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Thickened or yellow nails

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read

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

Is a fungal nail infection contagious?

Fungal nail infection can also infect the skin (or vice versa), so often goes hand-in-hand (pardon the pun) with athlete’s foot, a fungal infection between toes and on the soles of the feet. If this is the case, you should get this treated at the same time as your nails. Your pharmacist can help in the first instance, suggesting an anti-fungal nail cream or lacquer, and/or a nail softening cream. Be warned, it’s a long game and aims to remove the infected nail or halt the spread of infection until it grows out.

Athlete’s foot, and to a lesser extent fungal nail infection – can spread by sharing towels, bed linen, shoes and nail clippers or scissors. You should wear shoes or sandals in communal areas such as changing rooms, especially if the floor’s warm and moist.

Keep feet well-aired and avoid shoes that make them feel hot and sweaty. Keep nails as short as possible.

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 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 portion 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 antifungal tablets. Again, treatment is a long game – at least 3 to 6 months.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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