Treating fungal nail infections
Supporting customers with fungal nail infections
You have a role to play in managing customers' expectations of how quickly they might see results when treating fungal nail infections. Nails grow slowly and treatment can only work at the rate of nail growth; treatment should be continued for 6 months for fingernails and 9 to 12 months for toenails.3 If customers understand how long it can take to treat a fungal nail infection, they may be more likely to persevere and comply with the treatment.
Once weekly treatments like Curanail may also help with compliance when treating mild fungal nail infections as they require minimal time and effort to use. One 3ml bottle can potentially provide treatment for 12 months. Curanail can be used alongside oral antifungal treatments.
Preventing fungal nail infections: self-care advice3,4
- Do
- Don't
- When to refer
- Keep nails trimmed short and filed down
- Maintain good foot hygiene and keep feet clean and dry
- Treat a fungal nail infection as soon as possible to avoid it spreading to other nails
- Treat athlete's foot as soon as possible to avoid it spreading to nails
- Wear well-fitting, non-occlusive shoes
- Replace old shoes that could be contaminated with fungal spores
- Wear absorbent cotton socks and wear clean socks every day
- Wear protective footwear when using communal bathing places and gyms
- Share towels, nail clippers and scissors
- Wear shoes that make feet feel hot and sweaty
- Wear other people's shoes
- Allow prolonged or frequent exposure to warm, damp conditions
- Expose nails to trauma
Customers should be referred to their GP if:
- More than 2 nails are infected
- The nail matrix is affected
- They have diabetes
- They have a weakened immune system
- They are pregnant or breastfeeding
Proceed to the next screen to test your knowledge and record your learning.
Pharmacists and pharmacy technicians can use this as one of their revalidation activities.
References
1. https://cks.nice.org.uk/topics/fungal-nail-infection/
2. https://www.bad.org.uk/shared/get-file.ashx?id=205&itemtype=document
3. https://cks.nice.org.uk/topics/fungal-nail-infection/management/management/
4. https://www.nhs.uk/conditions/fungal-nail-infection/
All references last accessed September 2022
Curanail 5% w/v Medicated Nail Lacquer (UK)
Active Ingredient: 5% w/v amorolfine in the form of hydrochloride.
Presentation: Medicated nail lacquer.
Indications: Mild cases of distal and lateral subungual onychomycoses caused by dermatophytes, yeasts and moulds limited to up to 2 nails.
Dosage and Administration: Adults Only – Apply to the affected finger or toenails once weekly (see summary of product characteristics for full technique). Cosmetic nail lacquer may be applied at least 10 min after Curanail application. Treatment duration depends on intensity and localisation of infection. Generally, it is six months for finger nails and nine to twelve months for toenails. Not recommended for use in patients below the age of 18 years.
Contraindications: Hypersensitivity to any of the ingredients.
Precautions and Warnings: Curanail should not be applied on the skin around the nail. Avoid contact with eyes, ears and mucous membranes. Patients with predisposing conditions such as peripheral circulatory disorders, diabetes mellitus and immunosuppression should be referred to a doctor. Patients with nail dystrophy, destroyed nail plate, nail pain or inflammation should also be referred to a doctor. When using organic solvents impermeable gloves should be worn. In case of a systemic or local allergic reaction, the product should be stopped immediately, and medical advice should be sought. Remove the product and do not reapply.
Pregnancy and Lactation: Should not be used during pregnancy and/or lactation.
Side Effects: Adverse drug reactions are rare. Nail disorders (e.g., nail discoloration, broken nails, brittle nails) may occur. These reactions can also be linked to the onychomycosis itself. Rare (≥ 1/10000, < 1/1000) adverse drug reactions include: nail disorder, nail discoloration, onychoclasis (broken nails), onychorrhexis (brittle nails). Very rare (< 1/10000) reactions include: skin burning sensation. Adverse reactions with an unknown frequency include hypersensitivity (systemic allergic reaction), erythema, pruritus, contact dermatitis, urticaria, blisters.
Packaging Quantity and Cost: 3ml: £23.99
Marketing Authorisation Holder: Galderma (U.K.) Limited, Evergreen House North, Grafton Place, London, NW1 2DX.
MA Number: PL 10590/0049
Legal Category: GSL
Date of Revision: October 2022
Adverse events should be reported. Reporting forms and information can be found at
https://yellowcard.mhra.gov.uk/ Adverse events should also be reported to Galderma (UK) Ltd:
E-mail: medinfo.uk@galderma.com Tel: +44(0)300 3035674.