A toenail that has turned yellow-brown, thickened and crumbly — or started lifting from the nail bed — is usually a fungal nail infection (onychomycosis). It won’t clear on its own, pharmacy paints only reach mild early cases, and the effective tablet treatment needs a doctor. A registered Irish doctor can assess your nails by video for €34.99 and set out the treatment path that actually works.
Book a fungal nail consultation — pick a time below
The consultation is preselected. Choose a slot, add your details, and a registered Irish doctor will call you.
Employer sick notes issued for up to 7 days. No physical examination or wet signature required. Appointments typically within 30 minutes. At busy times, your doctor may call up to 20 minutes after your booked time.
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A sick note and a fit-to-work certificate certify opposite things — that you are unfit for work, and that you are fit to return. Each needs its own clinical assessment, so they cannot both be issued from the same consultation. If you need both, please book two separate appointments. Booking this consultation intending to obtain both does not entitle you to a refund.
White, yellow or brown discolouration starting at the nail’s free edge and creeping back.
Thickened nail that’s hard to cut; crumbly or powdery debris beneath it.
Nail lifting away from the nail bed; sometimes a distorted, ridged shape.
Often accompanied by athlete’s foot between the toes — the usual source.
Not every ugly nail is fungal: psoriasis, repeated trauma (runners’ toenails) and ageing changes can look similar — one reason a proper look matters before months of treatment.
Thickened, crumbling, yellow — the slow-motion look of a fungal toenail. Photo: James Heilman, MD, Wikimedia Commons, CC BY-SA 3.0.
Treatment options — honestly explained
Mild, early, edge-only infection: a topical lacquer (amorolfine) applied weekly can work, but demands persistence — 9–12 months on toenails.
Established infection: oral terbinafine is the gold standard — typically 12 weeks for toenails, with cure rates far above any paint. The doctor checks suitability (liver health, other medicines) first, and confirming the fungus with a nail clipping before a long course is good practice the doctor can arrange.
Treat the athlete’s foot too — otherwise the nail simply gets re-seeded.
Patience is part of the prescription: nails grow slowly — a toenail takes 12–18 months to fully replace itself, so the nail looks normal long after the fungus is dead. Judge success by healthy nail growing from the base.
See a doctor promptly rather than self-treating if you have diabetes or poor circulation (foot infections escalate faster and matter more); if the skin around the nail is hot, swollen and painful (bacterial infection — see our paronychia page); or if a dark streak or patch appears in or under a nail without an obvious injury — that needs in-person assessment to rule out melanoma.
Stop re-infecting yourself: rotate and air shoes, change socks daily, treat shoes with antifungal powder, keep nails short and straight-cut, flip-flops in shared showers and gyms, and never share clippers. Small habits decide whether cleared nails stay clear.
How the online consultation works
Book a time above — same-day appointments are usually available, seven days a week.
Show your nails by video — clear, close-up photos in daylight help enormously.
Get your plan — confirmation steps if needed, the right treatment prescribed electronically to your pharmacy, and prevention habits that stop it coming back.
Frequently asked questions
Will a fungal nail clear up by itself?
No — untreated, it slowly spreads along the nail and often to other nails. The earlier treatment starts, the easier the cure.
Do the pharmacy nail paints work?
Only for mild, early infections at the nail edge, and only with months of weekly use. Once the infection is established or near the nail base, tablet treatment is far more effective.
How long does tablet treatment take?
Terbinafine is typically taken for 12 weeks for toenails. The nail then needs many more months to grow out normally — the medicine kills the fungus; time replaces the nail.
Is terbinafine safe?
For most people, yes — it’s well established. The doctor reviews your liver health, alcohol intake and other medicines first, and a confirming nail sample before a long course is good practice.
Why do my fungal nails keep coming back?
Usually untreated athlete’s foot, fungus living in shoes, or stopping treatment early. Treating the skin, decontaminating footwear and finishing the full course are what make results stick.
I have diabetes — does that change things?
Yes — foot and nail infections deserve earlier, more careful treatment and proper foot care when you have diabetes. Book a review rather than self-treating, and see someone in person quickly if the skin becomes hot, red or painful.
This page is general health information, not a diagnosis. A registered Irish doctor will assess your individual situation during your consultation. In an emergency call 999 or 112.
Aoife isn't a doctor. For emergencies call 999 or 112.
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