Clearanail® Mechanical Fenestration for Fungal Nails

Clearanail® is a precision nail treatment system designed to create microscopic channels through the nail plate. The device retracts the drill bit when it reaches the nail bed, helping to reduce the risk of contact with the underlying tissue.

Onychomycosis (fungal nail infection) is a common condition that can be difficult to treat due to the naturally protective structure of the nail. Mechanical fenestration of the nail using Clearanail® creates pathways through the nail, allowing topical treatments to reach the affected areas more effectively.

A published research study in 2019 investigated mechanical nail fenestration and found that it improved the delivery of ciclopirox through the nail by 3–4 fold after 42 days in an in vitro model. Your podiatrist will discuss whether Clearanail® is suitable for you based on your individual circumstances.

Who May Benefit From Clearanail®?

Clearanail® may be suitable for people experiencing fungal nail infections who have tried over-the-counter products or treatments prescribed by their GP without achieving the results they hoped for.

Your podiatrist will assess whether Clearanail® is appropriate for you during a routine appointment. They will consider factors including:

• How the fungal nail infection is affecting you
• The severity and extent of the infection
• Whether part or all of the nail is affected
• Any medications you are taking
• Any relevant health conditions

Your podiatrist will explain the treatment options, discuss the Clearanail® packages available, and provide information for you to take away and consider.

If Clearanail® is suitable and you decide to proceed, we will arrange your treatment appointment with a trained podiatrist and ensure the Clearanail® equipment is available.

Please note: Clearanail® treatment is currently only available at our Roundhay Clinic.

What Is Included in the Clearanail® Package?

The quantity of products supplied will vary depending on the number of nails affected.

Appointment 1 Includes:

1. Creation of treatment channels in all infected areas of each affected nail
2. Dermatophyte test using nail dust collected during treatment (which may provide more accurate sampling than nail clippings)
3. Antibacterial detergent to use at home
4. Shoe and sock spray to use at home
5. Antifungal cream based on test results to use at home
6. Nail spray based on test results to use at home

Appointment 2 (approximately 6–8 weeks later) Includes:

1. Additional treatment channels created in any newly affected areas if required
2. Further nail spray supplied based on test results

Does Clearanail® Work on All Fungal Nail Infections?

Every patient is different, and several factors can influence treatment suitability and outcomes. Clearanail® may not be recommended if your podiatrist does not feel it is the most appropriate option for your individual circumstances.

Is Clearanail® Treatment Successful?

No treatment can guarantee complete success; however, your podiatrist will discuss all suitable options with you and will only recommend Clearanail® if they believe it is an appropriate treatment choice.

What Is the Cost of Clearanail® Treatment?

Prices vary depending on the number of nails affected and the time required to complete treatment.

• 1–3 nails: £283
• 4–6 nails: £359
• More than 6 nails: £380

The price includes:

• Both Clearanail® treatment appointments
• Dermatophyte testing
• Treatment products supplied for home use



Clearanail® Frequently Asked Questions

How do I get assessed to see if I am suitable?

Please book a Routine Appointment with one of our podiatrists. During this appointment, your podiatrist will take a comprehensive medical history and assess whether Clearanail® is suitable for you.

They may also provide routine podiatry treatment during this appointment, such as reducing thickened fungal nails, removing hard skin, or carrying out nail care where required.

If Clearanail® is suitable, your treatment plan will be discussed with you and a further appointment will be arranged.

What happens if I am not suitable for Clearanail®?

If Clearanail® is not suitable, your podiatrist will use the remaining appointment time to provide routine treatment where appropriate and discuss alternative treatment options that may be beneficial.

How much does the Routine Appointment cost?

£55 – New Patient Routine Appointment

£48 – Existing Patient Routine Appointment

How much does Clearanail® cost?

Clearanail® treatment costs:

1–3 nails: £283

4–6 nails: £359

More than 6 nails: £380

This includes two treatment appointments and products supplied for use at home.

Is a deposit required to book?

Yes. A £150 non-refundable deposit is required to secure your appointment. The remaining balance will be payable at your first Clearanail® appointment.

I cannot find the Clearanail® package online to book. Why?

Only a Routine Appointment can be booked online initially. If your podiatrist confirms that Clearanail® is suitable for you, they will arrange a Clearanail® appointment of the appropriate length.

Is Clearanail® suitable for everyone?

Clearanail® treatment is not suitable for everyone. It is not recommended for:

Patients under 18 years old

Patients who are pregnant or breastfeeding

Your podiatrist will advise if another treatment option would be more appropriate.

How many treatment channels are required?

This depends on the area of nail affected. Treatment channels are only created in areas where the nail is affected.

Each channel takes approximately 10 seconds to create.

Does Clearanail® hurt?

Most people do not experience pain during treatment. Some patients may feel mild discomfort or a slight pricking sensation.

Will the treatment channels be visible?

Yes, they may be visible if you look closely. They are extremely small, measuring approximately 0.4mm in diameter.

Can I wear nail varnish after treatment?

No. Nail varnish or lacquer should not be applied after treatment, as this may block the channels and prevent topical treatments from reaching the nail.

How long will the treatment channels remain?

The channels remain within the nail until they grow out naturally.

A big toenail can take approximately 12–18 months to fully grow out.

Can I have laser treatment for fungal nails?

We regularly review emerging treatments and discuss developments with manufacturers. Currently, we do not feel there is sufficient clinical evidence to support offering laser treatment as a proven long-term solution for permanently removing fungal nail infections.

We will continue to monitor developments in this area and review our treatment options as new evidence becomes available.

Reference

Cordoba Díaz D, Losa Iglesias ME, Becerro de Bengoa Vallejo R, Cordoba Diaz M. Transungual Delivery of Ciclopirox Is Increased 3–4-Fold by Mechanical Fenestration of Human Nail Plate in an In Vitro Model. Pharmaceutics. 2019;11(1):29. doi:10.3390/pharmaceutics11010029.