Onychomycosis, a term used to describe a fungal infection of the nail, presents a challenge to dermatologists because of the requirement for long courses of therapy and the high recurrence rates. This most common disease of the nails presents as tinea caused by dermatophytes such as Trichophyton rubrum and Trichophyton mentagrophytes var. interdigitale, although yeasts or non-dermatophytic moulds may also be causative organisms. Toenails are more commonly affected than fingernails, and these infections are frequently chronic and resistant to treatment.2 The infected nails appear discoloured, thickened and dystrophic, which may impact negatively on the social life of the patient. The first stage of onychomycosis involves hyperkeratosis of the under surface of the distal nail plate and the distal nail bed (hyponychium). Progressive nail involvement produces total dystrophic onychomycosis (TDO) and destruction of the infected nail plate.