Category
Threshold Criteria
Fungal nail infection is a common and benign condition. Terbinafine should be considered as treatment for dermatophyte fungi (the ones that cause athlete’s foot) after confirmation by nail clippings which should be sent for mycology before treatment is commenced. Treatment is usually required for 6 weeks for fingernail infections and for 12-16 weeks for toenail infections.
• Oral antifungal treatment is required for child under the age of 18 years.
Only about 50% of nail infections are cured and there is a high risk of relapse and re-infection.
Onychomycosis may produce cosmetic symptoms only and it is accepted that in such cases, treatment is not clinically necessary.
Where diagnosis is uncertain Advice and Guidance can be used via ERS, which may avoid referral to secondary care.
Eligibility
| LLR ICB will only fund referral to Podiatry where one of the following criteria is met · The nail is traumatized by the person’s footwear causing pain, or deformed toenails are causing pain to adjacent toes · The person has diabetes, vascular disease, or a connective tissue disorder (because of a higher risk for secondary bacterial infections and cellulitis). · The person is, or is likely to become, severely immunocompromised (for example with haematological malignancy or its treatment). |
Guidance
| ARP 45 Review Date: 2026 |
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