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Thickened or yellow nails

Dr Roger Henderson
Reviewed by Dr Roger HendersonReviewed on 13.10.2023 | 3 minutes read
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This is characteristic of a fungal nail infection. Yellowing and thickening usually start at the tip, becoming soft and crumbly and harder to cut. Over weeks it can spread to the rest of the nail, replacing the healthy pink parts and causing it to lift off. Eventually, over the course of a few months, the whole infected nail may come off.

People are usually bothered by the appearance, and only notice when summer announces itself and the flip flops come out, after a winter of feet in warm sweaty socks and shoes. It can occasionally cause swelling and pain.

Tinea unguium, the medical term for fungal nail infection, is more common in the toenails than fingernails. It can affect one nail or several, usually on the same hand or foot, and can eventually spread to the other foot.

Doctor’s advice

Healthwords pharmacists' top tips

Fungal nail infections will not get better without treatment. But it is important to say, that treatment is only necessary if the person is bothered by the look or feel of the nail.

Fungal nail infections can be caused by the same culprit that causes athlete's foot. Although athlete's foot can be cleared quite easily with a course of antifungal creams or sprays within a week or two, once the infection spreads to the nail it is often more difficult to treat.

There are specific treatments for fungal nail infections that are available at the pharmacy in the form of fungal nail lacquers. These come in various types from applying once a week, or applying daily for the first month. Either way, treatment time is 6 -12 months and commonly won't work without other treatment methods alongside. Nail lacquers have the best chance of working if they are started at a very early stage.

If the base of the nail bed (known as the Lunula) is affected, or if you have more than a few fingers and toes affected, it may be worth speaking to your doctor for prescription-based treatments with a course of antifungal tablets such as terbinafine for a few months instead.

Am I fit for work?

You are fit for work if you have a fungal nail infection.

When should I see my doctor?

If over-the-counter treatments haven’t helped, or a large proportion of the nail is infected, or several nails are infected, you should book a routine appointment with your doctor who will examine you. They may ask you to take nail clippings to confirm the diagnosis before considering you for anti-fungal tablets. Again, treatment is a long game – at least 3 to 6 months.

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Dr Roger Henderson
Reviewed by Dr Roger Henderson
Reviewed on 13.10.2023
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