• superficial infections and very early distal and localised nail disease requires treatment for at least six months for fingernails and at least 12 months for toenails with topical treatments (1)

• success of these treatments is only 40%

• paint of 28% Tioconazole with undecylenic acid may be apllied twice daily or 5% Amorolfine paint may be used once or twice a week (1)

• 40% urea paste application by a chiropodist to help dissolve parts of the diseased nail prior to topical anti-fungals will further help treatment.

• alternatively distal localised disease may be treated with systemic therapy

Reference:

• (1) Health Protection Agency 2009. Fungal nail & skin infections: diagnosis & laboratory investigation – Quick reference guide for primary care