What if oral antifungal treatment does not relieve discoloured nails?

A nail can remain yellow, white, brown or thick while damaged nail gradually moves towards the tip. Treatment can address infection without instantly restoring the appearance of the existing nail plate. Improvement is better judged by healthy nail growing from the base and the affected area moving outward.

Persistent colour can also reflect a different problem, such as repeated injury, pressure from footwear, inflammation around or under the nail, or a pigment change. Not every discoloured nail is caused by fungus, and more than one nail problem can occur at the same time. A clinician may examine the nail and, when appropriate, test a clipping or scraping before changing medication.

Arrange a follow-up with the prescriber or a dermatologist, especially if there is no healthy growth from the nail base or several nails remain affected. Take a list of every medicine and supplement you use, and describe missed doses, side effects, footwear pressure, nail picking, salon treatments and any injury.

Do not start another antifungal course, extend the course, or share tablets without medical advice. Keep nails trimmed and dry, change damp socks, avoid aggressive filing, and use roomy footwear. Photographing the nail at intervals can help show whether the discoloured area is moving outward.

Seek prompt medical assessment for increasing pain, warmth, swelling, pus, spreading redness, bleeding, or a nail that is lifting quickly. Arrange an examination for a new dark streak, pigment extending onto the surrounding skin, or a change affecting one nail without an obvious injury. People with diabetes, reduced circulation, or a weakened immune system should seek advice early when a nail becomes painful or inflamed.

Ask whether the original diagnosis needs testing, whether the nail shows new growth from its base, and whether an injury or inflammatory condition could explain the colour. You can also ask whether your medicines need monitoring, when progress should be reassessed, and which changes would warrant an earlier appointment.