Have you had this problem diagnosed by a healthcare professional before?

    YesNoOther

    Why do you need treatment today?

    I’ve had this problem before and need a REPEAT prescriptionI’ve had this problem before but want to try a NEW medicationI’ve NOT had this problem before and want to try a medication to helpOther

    Which nails are affected? Please select all that apply

    Finger NailsToe NailsOtherI don’t know

    Finger Nails

    ThumbIndex fingerMiddle fingerRing fingerLittle fingerLeft handRight handBoth handsOther

    Toe Nails

    Big toe2nd toeMiddle toe4th toeLittle toeLeft footRight footBoth feet

    0%

    Do you have any of the following symptoms? Please select all that apply

    Discoloration(yellow, brown, or white) Thickened or brittle nailLoss of smoothness or small pits/holes have formedNail curving the wrong way (like a spoon) I have lost a lot of my nailCrusting or scaling around the nail(s)It looks infectedPain or sensitivityBad smell or malodourDischarge or oozingBleedingWhite linesOtherI don't know

    Please rate from 1-10 how painful it is (0= no pain, 10= worst imaginable):

    Do you experience any of the following additional symptoms?

    Painful or swollen skin around the nail

    Pus or discharge from the affected nail

    Itching or burning sensation around the nail

    Redness or warmth around the nail

    None of the above

    Do you have any of the following conditions that may increase your risk of fungal nail infections?

    Diabetes

    Peripheral vascular disease

    Psoriasis

    A weakened immune system (e.g., taking immunosuppressant medications, HIV, cancer treatment)

    Frequent use of communal areas (e.g., public pools, gyms)

    History of athlete’s foot

    None of the above

    Do you remember damaging your nail(s)?

    NoYesI don't know

    14%

    Do you also have any signs of fungal infection in other areas of the body?

    Athlete’s Foot
    – Itching, redness, and scaling between the toes or on the soles of the feet.

    Jock itch (Sweat rash)
    – Itchy, red rash in the groin or inner thighs.

    Ringworm
    – Red, ring-shaped, scaly rash on the body.

    Scalp infection
    – Itching, scaling, and hair loss on the scalp.

    Fungal infection in skin folds (Intertrigo)
    – Red, raw, and itchy patches in body folds (e.g., under breasts, armpits, groin).

    Pityriasis Versicolor
    – Small discoloured patches on the chest, back, or upper arms.

    Other

    I’m not sure

    No

    When did the problems start?

    How quickly did the problem start?

    Suddenly (minutes)Quickly (hours)Gradually (days)Slowly (weeks)Very slowly (months)Over several yearsOtherI don't know

    Is it getting worse?

    NoYesOtherI don’t know

    How does the problem behave?

    It's always thereIt comes and goesOtherI don’t know

    How long does it last?

    MinutesHoursDaysWeeksMonthsYears

    Please explain:

    28%

    Have you been unwell in any other way recently or experienced any of the following symptoms?

    No- I have been wellI have been unwell recently due to another condition, illness or circumstanceTemperatureFeverNauseaVomitingNight sweatsWeight lossExcessive tirednessJoint pain/ swellingOther concerning symptomsI don’t know

    Please tell us more

    Please tell us more

    Please tell us more

    Please tell us more

    Please tell us more

    Please tell us more

    Please tell us more

    Please tell us more

    Please tell us more

    Please tell us more

    Does anything make it WORSE? Please select all that apply

    Wearing tight, non-breathable shoes or socksSweating or moisture around the affected areaWarm, humid environmentsNot drying the affected area properly after washingWalking barefoot in communal areas (e.g. gyms, swimming pools)Wearing nail polish or artificial nailsProlonged use of non-breathable gloves (for fingernail infections)Poor foot or hand hygieneSharing towels, shoes, or personal itemsInjury or trauma to the nailOtherNone of the aboveI don’t know

    Does anything make it BETTER? Please select all that apply

    Trimming nails regularly and keeping them shortKeeping the affected area clean and dryWearing breathable shoes and socksWearing protective footwear in communal areas (e.g., shower sandals)Avoiding nail polish or artificial nails during treatmentChanging socks and shoes regularly to keep feet dryUsing antifungal powders to reduce moistureCertain products e.g. tea tree oil, aloe vera, coconut oil Certain supplements e.g. probiotics, vitamins, zinc OtherNone of the aboveI don’t know

    42%

    Have you already tried any of the following treatments?

    Antifungal Nail Lacquer
    e.g. Amorolfine (Curanail/Loceryl etc)

    Antifungal Tablets or Capsules
    e.g. Fluconazole, Itraconazole, Terbinafine

    Antifungal Creams or Gels
    e.g. Canesten (Clotrimazole), Daktarin (Miconazole), Daktacort (MIconazole & Hydrocortisone), Lamisil (Terbinafine), Ketoconazole

    Antifungal Powders or Sprays
    e.g. Lamisil (Terbinafine), Daktarin, Mycota, Scholl Athletes Foot Powder

    Antibacterial or Antiseptic Washes
    e.g. Hibiscrub, Dermol 500, Cetaphil Antibacterial

    Steroid Creams or Ointments
    e.g. Daktacort, Hydrocortisone, Eumovate (Clobetasone), Betnovate (Betamethasone)

    Cleansers/ Exfoliators
    e.g. Cetaphil, CeraVe, Purifide, La Roche Posay Effaclar, Neutrogena

    Moisturisers
    e.g. E45, Aveeno, Aloe vera

    Herbal/ Supplements/ Alternative treatments
    e.g tea tree oil, zinc, vitamins

    Other

    None - I haven't tried any treatments.

    57%

    Have you ever had any of these tests? (for this issue only)

    Nail clippingsSwabsNail biopsy (surgery)OtherNone of the aboveI don’t know

    Before starting treatment with oral antifungal tablets you will need to provide evidence of a recent satisfactory Liver Function Blood test from within the last month. You can either provide us a copy from your GP or you can pay for a private home testing kit to be sent to you (See our FAQ section for more details on these home testing kits)

    Have you recently had a liver function test (LFT)?

    YesNoOther

    Please upload the results by taking a photo/ screenshot of the results and uploading at the ‘Photo upload’ section at the end of this form- alternatively you can email it to us ([email protected])- please make sure the information provided clearly identifies you as the patient i.e. it contains either your name or date of birth.

    You will need to provide evidence of this to us before you submit this form

    Do you understand that you will need to provide proof of a liver function blood test (LFT) after 4-6 weeks of starting treatment in order to be able to safely continue your treatment?

    YesNo

    Is there anything else you feel is important for us to know that would prevent us from safely prescribing for you?

    NoYes

    71%

    Photo Upload

    • If this is a new problem then we require at least one photo of it (max 6 photos) using your phone or digital camera.

    • Take a "far away photo" (from 1 meter away) to show the location and size of the problem.

    • Take a close-up photo (10-12 cm away) to show the details.

    • If appropriate please include a size reference (e.g. a coin or ruler) in your photo for scale.

    Upload Photo 1





    Add another photo

    Upload Photo 2





    Add another photo

    Upload Photo 3





    Add another photo

    Upload Photo 4





    Add another photo

    Upload Photo 5





    Add another photo

    Upload Photo 6





    85%

    Do you understand and agree with the following?

    You are aware that you should complete the full course of antifungal treatment, even if your symptoms improve, to prevent the infection from coming back.

    You are aware that oral antifungal medications, such as fluconazole, itraconazole and terbinafine, can affect liver function and should not be used if you have current or previous liver disease. You should seek urgent medical help if you take these medications and notice symptoms of liver damage such as yellowing of the skin, dark urine, abdominal pain or nausea. These medications can interact with other drugs, such as blood thinners or antidepressants, so it’s important to read the patient information leaflet before use and speak to a medical professional for advice. You should also be aware that these medications can affect the heart’s rhythm (prolonged QT), especially if taken with other medications that affect the heart, so it’s important to inform the prescriber of any medications you are currently taking and read the patient information leaflet before using the product to check it is safe for you to use.

    You are aware that long-term use of steroid creams, ointments, lotions and other forms can cause permanent skin damage and skin thinning and should be applied sparingly and not be used continuously.

    You are aware paraffin containing preparations (emollients/creams/ ointments etc) can soak into clothing and bedding and cause a fire hazard. You should wash clothing and bedding frequently and avoid smoking and naked flames. You are aware that for any scalp applications they can be flammable and it is not recommended to blow dry your hair after using them.

    You are aware that if you have or develop new or worsening symptoms or concerns, or psychological distress, or your condition is not responding to treatment then you should see your GP as soon as possible.

    You will read the patient information leaflet supplied with any medication we send you and if you have any allergies to any of the ingredients or any contraindications, you will not take the medication and contact a DigiDerm clinician for further advice. You have informed us of any allergies you have by completing the general health questions.

    You have informed us of any current or previous medical conditions you have by completing the general health questions.

    You are not pregnant.

    You agree that if needed, a DigiDerm clinician may contact you via email, whatsapp or telephone in response to this consultation form to offer advice and suggest treatments where necessary, or if they feel they need more information to make an accurate diagnosis or assessment of your condition.

    You agree that if after reviewing your consultation, your skin problem is something we cannot treat or is not suitable for our service, then we will give you a full refund and suggest you visit your registered NHS GP for further advice.

    You are at least 16 years old and currently resident in the UK at the time of this consultation. This treatment is to be used only by you.

    You take responsibility to inform your own regular doctor/ NHS GP of this online consultation and any treatments supplied, or any changes in your circumstances.

    The answers provided to the above questions are true and accurate to the best of your knowledge.

    100%

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