Therapeutic pedicure in Coimbra

Nail fungus (onychomycosis) in Coimbra

Onychomycosis

Yellow, thick, brittle nails are not just cosmetic: they are an infection that, untreated, spreads to the other nails. Debridement and laser treat the nail; patience does the rest — a new nail takes months to grow.

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Registered Nurse · Ordem dos Enfermeiros no. 117508

What it is

Onychomycosis is a fungal infection of the nail — in most cases by dermatophytes, the same fungi that cause athlete’s foot, and sometimes by yeasts or moulds. It is the most common nail disease and mostly affects the feet, because closed shoes create the warm, damp environment the fungus likes.

It usually starts at the tip or side edge of the nail as a yellowish or whitish patch and progresses towards the base. Over time the nail thickens, collects debris underneath, lifts from the nail bed and may become deformed or break. Without treatment it does not clear on its own and tends to spread to neighbouring nails and to the skin.

Signs and symptoms

Yellowish, brownish or whitish nail, starting at the tip.
Thickening of the nail, which becomes hard to cut.
Brittle nail that crumbles or flakes.
Whitish material building up under the nail.
The nail lifting from the nail bed (onycholysis).
Nail deformity and, sometimes, an unpleasant smell or pain in shoes.

Most common causes

Contact with the fungus in changing rooms, swimming pools, gyms and public showers, walking barefoot.
Untreated athlete’s foot (fungal infection of the skin between the toes) spreading to the nail.
Closed shoes and feet that sweat a lot.
Nail trauma — from tight shoes, running, a knock — that opens the door to the fungus.
Age, diabetes, poor circulation, psoriasis and a weakened immune system increase the risk.
Sharing scissors, files or towels, and gel polish kept on too long.

Not every yellow, thick nail is fungus: psoriasis, trauma and other conditions can look similar. When in doubt, a doctor can order a mycology test (a nail scraping) to confirm the diagnosis before investing in a long treatment.

How it is treated

Treatment combines two things. Debriding the nail with a micromotor removes the diseased, thick part, reduces the fungal load and the pressure from shoes, and thins the nail so treatments — laser or antifungal lacquers — reach where they are needed. It is painless and immediately improves appearance and comfort.

Laser therapy heats the nail bed and plate in a controlled way, creating an environment hostile to the fungus. It is done in spaced sessions, and the number depends on progress: toenails grow 1 to 2 mm a month, and a completely new nail takes 9 to 12 months. Improvement shows at the base, as healthy nail pushes the diseased nail towards the tip.

To be clear: no onychomycosis treatment guarantees a cure in every case, and recurrences happen. Laser has the advantage of no systemic side effects and no drug interactions. In extensive or resistant cases a doctor may prescribe an oral antifungal, and debridement remains useful alongside it.

What happens at the appointment

1Assessment of the nail and surrounding skin; referral for testing when the diagnosis is in doubt.
2Debridement and thinning of the nail, removing the debris built up underneath.
3Laser therapy session on the affected nails.
4Guidance on antifungal lacquers and footwear care, to reinforce treatment between sessions.
5Follow-up sessions spaced according to progress, with photographs to compare growth.

What you can do at home

Dry your feet well, especially between the toes, and change socks daily (cotton or moisture-wicking fibres).
Alternate shoes so they dry between wears; use antifungal sprays or powders inside them.
Flip-flops in changing rooms, pools and public showers.
Keep your own scissors and files and disinfect them; do not share towels.
Treat athlete’s foot as soon as it appears, so it does not reinfect the nail.
Avoid polish or gel on the diseased nail during treatment: they hide progress and trap moisture.

When not to wait

Book without delay — or see a doctor — if you notice any of these signs:

Pain, redness, warmth or pus around the nail — there may be an associated bacterial infection.
You have diabetes or poor circulation: onychomycosis increases the risk of wounds and infection and should be treated early.
The nail changes colour in an unusual way: a dark or black streak under the nail not caused by a knock should be seen by a doctor.
Several nails affected, or the skin affected too, despite treatment.

Frequently asked questions

How many laser sessions are needed?+

It depends on the extent and how many nails are affected. The price is per session and the plan adapts to progress; as a rule, several sessions spaced over months, following the growth of the new nail.

Does the laser hurt?+

You feel warmth in the nail during application, sometimes a brief prick, but it is well tolerated and needs no anaesthetic. There is no recovery time: you leave walking normally.

When will I see results?+

Appearance improves immediately with debridement. The new, healthy nail appears at the base after 2 to 3 months and takes 9 to 12 months to fully replace the diseased nail.

Can I paint my nails during treatment?+

Better not. Polish hides progress and traps moisture. If you really need to, there are breathable polishes, but remove it before each session.

This information is general and meant to help you understand the problem. It does not replace an individual assessment or medical follow-up. If in doubt, book an appointment. Content reviewed by Priscila Arantes, registered nurse (Ordem dos Enfermeiros no. 117508).