Fungal nail treatments compared: time, cost and evidence

Summary

There is no single best treatment — there is a best treatment for the state of your nail. Mild tip infection favours a lacquer. Thickened, established single-nail infection favours removing the diseased nail. Multiple nails or matrix involvement favours oral treatment.

At a glance

Typical UK figures. Costs are indicative and exclude follow-on care.

• 40% urea removal set — 2–4 weeks of daily use, around £70, no prescription, best for one thickened nail
• Amorolfine lacquer — 6–12 months weekly, £20–£35, best for mild tip infection
• Oral terbinafine — 6–12 weeks, prescription, strongest evidence for extensive disease, needs monitoring
• Laser — 3–4 sessions, £150–£1,000, weak evidence, not NHS-funded
• Home remedies — indefinite, minimal cost, little evidence of cure

Combining approaches

The most effective real-world strategy is usually mechanical or chemical reduction of the diseased nail plus an antifungal — either topical to the exposed bed or oral where the infection is extensive.

When to seek medical advice

Before starting oral treatment, if several nails are involved, or if you have any condition affecting circulation or immunity.