Fungal nail infection on the NHS: what your GP can offer

The NHS treats fungal nail infection in two steps: a pharmacist first, who can recommend a paint-on antifungal, then a GP if that fails or the infection is more than mild, who can confirm it with a nail sample and prescribe tablets. The NHS does not fund laser treatment, treats appearance alone as a low priority, and offers NHS podiatry mainly to people whose other conditions make foot problems risky. For everything else there are private podiatrists, where an appointment typically starts at £48.

Key facts

Step one: what can a pharmacist do?

The NHS advice is to see a pharmacist if the look of the nail bothers you or it is painful. The pharmacist can:

• Confirm it looks like a fungal infection and rule out the obvious alternatives.
• Recommend a paint-on antifungal (amorolfine lacquer is the main one) and explain how to use it: file the nail, apply weekly, for six months for fingernails and nine to twelve for toenails.
• Tell you if a product is unsuitable, for example in pregnancy, breastfeeding or for under-18s.
• Advise on athlete’s foot, which often goes with it and must be treated.

Pharmacy treatment works for mild infections at the tip of the nail. If the base of the nail is involved, more than half the nail, or several nails, it is unlikely to cure and you may as well go to step two.

Step two: when should you see a GP?

See your GP about a fungal nail infection if:

• Pharmacy treatment has not worked after a reasonable trial.
• The infection is severe or has spread to other nails.
• You have diabetes, because foot problems are more serious.
• You have a weakened immune system, for example after a transplant or during chemotherapy.
• The nail is painful, lifting, or the skin around it is swollen.

What the GP can do:

Take a nail sample. Clippings and scrapings from under the nail go to a laboratory to confirm fungus and identify the type. Results take two to three weeks. NICE advises doing this before tablets are prescribed, because about half of suspected fungal nails are something else and tablets have side effects.

Prescribe tablets. Terbinafine, usually, for six weeks (fingernails) or three to six months (toenails); itraconazole for yeast infections or where terbinafine is unsuitable. The GP may order a blood test before and during treatment to check the liver. Our guide to terbinafine for fungal nails explains the course and side effects.

Refer. To NHS podiatry if you are in an at-risk group; to dermatology if the diagnosis is unclear or treatment has failed repeatedly.

Arrange nail removal. Rarely, for a badly infected, painful nail, the GP or an NHS podiatrist can remove it under local anaesthetic.

On the NHS, tablets cost the standard prescription charge per item in England and are free elsewhere in the UK.

What won’t the NHS fund for fungal nails?

• Laser treatment. Not funded, because the evidence is not strong enough; NICE does not recommend it.
• Treatment for appearance alone. A fungal nail that is not painful and not spreading is low priority, and some GPs will advise living with it or using pharmacy treatment.
• Routine nail cutting and thinning. NHS podiatry does not provide routine nail care for people without a medical need.
• Repeated courses of tablets without reconsidering the diagnosis.

Who can get NHS podiatry for fungal nails?

Access varies by area, but NHS podiatry services generally take referrals for fungal nails only where the person is at risk of complications:

• Diabetes, particularly with reduced feeling or poor circulation in the feet.
• Peripheral arterial disease.
• A weakened immune system.
• Rheumatoid arthritis and some other conditions affecting the feet.
• Nails so thick or painful that walking is affected.

If you are in one of these groups, ask your GP or diabetes team for a referral rather than treating the nail yourself. For everyone else, NHS podiatry is unlikely to be available for a fungal nail.

How much does private fungal nail treatment cost?

Private podiatrists treat fungal nails without a referral and offer what the NHS does not: nail thinning to make a thick nail comfortable and let treatment reach the fungus, laser, urea-based nail removal, and combination treatments. Some are independent prescribers or work with a prescriber and can arrange tablets privately.

What it costs, from the clinics listed on nailfungustreatment.co.uk (prices from clinic websites, checked October 2026):

Our guide to fungal nail treatment options compares every treatment, NHS and private, with what the evidence says about each.

Which route should you take?

1. If the infection is mild and at the tip: pharmacy paint-on treatment for nine to twelve months, plus athlete’s foot treatment and dry feet.
2. If it is more than mild, or step one fails: GP for a nail sample and, if confirmed, tablets.
3. If tablets are unsuitable or fail, or you want the nail made comfortable and treatment speeded up: a private podiatrist for nail thinning, laser or combination treatment.
4. If you have diabetes, poor circulation or a weakened immune system: GP or diabetes team first, every time.

How to find an HCPC-registered podiatrist

Podiatrists and chiropodists in the UK must be registered with the Health and Care Professions Council (HCPC). Listings on nailfungustreatment.co.uk show “Mentioned on their website: HCPC” where a clinic says it is registered; check the name on the HCPC register before you book. 640 of the 2,859 listed clinics say they treat fungal nails.

Sources

• NHS: Fungal nail infection
• NICE Clinical Knowledge Summaries: Fungal nail infection: management
• Royal College of Podiatry: Fungal nail infection
• Health and Care Professions Council: check the register
• Prices: clinic websites of listings on nailfungustreatment.co.uk, checked October 2026. Starting prices, not quotes.