Fungal nail infection is treated with paint-on antifungals for mild cases, antifungal tablets (usually terbinafine) for infections affecting most of the nail, and laser, nail removal or combinations for cases that fail or where tablets are unsuitable. Whatever the treatment, a cleared nail takes a year or more to grow out. Confirm the diagnosis first; about half of suspected fungal nails are something else.
Key facts
| Question | Answer |
|---|---|
| Most effective treatment | Terbinafine tablets: the fungus clears in around 3 in 4 people |
| Best for mild infection | Amorolfine paint-on lacquer, 9 to 12 months for toenails |
| How long until the nail looks normal | 12 to 18 months for a big toenail, whatever the treatment |
| Typical UK private cost | Fungal nail appointment from £48; laser from £85 a session (Oct 2026) |
| Test first? | Yes: about half of suspected fungal nails are something else |
Is it definitely a fungal nail infection?
Psoriasis, injury and bacterial infection all mimic fungal nail infection, and antifungal treatment does nothing for them. NICE and the NHS advise confirming with a laboratory test of nail clippings before starting tablets. A podiatrist or GP takes the sample; results take two to three weeks. If you are about to spend nine months painting a nail or four months on tablets, the test is worth the wait. Our guide to what a fungal nail infection looks like covers the alternatives.
Option 1: do nothing
Leaving a fungal nail infection untreated is a reasonable choice for some people. Fungal nail infections are not harmful for most people and treatment is slow, so leaving a mild infection alone is a legitimate choice. It will not clear on its own, and it usually spreads over years, so this is a decision to revisit rather than a cure. People with diabetes, poor circulation or a weakened immune system should not leave it.
Option 2: paint-on treatments
What they are. Antifungal lacquers or solutions applied to the nail. In the UK the main ones are amorolfine 5% lacquer (pharmacy, brand names include Loceryl and Curanail), applied once or twice a week after filing the nail; tioconazole solution, applied twice daily; and a range of products based on urea or acids that soften and thin the nail rather than kill the fungus directly (Scholl, Excilor, Emtrix and own brands).
How long. Six months for fingernails, nine to twelve months for toenails, with regular filing of the nail surface so the treatment penetrates.
How well they work. Modest. For amorolfine, trials report complete cure in roughly one in five to two in five people when the infection is limited to the tip and sides of the nail, and much less when the base of the nail or more than half of it is involved. The urea and acid products have little evidence for cure; they improve appearance by thinning the nail.
Who they suit. Mild infection at the tip or edge of one or two nails; the white superficial pattern; people who cannot take tablets; children, who should not take terbinafine.
Cost. £15 to £25 for a pharmacy lacquer that lasts a few months; a toenail course may cost £50 to £80 over a year. Our guide to shop-bought fungal nail treatments compares the products.
Option 3: antifungal tablets (terbinafine)
What they are. Terbinafine 250 mg once a day is the first choice for dermatophyte infections, the usual cause. Itraconazole, taken in week-long “pulses” each month, is the alternative for yeast infections or where terbinafine is unsuitable. Both are prescription-only; a GP prescribes them, normally after a positive nail sample.
How long. Terbinafine for six weeks for fingernails and three to six months for toenails. Itraconazole for two pulses (fingernails) or three (toenails).
How well they work. The best of any treatment. Trials report the fungus is cleared in around three in four people on terbinafine. A complete cure, meaning no fungus and a normal-looking nail, is less common, at roughly two in five to one in two. Rates are somewhat lower for itraconazole. The nail still takes a year to grow out.
Downsides. Side effects include headache, stomach upset, rash and loss of taste, which is usually temporary. Rarely, terbinafine affects the liver, so GPs often check liver function with a blood test before and during treatment. Not for people with liver disease, and not usually in pregnancy or breastfeeding. Itraconazole interacts with many other medicines and is unsuitable for people with heart failure. Our guide to terbinafine for fungal nails covers what to expect.
Who they suit. Infection involving more than half the nail or the base; several nails; failed paint-on treatment; anyone who wants the highest chance of cure and can take the tablets safely.
Cost. On the NHS, the standard prescription charge per item in England; free in Scotland, Wales and Northern Ireland. Privately, a prescription plus the medicine is usually under £50 for a course.
Option 4: laser treatment
What it is. A laser (usually Nd:YAG) heats the nail and the fungus beneath it in short pulses. Three or four sessions, two to four weeks apart, each taking ten to twenty minutes per foot.
How well it works. Promising but not proven. Small studies report improvement in appearance in a majority of people and fungal clearance in a minority to a majority depending on the study; there are few well-designed trials and NICE has not recommended laser as a first-line treatment. Many podiatrists combine it with a paint-on treatment or tablets.
Downsides. Warmth or a brief sharp heat during treatment; cost; no guarantee.
Who it suits. People who cannot take tablets or do not want to; people for whom tablets have failed; people who want to combine treatments to improve the odds.
Cost. Across 18 clinics listed on nailfungustreatment.co.uk with a published price, laser typically starts at £85 per session, with a course of three or four usually offered at a discount (checked October 2026). 147 listed clinics say they offer it. Our laser guide goes into detail.
Option 5: nail thinning and partial removal
A podiatrist can file or drill (burr) a thick infected nail down so that it is comfortable, looks better, and paint-on treatment can reach the fungus. This is often done every few months alongside another treatment and is a big part of what a “fungal nail appointment” at a podiatry clinic involves; the typical starting price across 66 listed clinics is £48 (checked October 2026).
Some clinics also apply a urea paste under a dressing to soften and remove the infected part of the nail without surgery.
Option 6: surgical nail removal
Under local anaesthetic, the nail is removed, usually with a chemical (phenol) applied to the base to stop it regrowing, or without, so a new nail can grow. Reserved for a nail that is painful, badly deformed or has failed everything else. Across 118 listed clinics with a published price, nail surgery typically starts at £350 (checked October 2026). Removal alone does not kill the fungus; it is normally combined with tablets or a topical treatment while the new nail grows.
Do home remedies work for fungal nails?
Tea tree oil, vinegar soaks, Vicks VapoRub and bleach solutions are widely recommended online. None has evidence of cure in a properly designed trial; tea tree oil has some antifungal activity in the laboratory and a couple of tiny studies, which is the strongest case among them. They are cheap and mostly harmless, so trying one alongside a proper treatment does no harm; relying on one alone usually means another year of spread. Our guide to tea tree oil and home remedies looks at the evidence.
Fungal nail treatments compared
| Treatment | Course | Chance of clearing the fungus | Main drawback | Typical UK cost |
|---|---|---|---|---|
| Do nothing | Indefinite | Very low | Spreads slowly | Free |
| Paint-on (amorolfine) | 9 to 12 months | Low to moderate, mild cases only | Daily or weekly for a year | £50 to £80 |
| Terbinafine tablets | 3 to 6 months | Around 3 in 4 | Side effects, liver check | Prescription charge |
| Laser | 3 to 4 sessions | Uncertain; promising | Cost, limited evidence | From £85 a session |
| Nail thinning | Every 2 to 3 months | Does not cure alone | Ongoing | From £48 a visit |
| Surgical removal | One procedure | Does not cure alone | Pain, recovery, cost | From £350 |
How do you stop a fungal nail infection coming back?
Fungal nail reinfection is common. After treatment: treat athlete’s foot at once, keep feet dry, wear flip-flops in shared showers, do not share nail tools, replace or disinfect old trainers with an antifungal spray, and keep nails short and filed.
How to find a podiatrist for fungal nails
Use the listings on nailfungustreatment.co.uk to find a clinic near you; 640 of the 2,859 listed podiatry clinics say they treat fungal nails. Look for “HCPC” on the listing and check the name on the HCPC register. For tablets, see your GP, or ask the podiatrist whether they work with a prescriber.
How does a podiatrist treat a fungal nail?
A podiatrist starts by confirming the diagnosis, usually with a nail clipping sent for microscopy and culture, because around a third of thick, discoloured nails are not fungal. Treatment then depends on how much of the nail is involved. For a mild infection at the tip, the podiatrist thins the nail (debridement) with a burr so that an antifungal paint can reach the nail bed, and may use the Lacuna method, drilling tiny holes through the nail plate for a spray-on antifungal. For a thick, painful or badly affected nail, the podiatrist can reduce it, remove the loose part, or remove the whole nail under local anaesthetic so a new one grows back with antifungal treatment from the start. Laser treatment is offered by some clinics. Tablets are prescribed by a GP, not a podiatrist, but the podiatrist will often recommend them for a confirmed, extensive infection.
Sources
- NHS: Fungal nail infection
- NICE Clinical Knowledge Summaries: Fungal nail infection: management
- British National Formulary: Terbinafine and Amorolfine
- Cochrane: Oral antifungal medication for toenail onychomycosis
- British Association of Dermatologists: Fungal infections of the nails
- Prices: clinic websites of listings on nailfungustreatment.co.uk, checked October 2026. Starting prices, not quotes.