What is a fungal nail?
Fungal infections on your feet are much more common than you might think. Fungus survives in warm, moist and dark environments and can be found anywhere on your body. Unfortunately, your feet naturally provide a perfect place for the fungus to thrive. It’s rare that our feet are not in socks or sweaty shoes, especially for those that lead an active lifestyle.
Your toenails are also particularly susceptible to fungal infections, a lot more so than your armpits or groin. When this happens, it is known as Onychomycosis. As mentioned previously, our feet naturally provide the perfect environment for fungus to grow; this is why we must be diligent in preventing fungus before it becomes an issue. If you feel you may already have a fungal infection, call us for a correct and proper diagnosis and we can begin to discuss treatment options.
How is a fungal nail diagnosed?
Podiatrists have a great knowledge and understanding of all things foot-related; experienced podiatrists can usually diagnose Onychomycosis just by looking at the nail. The nail will usually show some signs of damage or indication of a fungal problem by becoming crumbly and brittle or turning a yellow or brownish colour. Fungal nails become even more apparent if there are signs of fungal infection on the skin of the foot.
To ensure our diagnosis is correct, we will always run a test just to be sure. This can be done in a couple of different ways:
Microscopy and Culture (M&C)
This method is the one most often used by the NHS; however, in my opinion, it isn’t the best. It can take several weeks to attain results and is often inaccurate or incorrect. These inaccuracies are usually due to the way the nail sample is collected.
Diafactory fungal testing (AKA the FiveMinuteFungus test)
This test operates in a similar manner to a covid 19 lateral flow test. It takes only a few minutes and has an accuracy percentage rate of 95%. This is the type of fungal nail test we use here at our podiatry clinic in Southam because of its accuracy and great results.
Treatments For A Fungal Toenail In Southam, Warwickshire
Treatment options for fungal nails can vary. We use a couple of different methods, depending on the severity of the fungal nail and its location. When treating fungal nails, there are two main aspects that we should consider before we look at other treatment options, these are:
Prevention
Preventing a fungal nail is one of the best ways to treat them. To do this, we need to change the environment in which they survive; this means treating your shoes with anti-fungal spray, ensuring you change your socks regularly and maintaining good personal foot hygiene. Making it difficult for the fungus to survive on your nails or foot will help to prevent reoccurrence.
Toenail Removal
One of the most direct treatment options is removing the nail entirely and destroying the nail matrix; there will be no nail for the fungus to infect. Destroying the nail matrix also stops the nail from growing back, preventing the risk of further infections. The alternative to removing the entire nail is temporary removal; upon doing this, we can apply a fungal nail treatment directly to the nail bed to treat the infection.
Toenail Fenestration
This process involves drilling a number of tiny holes into the nail, allowing a topical anti-fungal treatment to more easily penetrate the nail bed and kill the fungal infection. When drilling holes, you must be careful not to damage the nail bed underneath; if you think this will be the best option for you, you should look out for podiatrists that offer Clearanail or Lacuna methods of treatment.
Toenail Debridement
Toenail debridement involves shaving back the nail, and removing as much of the damaged, crumbly or thickened nail as possible. This increases the efficiency of anti-fungal agents such as amorolfine paint. This filing can be done in a couple of different ways, but it is most often completed using a diamond deb file/foot file or a drill. You should always visit a professional podiatrist to have this completed; trying to do this yourself at home could lead to further injuries.
Photodynamic Surgery
Laser therapy and treatments such as PACT have been found to be a useful method to treat fungal nails in more recent times as it is less invasive, and you can destroy the fungal cells using light. Similar to most of the other treatments above; however, this treatment method takes time. You will likely need multiple sessions for the best chances of success using this treatment method.
Oral Treatments
Terbinafine and itraconazole are two fungal nail treatment methods that are both available in tablet form, meaning they can be delivered straight to the nail matrix through oral ingestion. However, this method of treatment comes with some risks and should always be discussed with your podiatrist or GP before being undertaken. NICE (NHS) guidelines advise that a minimum of 3 nail matrices should have an infection present before oral treatment should be considered.
How to prevent fungal toenails
As mentioned previously, the best way to treat a fungal nail, is to prevent it from occurring in the first place. Good foot hygiene is essential, as well as remembering to wash your feet regularly and dry them thoroughly between the toes. Changing your socks frequently is also a good way to prevent infection; try to opt for socks made of natural fibres or moisture-wicking socks to prevent the build-up of excess sweat. You should also wear socks or sliders when in public spaces like swimming pools and locker rooms, as fungal infections can be contagious and easily spread.
If possible, you should also rotate your choice of footwear daily, allowing one pair of shoes to dry fully while wearing another. You can also treat your shoes with anti-fungal sprays like Daktarin to reduce fungal loads.
At Health First Foot & Gait Clinic, we have a footwear sanitisation device called a Klenz machine. This can be used to lower the fungal load in up to 3 pairs of shoes & socks at once. The process takes about 20 minutes, so can be done while you wait. Further details on this are available at our reception on 01926 811272.
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Excellent service. I am so pleased with the help, advice and treatment recieved. Many thanks
Jackie Dewdney
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Excellent well informed professional service. Treatment options discussed, and every effort made to deliver appropriate care promptly.
Thank you to Jonathan and the team. Carol Brewer
I was recommended to go and see Jonathan from an excellent local pilates instructor who I trust implicitly, so I knew that the recommendation didn't come lightly. I was not disappointed. Jonathan has been attentive, professional, knowledgeable and provided a very considered solution to my plantar fasciitis. His team are always friendly and helpful - even when I got stuck in traffic and missed my appointment! Highly recommend!
Clare Price
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Excellent experience at the Health First Foot Clinic. I went with a long term problem with my foot which I had self diagnosed incorrectly as a sprained ankle. My injury was assessed and diagnosed and I had a course of treatment . The treatment was further complicated by recent knee replacement but Jonathan continued to find ways to make the treatment work allowing for my recovering knee .I am pleased to say my injury is almost fully recovered which wouldn't have happened if I hadn't gone and they hadn't been so patient . Very happy with the diagnosis and treatment .
The Pet
Mr Small and team provided a really excellent service for my elderly mother and kept her on her feet, mobile and active for the two years she lived near Southam, thank you very much!
Charlotte Gath
- My 15 year old son had an ingrown toenail which was very painful. We were able to see Jonathan very quickly who explained everything really clearly, he advised minor surgery to remove part of the nail and said he could do the procedure there and then. The procedure was carried out professionally and with every care for my son. I would highly recommend Jonathan and his clinic. Excellent aftercare also. Thanks so much.
Karen Grant
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I've been battling with planter fasciitis in my heel for 15 months, Jonathan small was highly recommended. I got no such luck from my doctor. I give these a ring and got me in straight away. Met Jonathan had a brief chat the knowledge and information given was very helpful put me on a 6 week course and my foot is the best its been in a long time.
From start to finish my experience was great. highly recommend Jonathan and his staff all very friendly. Cheryl Higgins
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I made an appointment with Jonathan at the Health First Clinic in Southam, as recommended by Vicki Cooper. It sounded like I had too many issues for Vicki to deal with. I turned up asking for help with removing verrucas that had been there for years and help with an ingrown toenail, that although had been removed and treated, had grown back. I was astounded at Jonathan’s knowledge, and it turns out I was given completely the wrong advice, and treatment, by two other Podiatrists🤬😞. He gave me all instructions and options I didn’t know about, on how to remove the Verrucas, and it turns out my ingrown toenail wasn’t ingrown at all and so was removed and treated for no reason🤦♀️. Note to self, DON’T trust just anyone, trust THE BEST. Thanks to Jonathan and his team at Health First, I now look very differently at my feet. 👍😊
Sonia Hargreaves
After running a long-distance ultra marathon, my feet were in poor shape! They got some much-needed TLC (and more sympathy than from my GP!!). Jonathan sorted out a blister that was hidden under another blister and got my feet on the way to healing 😀 Zoe Beale
- As an owner of 3 dogs I’m pretty much on my feet the whole time. However, walking became very painful because of my feet. The culprits were seed corns and awful cracked heels on both feet. Jonathan was excellent at carrying out very effective treatment and advising on an aftercare/maintenance routine. My feet now look and feel so much better and I’m pain free!
Lorelle Horn
Excellent service. The clinic was efficient enough that Jonathan was able to undertake toe surgery on the same day of my first appointment (just minutes after the problem was diagnosed!). The staff were very friendly and informative, and kept me very much at ease during the entire process. I was very appreciative and will be returning if I have any similar problems in the future. Highly recommended!
Joe Miller
- Thank you Jonathan for inviting me along to your Dynamic & Disasters of The Diabetic Foot seminar and thank you for sharing your wealth of knowledge. For anyone who has been diagnosed as diabetic I would urge you to visit Jonathan for a comprehensive diabetic foot assessment. You only have one pair of feet so treat them with respect and they will last a lifetime. I look forward to working with you on our quest to treat and educate on foot health. Kind regards - Debbie Hewitt, Foot Health Practitioner (Rugby)
Debbie Hewitt
I have had persistent pain with my toenails for years, but did not know the cause of the problem.
Previous visits to a different podiatrist left me with no answers! After researching local podiatrists I found that Health First came highly recommended.
Mr Small quickly found out the cause of my problem and recommended the best treatment options.
The staff were all very friendly and made me feel welcome. All very professional.
I cannot recommend them enough to anyone! Will be going back for my follow up treatment in the new year. Millie Hefferan
- Jonathan is very helpful and knowledgeable, he has looked after my feet over the years and I trust him completely. He is always polite, kind and considerate
Tracey Bianciardi
Highly recommend this practice. Jonathan and his team are extremely professional and friendly. As a cancer patient I was anxious to find a podiatrist whom I could trust completely. Jonathan took time to fully understand my medical situation and on-going difficulty with my toes. He was proactive in communicating with my Oncologist and the required nail surgery took place 2 days after my initial appointment. Everything was carefully explained and skilfully carried out. I am one very satisfied customer! Angela Terry
- Jonathan is great - passionate, knowledgeable and dedicated to getting people’s foot problems sorted.
I had the pleasure of helping him recently with promotion material for a podshealheels and he delivered a superb lecture to a group of patients and professionals.
Dave James
Jonathan is an inspirational Podiatrist.
Having attended several courses that have been run by Jonathan and having been lucky enough to have heard him speak at multiple professional events, my knowledge has increased dramatically, as has my love for Podiatry.
A true gentleman and a fabulous educator. Sarah Byrne
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Excellent treatments fully recommend. Jonathon is very professional and knows what he is doing. Very experienced and takes into account your needs. I am currently relaxing with a hot wax treatment.
Valerie Jukes
Everything you can think of is available here! Jane Vaughan