking at.
What results look like, honestly
Nobody can clear a fungal nail instantly, with any treatment, because the nail you can see is already grown. What changes is the new nail coming through behind it, and you are watching it advance at roughly three millimetres a month.
The good news for fingernails is that this is around three times the speed of a toenail. Where a toenail can take a year or more before the result is obvious, a fingernail commonly grows out fully in four to six months. You see whether it is working far sooner.
We will not promise you a guaranteed cure, because the published evidence on laser treatment of fungal nails reports improvement in nail appearance rather than a certainty, and most of that evidence is based on toenails. What we will do is tell you honestly what we expect in your case, and tell you if we think you are unlikely to get value from it.
Keeping it from coming back
Fungal fingernail infection frequently travels. It often comes from the feet, from a skin infection elsewhere on the hand, or from repeated damage to the nail fold. Treating the nail while leaving the source untouched is how people end up doing this twice.
Because we treat toenails and fingernails in the same clinic, we look at both. That sounds obvious. It is not what happens when your fingernails and your feet are treated by two different practices that never speak to each other.
Common questions
How do I know if it is actually fungal?
You often cannot tell by looking, and neither can anyone else without examining it. That is the point of the consultation. Nail psoriasis, old trauma, gel and acrylic damage and chronic inflammation of the nail fold all mimic fungal infection.
Does the laser hurt?
No anaesthetic is needed. Most people feel warmth and nothing more.
How many sessions will I need?
It depends on how many nails are involved and how far the infection has gone. We will give you a number at the consultation rather than a vague answer now.
How long before I can see a difference?
You are waiting for clear nail to grow out from the base, at about three millimetres a month. On a fingernail, full growth out commonly takes four to six months, so you get a clear read much sooner than you would on a toe.
What does it cost?
We give you the full cost of the course at the consultation, once we have seen how many nails are involved and how many sessions you are likely to need. There are no charges added on after that.
Can you treat my toenails at the same time?
Yes, and in many cases we should. Fungal infection often moves between the feet and the hands, and treating one while ignoring the other is how it comes back.