Fungal nail infections impact 1 in 4 people over the span of their lifetime. Appearing as unsightly deterioration of the nails on both the hands and feet, they can be both embarrassing and uncomfortable to live with. Many people will endure fungal nail infections for longer than necessary because they are considered to be harmless, but the longer you go without treatment, the harder they are to cure.

The Bell Practice treats fungal nail infections on a daily basis and we have seen them in every stage of progression. For this reason, we have outlined exactly what causes fungal nail infections and how they can be treated in the most painless and convenient way.

What causes fungal nail infections?

Fungal nail infections are caused when fungus infects the nails. It is highly contagious, infecting the nail bed and nail itself. The fungus does not need to be transferred from skin to skin contact and can linger on surfaces, making it easier to catch in areas where you are likely to walk barefoot like spas, swimming pools, changing rooms, shower cubicles, drama studios in schools, and others.

You can be more susceptible to fungal nail infections if you have trauma to the nail, a weakened immune system, conditions that impact your circulation, or if you have diabetes.

The signs of fungal nail infections

Fungal nail symptoms aren’t always obvious at first, but can present as:

• Hardening of the nail (sometimes to the point of pain)
• Distortion to the shape of the nail
• White or yellow lines, or complete yellowing
• Brittle texture to the nails
• Loss of natural shine
• Nail coming loose from the skin
• An unpleasant smell from the impacted toe(s)
• Skin infections around the toenail
• Discolouration at the sides of the nail or nail bed
  
  

Types of fungal nail infections

Fungal nail infections do not all present in the same way. The pattern of infection depends on how the fungus enters the nail and which part of the nail unit becomes affected. Recognising the type of infection helps guide the most appropriate treatment and gives an indication of how long recovery may take.

Distal subungual infection (most common)

This is the type of fungal nail infection most people experience. The fungus enters the nail from the skin at the tip or sides of the toe and spreads underneath the nail plate. Because the infection sits under the nail, it can be slower to treat and often requires sustained therapy while the nail grows out.

You may notice:

• Yellow, brown, or whitish discolouration starting at the edge
• Thickening of the nail over time
• Crumbly debris beneath the nail
• Gradual lifting of the nail from the nail bed
  
  

Superficial white infection

This form affects the surface of the nail rather than the deeper structures. As it is more superficial, this type can sometimes respond more quickly to treatment when identified early.

It often appears as:

• Chalky white patches on the top of the nail
• A rough or powdery texture
• Nails that become soft and easier to scrape
  
  

Proximal subungual infection

Less common, this infection begins near the cuticle and spreads outward.

Signs may include:

• Discolouration starting at the base of the nail
• Progressive involvement of the entire nail
• Possible association with lowered immunity

Because this type enters through the skin around the nail, it is important to assess any underlying health factors that may be contributing.

Total dystrophic infection (advanced stage)

This describes a more severe, long standing infection where the nail has become extensively damaged. At this stage, treatment focuses not only on clearing infection but also on improving comfort and supporting healthy regrowth.

The nail may be:

• Markedly thickened and distorted
• Fragile or broken down in structure
• Darkened and separated from the nail bed
• Difficult or uncomfortable to manage in footwear
  
  

Does the type of fungal infection you have matter?

Yes. Different patterns of infection respond differently to treatment. Early, surface level infections are generally easier to manage, whereas deeper or long standing infections require a more persistent approach. Assessment by a podiatrist ensures the correct diagnosis and helps prevent unnecessary delay in recovery.

Are fungal nail infections harmful?

Fungal nail infections are rarely harmful if treated early aside from the obvious damage that they cause your nail. However, if the infection is severe, you are pregnant, or you have diabetes, then it can lead to complications so it is vital that you see a professional podiatrist.

Neglecting treatment raises the risk of infection transmission to others and secondary bacterial infections. Emotional wellbeing can be impacted due to the visible effects of the infection, while difficulty walking might arise from thickened nails causing discomfort in shoes.

Are fungal nail infections painful?

Fungal nail infections aren’t initially painful but as they progress they can grow more uncomfortable for a wide range of reasons. It’s important to remember that it is an infection; inflammation and irritation to the surrounding skin can cause mild discomfort to severe pain. Thickening of the nails causes rubbing on the surrounding skin and other toes, and in some stages of infection, the nail can start to lift from the skin, leading to pain.

Pain can also be caused by a secondary infection.

How is a fungal nail infection diagnosed? 

A podiatrist will conduct a thorough examination of the impacted toes, making note of your symptoms. In some cases, they may wish to send a sample for further assessment.

From this, a treatment plan can be created.

How are fungal nail infections treated?

Although fungal nail infections are common, they rarely clear up without treatment. Because nails grow slowly, improvement can take time and patience; a healthy nail will only become visible as it gradually replaces the damaged area.

Treatment is tailored to the severity of the infection, alongside your general health and how far the fungus has progressed.

Mild to moderate infections

In the earlier stages, treatment may focus on topical approaches recommended by a pharmacist or clinician. These can include anti fungal nail creams, which are applied regularly but may take many months to fully treat the infection.

Nail softening treatments are also used for a short period to soften the infected nail so that affected areas can be gently removed. Softening and reducing the diseased portion of the nail helps target the infection more directly, as fungal organisms often sit beneath the nail plate rather than just on the surface.

At The Bell Practice, we are proficient in providing Clearanail treatment. This involves drilling microscopic holes into the nail, allowing topical medicines to penetrate beyond the nail’s surface.

More advanced infections

If the infection is more established, your GP may recommend oral anti fungal medication, prescribed when topical treatments alone are unlikely to be effective.

In more persistent cases, chemical or surgical nail removal may be considered to allow healthy regrowth. Some patients may also be offered laser therapy as part of a treatment plan.

Why treatment takes time

Fungal nail infections can be stubborn. Nails grow slowly, so even when the fungus has been treated, it can take several months before a clearer nail replaces the damaged one. Early intervention generally makes the infection easier to manage and limits spread to other nails.

Can you treat a fungal nail infection at home?

Mild fungal nail infections can be treated at home with topical treatment provided by a pharmacist, but you should always have the nail assessed prior to proceeding with anti fungal nail creams.

How to prevent fungal nail infections

Fungal nail infections aren’t always preventable but there are precautions you can take to reduce your risk of catching one:

• Keep toenails trimmed straight across and maintain good nail hygiene.
• Avoid sharing nail clippers, files, towels, or footwear.
• Choose well fitting footwear and avoid tight shoes that create a warm, moist environment where fungi thrive.
• Treat conditions such as athlete’s foot promptly to prevent spread to the nails.
• Wear protective footwear, such as flip flops, in communal areas like pools and changing rooms.
• Wear clean socks every day.
  
  

When to see a podiatrist about fungal nail infections

You should visit a podiatrist or a GP as soon as you notice the signs of fungal nail infection. This way, you will be able to see results more quickly and prevent advancement of the infection before you need to have the nail removed.

At The Bell Practice, we provide the latest solutions to treat fungal nails with visible results in as little as 2-8 weeks. Our team of specialists are accomplished in both diagnosis and treatment of unsightly infections, assessing the previous health concerns of the patient and understanding which treatment plan works best for your condition and your circumstances. Whether you’ve noticed the signs of a fungal nail infection or have been living with symptoms for an extended period of time and require more advanced treatment, contact our team of podiatrists who will guide you towards cleaner, healthier nails.