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Lacuna method for fungal nails

What is the Lacuna Method?

The Lacuna method is the term used for a fungal nail treatment involving the drilling of very small holes in the nail plate to aid the penetration of antifungal solutions to the infection at the nail bed.

How does it work?

It it is now understood that the active part of the fungal nail infection is actually on the nail bed (the skin beneath the nail) and not the nail itself. The nail plate acts as a barrier between the application of antifungal solutions purchased over the counter accessing this active portion of the infection.

Small holes drilled into the nail plate allow the antifungal solution to access the nail bed, therefore the active portion of infection. The pressure from footwear on the nail helps redistribute the treatment under the surface of the nail. This stops the fungus spreading and encourages the healthy nail to grow out, along with the holes. As with any antifungal treatment, this takes time, as the infection will clear only as fast as your toenails grow, which can take up to 18 months.

Who can benefit from the Lacuna Method?

People with a mild-moderate fungal nail infection - infection that doesn't reach past the cuticle, as antifungal solutions cannot access this portion of the nail.

Symptoms of a fungal nail infection include:

  • Nail thickening
  • Nail discolouration - usually either white/dark/yellow
  • Brittle nail texture
  • Build up of debris under the nail
  • White patches on the nail plate
  • Lifting of the nail

What does the Lacuna Method involve?

Step 1

A thorough assessment is required first. A thorough examination of the nails, advice will be given regarding how to prevent future reinfection.

Step 2

A photo will be taken of the nail so progress can be monitored.

Step 3

The nail is cleaned and prepared.

Step 4

Micro holes are drilled into the nail plate around the infected portion of nail. This may feel like a hair being plucked.

Step 5

Home care advice is given on what is required in between appointments.

Step 6

The nail will be reviewed around 6-8 weeks later, further holes are drilled if necessary. This will continue until the infection has cleared.

If your podiatrist deems that the treatment is not effective for you, other methods of treatment will be discussed. Other fungal nail treatment options include:

Examples of the treatment:

Examples of the treatment.

For more information regarding our treatments or to book an appointment please contact us either via email at or call 0330 088 4222

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