Dermatology · General Practice · 2 h ago
British Association of Dermatologists issues 2026 onychomycosis guideline
A UK expert group reviewed published evidence and developed 44 recommendations for managing fungal nail infection. The guideline emphasizes accurate diagnosis, individualized treatment and primary-care management, with referral for more complex cases.
- Guideline sets out 44 recommendations for fungal nail infection.
- Accurate diagnosis and individualized treatment are emphasized.
- Terbinafine is first-line for many patients.
- Complex cases may need dermatology referral.
The British Association of Dermatologists’ 2026 guideline was developed by a UK-based group including consultant dermatologists, pharmacists, podiatrists and people with lived experience of fungal nail infection (onychomycosis). The group reviewed published treatment evidence and produced 44 recommendations, a patient management pathway, research priorities and audit points. The source summary does not provide details of the evidence-review methods or specific study results.
The guideline says accurate diagnosis is important and that treatment decisions should account for infection type, age, general health and patient preference. Topical treatments may be suitable for mild infection or when oral medication cannot be taken. Oral terbinafine is described as first-line for many patients; itraconazole or fluconazole are options when terbinafine is unsuitable. Combination treatment may help in stubborn infections. Antifungal medicines can also be used in children and young people, with doses adjusted for age and weight.
The group notes that nails may not regain their previous appearance even after the infection is cured, and recommends discussing treatment benefits, risks and duration. Most care takes place in primary care, while more complex cases may require dermatology referral. The full text was not provided with the source, limiting assessment of the evidence underpinning individual recommendations.
In practice
For clinicians managing fungal nail infection, the guideline supports confirming the diagnosis and tailoring treatment to infection type, age, general health and patient preference. It identifies topical therapy as an option for mild infection or when oral treatment cannot be taken, and oral terbinafine as first-line for many patients, with itraconazole or fluconazole alternatives when it is unsuitable. This is professional-society guidance, but the supplied summary does not include the full evidence review or recommendation grading; it also notes that nail appearance may not fully recover after cure.
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British Journal of Dermatology: British Association of Dermatologists guideline for managing fungal nail infection (onychomycosis) 2026 ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.