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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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
They have always been helpful, professional, courteous and caring
John Veasey
- Jonathan Small has been treating me for a range of foot and gait problems for a number of
Years including plantar fasciitis, Morton’s neuromas and joint hypermobility. As well as physical
Treatment he has supplied me with various orthotics which have really helped me keep
Mobile and reasonably fit. I am undergoing treatment at the moment and I fully expect that
Jonathan will be as successful as he has been in the past. All the staff at Health First are
Friendly and helpful.
Pam Alexander
I had an issue with an ingrown toenail, which was very painful. Jonathan was a star in performing the nail surgery. My foot is now on the road to recovery and I couldn’t be any happier. Highly recommend coming here with any foot problems!
Angelika Price
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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
Specialist podiatry advice from a highly skilled professional - bridging the gap between podiatry and physio. Jo Webb
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Excellent!!! Very professional service, great treatment and aftercare. Definitely recommend. Thanks for fitting me in at short notice too!!
Clare Everest
hi everyone
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
- Jonathan Small and his team have been excellent. A person centred, straight forward approach and really genuine team. I had been told by NHS and other podiatrists that the healing after ingrowing toe nail would take up to 12 weeks yet after the surgery at Health First Foot, it has completely healed in just over 3 weeks. Going privately was one of the best investments I've made. Thank you Health First !
Nikki Jackson
I was suffering with quite a complicated situation, both plantar fasciitis and Achilles tendon insertion and they required different treatment. Johnathon expertly explained how he was going to deal with the problem and glad to say that after an intensive course of treatment things have improved. Di Griffin-Bloxham
- Everything you can think of is available here!
Jane Vaughan
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
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Jonathon looked after my mum's feet for a number of years and despite her being a difficult patient at the best of times especially after her stroke he was never anything but cheerful and polite. I was always very grateful for the way he looked after mum and I would highly recommend his services.
David Buchholz
Great service and an extremely friendly atmosphere. Lovely people work here. Liam Alexander
- Absolutely great, two big toes up!
Gary Shaw
I have been seeing Jonathan for over 20 years. He did a wonderful job to get me from hobbling around a golf course, barely able to finish a round, to fully engaging in a range of sports and activities I thought were beyond me for good. I continue to use his services when worn-out orthotics need replacing. He is a consummate professional and a very friendly, decent guy to boot. He is well supported by his excellent reception team. I thoroughly recommend Health First to anyone looking for a top quality foot care service and am happy to vouch in person if anyone cares to get in touch.
Andrew Hall
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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
I can so recommend this company, their treatments and advice were exemplary and I was made to feel so relaxed and looked after from beginning to end Jackie King
- I experienced a very accurate diagnosis. Treatment was good and the pain is easing very nicely. Greeted by a pleasant lady on reception and advised of the need to follow PPE. Met with Jonathan who is very friendly and professional just as you would expect. Highly recommend him to help solve your feet/foot problems.
John Dewar
Had a fantastic day observing in clinic yesterday!
Jonathan AMAZED me with his extensive knowledge, he was very supportive & I learnt so much just in 1 day!
I admire Jonathans determination & drive to help his patients resolve any issues they may have & I hope to follow in his footsteps once I graduate from university.
Thanks again for the opportunity your useful and excellent advice will always remain with me.
Faye 🙂 Faye Green