Fungal nail treatments: what works best?

Mild fungal nail infections can be treated at home with over-the-counter products, but you'll need to be persistent as it may take 6 to 12 months to successfully get rid of an infection.

Here, we explain what causes fungal nail infections, how to spot the signs, which treatments actually work – and how to get them cheapest.

We also have expert insight from Dr Dhruvkumar Laheru of the British Association of Dermatologists, Emma McConnachie, an HCPC registered podiatrist, and Sarah Bradshaw, a dermatology specialist podiatrist with the Royal College of Podiatry.

Find out how to choose the best treatment, what to avoid, and the best ways to prevent a fungal nail infection coming back.

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What is a fungal nail infection?

A fungal nail infection is a common condition where fungi invade the nail, typically through small cracks or cuts around it, causing it to become discoloured, thickened and brittle. Infections are more common in toenails than fingernails, though they can occur in either.

The infection often starts subtly, with a small white or yellow spot under the nail tip. Over time, the nail may become discoloured, thickened, crumbly or distorted in shape. In some cases, it can separate from the nail bed. 

Fungal nail infections usually aren’t painful in the early stages, but they can become uncomfortable if left untreated. Recognising the signs early and seeking treatment can help prevent the infection from spreading or worsening.

Fungal nail symptoms

• Discolouration, thickening or lifting of the nail, pain or swelling, unpleasant odour, hard to trim

The earlier you spot and treat it the better. Consultant dermatologist Dr Dhruvkumar Laheru explains what a fungal nail infection might look like early on: 'When fungi infect a nail, they commonly start at the edge and spread down the side of the nail towards the base of the cuticle.' 

Registered podiatrist Emma McConnachie adds that you might spot 'patches of discolouration, which are white or paler than the normal nail. For some, it will be a stripe or flame-like shape in shades of orange or brown, starting at the tip of your nails and heading for the cuticle. 

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'However, it's important to remember that there can be many reasons for changes to a nail, including trauma and other dermatology conditions, such as psoriasis or lichen planus, and even melanomas.'

If you have changes to your nails you are concerned about, and are unsure of the cause, speak to your GP, pharmacist or a podiatrist. You can also find out more on the NHS guide to fungal nail problems.

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Fungal nail treatments: what are your options?

Over-the-counter (OTC) treatments

There are two main types of fungal nail treatment available to buy over the counter - medicated and non-medicated:

• Medicated treatments: These usually contain clinically proven antifungal ingredients like amorolfine. They're designed to kill the infection and may come in the form of nail lacquers or topical solutions. Some are available over the counter, while stronger options may need a prescription.
• Non-medicated options: These don't actively kill the fungus but work by creating an environment that stops it from thriving. They’re often used for mild infections or as a preventative step to stop reinfection after using a medicated treatment.

Some treatments require you to file the surface of the nail regularly to help the product absorb better.

Antifungal nail lacquers and creams can be effective for mild infections. According to a 2022 report on the National Library of Medicine, success rates improve with consistent, long-term use and regular nail filing. 

Below are examples of products that might be worth trying, based on search popularity and product strength. 

These brands are popular across major UK retailers, such as Boots and Lloyds Pharmacy, and typically have reviews with an average of 4.5 stars or more across the platforms we checked. However, please note that we have not tested or reviewed these products.

Fungal nail treatments compared

What to do if over-the-counter fungal nail treatment doesn't work

If spot treatments aren't doing the trick, there are other options, but you'll need to see a GP or other health professional. The main options are:

Prescription medications

These include oral antifungals like terbinafine or itraconazole, which are typically more effective for moderate to severe infections, where first-line treatments haven't worked. 

Speak to your GP, pharmacist or a podiatrist. You can also find out more on the NHS guide to fungal nail problems.

Laser treatment

These target the fungus beneath the nail surface with concentrated light. Results from 2023 trials are mixed, showing some promise, especially when combined with topical treatments, but they are not yet considered a standalone cure. Laser treatment is not currently available on the NHS.

Sarah Bradshaw, dermatology specialist podiatrist with the Royal College of Podiatry, told us: 'To date, there have been no quality studies that have demonstrated that laser treatments can cure fungal infections in the toenails.'

She added: 'However, it is accepted that [lasers] can provide a temporary improvement. The NHS does not offer laser treatment for fungal toenails, however it is available within the private healthcare sector.'

Be persistent

Ultimately, you need to prepare for the long haul when it comes to treating fungal nail problems. Dr Laheru warns: 'fungal nail infections, in the most part, do not clear up by themselves.

He adds: 'It can take up to a year to successfully clear a fungal toenail infection, and while fingernails are easier to treat, reinfections can occur on both. The aim of the treatments will be to get rid of the fungus – with time, the nail will return to normal.'

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How to treat a fungal nail infection successfully

1. Identify the infection early: Look for signs like discolouration, thickening, brittleness or distortion of the nail. If unsure, or if symptoms worsen, speak to a pharmacist or GP.
2. Choose the right treatment: For mild infections, over-the-counter products may be enough if used consistently. For more severe or stubborn cases, oral prescription antifungals or a combination of treatments may be required. 
3. Maintain good nail hygiene: Keep nails trimmed and clean. Avoid using nail polish or artificial nails while treating the infection, as these can trap moisture and worsen the condition.
4. Use preventive measures: Wear breathable footwear, change socks daily, and use antifungal spray or powder if prone to sweaty feet. Always disinfect nail tools and avoid walking barefoot in communal areas.
5. Be consistent and patient: Treatment can take several months, especially for toenails, which grow more slowly. Even once the infection is cleared, it can take time for the damaged nail to grow out fully. Sticking with your treatment plan is key to success.

What causes fungal nail infections – and how to prevent them from returning

Causes of fungal nail infections:

• Warm and damp feet
• Feet that aren't kept clean and dry
• Damaged nails
• Weak immune system
• Other health conditions, such as diabetes and psoriasis

Fungal nail infections are usually caused by an overgrowth of fungi in warm, moist environments. 

These organisms thrive in places like communal showers and swimming pools. Wearing tight or poorly ventilated footwear can create the perfect conditions for fungi to multiply.

Minor trauma to the nail, such as from ill-fitting shoes or injury, can also create small openings, allowing fungi to enter. 

Podiatrist Emma McConnachie adds: '[Fungal nail infections are] a progression of the fungal skin infection tinea pedis, commonly referred to as athletes foot.' 

She advises that 'drying between your toes properly will reduce the risk of the skin becoming too moist and breaking down, which provides a perfect access point for the infection. If you have sweaty feet, changing your socks when they get damp can also help.'

Why does my fungal nail infection keep coming back?

'Some will suffer with recurring infections because the condition has not been fully treated or they are exposed and reinfected', McConnachie tells us. 

She advises: 'Good foot hygiene is one of the best ways to ensure it doesn’t return.

'Make sure to wash and dry your feet daily, wear pool shoes or flip-flops in communal changing areas to prevent exposure to the infection, and change your shoes regularly to prevent excess moisture from building up.

'And get the right treatment early.'

Sarah Bradshaw adds: 'There are lots of other conditions that can be easily mistaken for a fungal infection. There is often an accompanying skin infection that also needs to be addressed.'

She advises visiting your podiatrist to have the issue professionally assessed and diagnosed. 

You can find your nearest HCPC registered private podiatrist at rcpod.org.uk/find-a-podiatrist or check with your local NHS service to find out the podiatry services available in your area.

Meet our experts

For our guide to treating fungal nail infections, we called on skin and foot experts for tips and advice, and researched the products available. We also noted your most searched-for questions, and checked prices.

Our experts for this guide were:

Dr Dhruvkumar Laheru Consultant Dermatologist & Skin Cancer Lead, speaking on behalf of the British Association of Dermatologists

Dr Dhruvkumar Laheru is a consultant dermatologist who specialises in nail diseases and surgery. Trained in the UK, he further honed his skills through international experience in Brussels, Belgium, and has had specialised training in plastic surgery. 

He actively manages local and national referrals in dedicated nail clinics, while also serving as the BHNS Nail Lead. His commitment extends to educating specialists and trainees through lectures at teaching events, both on national and international forums.

Emma McConnachie, Podiatrist, BSc (Hons) MRCPod MFPM RCPS (Glasg)

Emma McConnachie is an HCPC-registered podiatrist practicing in Stirling, central Scotland. She is a spokesperson for the Royal College of Podiatry, the professional body for podiatrists. 

She has appeared in over 300 UK publications, as well as radio and global media outlets, and is the resident podiatrist for BBC Radio Scotland, appearing regularly on the weekly health surgery answering questions from members of the public.

Sarah Bradshaw, MSc Clinical Dermatology, BSc (Hons) Podiatry, DipHE Nursing

Sarah Bradshaw is an HCPC-registered Dermatology Specialist podiatrist and a member of the Royal College of Podiatry, The Primary Care Dermatology Society, The British Dermatology Nursing Group and The British Photodermatology Group. She also helps to chair the Dermatology in Podiatry Specialist Advisory Group for the Royal College of Podiatry.