The Lacuna Method is a treatment for fungal nails. The nail is fenestrated, meaning several rows of tiny holes are drilled through the nail plate to the nail bed – the number of holes depends on the size of the nail being treated and the extent of the infection.


Anti-fungal spray (Terbinafine 1% known as Lamisil) is applied over the nail, the fenestration means that is can pass through the holes and get under the nail to reach the infected area. It can then treat the infection more effectively than it were being applied to the impenetrable surface of the nail. This spray is then applied daily at home, until the infection is clear.


Toe nails grow slowly, and the treatment may need to be applied for 6 months and in some cases, even longer. During the treatment period, the affected nails should not be cut at home. You will need to keep up regular nail cutting treatments so we can monitor the progress of the treatment (approximately every 6 weeks). More holes may need to be added as the nail grows forward.  Any fungal infection of the skin must also be treated, and socks should be ‘hot-washed’ or soaked in Napisan/Milton prior to washing – no avoid re-infection.

If you would like any more information on the lacuna method please contact us here

Louise Reaney Podiatry