The fungi that cause nail infections live on skin and surfaces around us. They get into the nail through tiny cracks or trauma (stubbing your toe, ill-fitting shoes) and thrive in warm, moist, dark environments like sweaty shoes. Risk factors include athlete's foot, diabetes, age, poor circulation, repeated nail trauma and using shared changing rooms or pool areas.

Early signs are a white or yellow spot under the tip or side of the nail. As it progresses the nail becomes discoloured (yellow, brown, white or black), thickened, brittle, distorted in shape and may lift away from the nail bed. Some people notice a slight odour. The nail rarely hurts unless the infection becomes severe.

Most fungal nail infections can be diagnosed by clinical examination alone. The podiatrist looks at the pattern of discolouration, thickness, location and progression. If there's any doubt or the infection isn't responding to treatment we can take a small nail sample and send it for laboratory testing to confirm the type of fungus and guide treatment.

Effective treatment usually requires more than one approach:

• Nail debridement to thin and clear the infected nail (critical step that's often missed)
• Topical antifungal solutions or lacquers applied regularly
• Footwear and sock hygiene to stop reinfection
• Treatment of any concurrent athlete's foot
• GP referral for oral antifungals if the infection is severe

We tailor the mix to your case at your first appointment.

Treatment is long because nails grow slowly. A toenail takes 12 to 18 months to grow out fully. So even when the fungus is killed, visible clearance follows the nail growing out. Expect monthly debridement appointments for the first few months then less frequent. Most patients see clear new nail growth from the base by 3 to 6 months and full clearance by 12 to 18 months.

Two main reasons. First, the thick, dense infected nail stops the active ingredients reaching the fungus underneath. Without professional debridement, the medicine sits on top of the nail and never gets to where the infection lives. Second, many over-the-counter products use weaker antifungal agents than what's available through a podiatry-led programme.

Fungal nail infections are mildly contagious. The fungus can transfer through shared towels, shower floors, shoes or pedicure tools. Family members in the same household can pick it up over time. Simple precautions reduce spread: don't share towels, wear flip-flops in shared changing rooms, change socks daily and make sure shoes dry out fully between wears.

Yes, recurrence is possible. The same risk factors that caused it the first time (sweaty feet, ill-fitting shoes, family history of athlete's foot) can lead to reinfection. The key is changing the conditions that allowed the fungus to thrive. We'll cover this in your final treatment review so you stay clear long-term.

For your first appointment, allow up to 60 minutes. This gives us enough time for a thorough history, examination and treatment in the same visit. Follow-up treatments are typically up to 30 minutes for the vast majority of cases. We'll confirm the exact length when you book.

No. You can book a podiatry appointment directly with us with no GP referral needed. We can write to your GP after your appointment if there's anything they should know.

Wear something comfortable that's easy to roll up to the knee. Bring the shoes you wear most often (we'll often look at how they're wearing for biomechanical clues). If you've had any imaging or test results related to your feet, bring those too. Otherwise just bring yourself.

Podiatry & chiropody is available at our Great Dunmow clinic at 12 Stortford Road, CM6 1DA. The clinic has on-site disabled parking available on request. Just give us a call ahead of your appointment.