Laser treatment for fungal nail infection uses pulses of light to heat the nail and the fungus beneath it, with the aim of killing the fungus without damaging the nail bed. A course is three or four sessions a few weeks apart, each lasting ten to twenty minutes per foot. The evidence is promising but limited: most people see improvement, fewer are fully cleared, and results are better when laser is combined with a paint-on or tablet treatment. Across UK podiatry clinics listed on this site, a session typically starts at £85.
How it works
The fungus lives in the keratin of the nail and the nail bed, where creams struggle to reach and tablets reach only through the bloodstream. A laser delivers energy through the nail plate as heat. Fungal cells are more sensitive to heat than the surrounding tissue, so a temperature that the nail bed tolerates for a few seconds can damage the fungus.
Most UK clinics use a long-pulsed Nd:YAG laser at 1064 nanometres. The podiatrist passes the handpiece over the whole nail and the skin around it in a grid, several times, until the tissue reaches a target temperature, then moves to the next nail. Some clinics use other wavelengths or “cold” diode lasers (such as the Lunula), which work by a different mechanism, stimulating the tissue rather than heating it; these have even less evidence.
What a course involves
- Assessment. The podiatrist examines the nails, often takes clippings for laboratory confirmation that it is fungal, and thins the nail with a burr so the laser penetrates better.
- Sessions. Three or four, two to four weeks apart. Each foot takes ten to twenty minutes. No anaesthetic, no dressing, back into shoes straight away.
- Between sessions. Most clinics ask you to apply a paint-on antifungal and to treat any athlete’s foot, and to disinfect or replace shoes.
- Review. At three to six months the nail is checked as it grows out. Because toenails grow about one millimetre a month, the final result is not visible for twelve months or more.
What the evidence says
Honest summary: laser is promising, under-studied and oversold by some clinics.
- Small studies, mostly of fewer than fifty people and often without a comparison group, report visible improvement in a majority of nails and clearance of fungus on laboratory testing in anywhere from a quarter to over half of nails, depending on the study, the laser and the follow-up period.
- The few trials with a control group have found smaller effects, and some found no significant difference from no treatment on laboratory cure.
- NICE’s guidance for GPs does not include laser among recommended treatments, and the NHS does not fund it.
- Studies combining laser with a topical antifungal report better results than either alone, which is how most experienced podiatrists use it.
What this means in practice: laser can be a reasonable choice when tablets are unsuitable or have failed, or when you want to add to a topical treatment, as long as you go in expecting improvement rather than a guaranteed cure. A clinic that quotes a cure rate above 80 per cent, or promises one session, is quoting the manufacturer rather than the evidence.
Who it suits
- People who cannot take terbinafine or itraconazole because of liver disease, other medicines, pregnancy plans or side effects.
- People for whom tablets have not worked.
- People with a mild to moderate infection who want to combine laser with a paint-on treatment.
- People who want a treatment with no drug side effects and are prepared to pay for the chance of a faster result.
Who it does not suit
- A nail that is more than three-quarters infected or fully dystrophic; tablets or removal do better.
- Anyone who has not had the diagnosis confirmed. Laser does nothing for psoriasis or a bruised nail.
- People with a condition affecting sensation in the feet, who may not feel the heat; the podiatrist will assess this.
Side effects
Mild and short-lived: warmth, pinprick heat, slight redness around the nail for a few hours, and occasionally a small blister or temporary darkening of the nail. There is no recovery time.
Cost
Across 18 podiatry clinics listed on this site with a published laser price, a session typically starts at £85, with the middle half of clinics charging between £65 and £120 (prices from clinic websites, checked October 2026). A course of three or four sessions is usually priced at a discount, commonly £250 to £400, and many clinics include nail thinning and the initial assessment. 147 of the 2,859 listed clinics say they offer laser.
Ask what a quote includes: number of sessions, number of nails, assessment, nail thinning, a laboratory test, and what happens if the nail is not clear at review.
Laser compared with the alternatives
| Laser | Terbinafine tablets | Paint-on (amorolfine) | |
|---|---|---|---|
| Course | 3 to 4 sessions over 2 to 3 months | 3 to 6 months daily | 9 to 12 months weekly |
| Chance of clearing the fungus | Uncertain; perhaps a quarter to a half | Around 3 in 4 | Low to moderate, mild cases |
| Side effects | Warmth, minor | Stomach, taste, rare liver effects | Minimal |
| NHS availability | No | Yes, by prescription | Pharmacy |
| Typical cost | From £85 a session | Prescription charge | £50 to £80 a year |
Our guide to fungal nail treatment options compares all the options, and the terbinafine guide explains what tablets involve.
Finding a clinic
Use the listings on this site to find a podiatry clinic near you that offers laser and compare published prices. Look for “HCPC” on the listing and check the name on the HCPC register. Ask which laser they use, how many courses they have done, what they combine it with, and what they consider a success.
Sources
- NICE Clinical Knowledge Summaries: Fungal nail infection: management
- Cochrane: Oral antifungal medication for toenail onychomycosis (comparison figures)
- British Association of Dermatologists: Fungal infections of the nails
- Royal College of Podiatry: Fungal nail infection
- Prices: clinic websites of listings on nailfungustreatment.co.uk, checked October 2026. Starting prices, not quotes.