Fungal Nail Infections are the most common type of fungal infection seen by GPs. It affects between 2 and 8% of adults in the UK, particularly men. 80% of nail infections occur in the toes. The dermatophytes Trichophyton rubrum and Trichophyton mentagrophytes var interdigitaleare responsible for most toenal infections, but the incidence has risen over time.

Fungal Nail Infection is rare in childhood. The incidence of fungal nail infections increases with age and they are most frequent in those over 60 years of age. Most fungal nail infections are characterized by discolourisation and thickening of the free edge of the nail, which becomes yellow and crumbles.

There is debate as to whether treatment for fungal nail infection is justified or whether it is more a cosmetic concern. However, toenail infections present a risk as a portal for entry for significant bacterial sepsis, particularly in diabetics. For fungal nail infections, terbinafine gives the highest cure rate (76%) after three months and is the most cost effective. Combination with topical nail lacquer such as Trosyl® (Tioconazole) nail paint in difficult cases improves cure rates.

It is an important facet of Modern life that fungal elements in clothing, such as socks, survive standard washing-machine cycles at 40oC, but are eradicated at higher temperatures, such as 60oC.

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