Can telemedicine treat Nail Fungus (Onychomycosis)?

Audience: pediatric

Nail fungus, or onychomycosis, is a common infection that affects the nails, causing thickening, discoloration, and sometimes discomfort. In children, it can be less common but still occurs. Telemedicine can help by allowing caregivers to consult healthcare providers remotely to discuss symptoms and get advice on treatment options. Through video or photo sharing, doctors can often assess the nail's appearance and recommend initial care steps or medications. However, some cases may need in-person visits for nail samples or more detailed exams. Early treatment can prevent the infection from worsening or spreading. Telemedicine offers a convenient way to start care, especially when visiting a clinic is difficult. Always watch for signs that need urgent attention or physical exams. This guide explains how telemedicine fits in managing nail fungus in children.

Red flags — go in person / ER

• Nail infection spreading rapidly or causing severe pain — seek in-person medical care promptly.
• Signs of nail infection with fever or swelling around the nail — urgent evaluation needed.
• Child has a weakened immune system or other health conditions and shows nail infection — consult healthcare provider urgently.

What telemedicine can do

• Initial assessment of nail appearance via video or photos.
• Providing guidance on nail care and hygiene.
• Recommending over-the-counter or prescription antifungal treatments when appropriate.
• Monitoring treatment progress and side effects through follow-up virtual visits.

What telemedicine cannot do

• Performing laboratory tests like nail clipping or culture samples.
• Diagnosing complicated or unusual nail conditions requiring biopsy.
• Managing severe infections with systemic symptoms needing urgent care.
• Prescribing medications that require physical examination or monitoring not feasible remotely.

What is Nail Fungus (Onychomycosis)?

Nail fungus is an infection that affects the fingernails or toenails. It can make nails look thick, yellow, brittle, or crumbly. This happens when tiny fungi grow under or inside the nail. In children, nail fungus is less common than in adults but can still occur, especially if there are injuries or other skin conditions.

How Telemedicine Can Help

Telemedicine lets you connect with a healthcare provider using video calls, photos, or phone. For nail fungus, you can show the affected nails and describe symptoms. The provider can often suggest treatments like antifungal creams or medicines and give advice on nail care. This can save time and avoid travel to a clinic.

When an In-Person Visit is Needed

Sometimes, the doctor may need to see the nail in person to take a small sample for testing. This helps confirm if fungus is the cause or if another problem exists. Also, if the infection is severe, spreading, or causing pain, a physical exam is important to decide the best treatment.

Preventing Nail Fungus in Children

Good nail hygiene helps prevent fungus. Keep nails clean and dry, avoid sharing nail clippers or shoes, and wear breathable socks. If your child has a skin condition like athlete's foot, treating it early can reduce the risk of nail fungus.

Treatment Options

Treatments may include antifungal creams, ointments, or oral medicines. These often take several weeks or months to work. Follow the healthcare provider’s instructions carefully. Telemedicine providers can guide you on how to use these treatments safely.

How to prepare for your tele-visit

• Clean and dry the affected nail before the visit.
• Take clear photos of the affected nails from different angles.
• List any symptoms your child has, such as pain or changes in nail color.
• Prepare a list of any medications or treatments your child is currently using.
• Have a quiet, well-lit space ready for the telemedicine appointment.
• Be ready to describe when the nail changes started and any possible exposures or injuries.

After your tele-visit

• Follow the treatment plan and medication instructions given by the provider.
• Keep nails clean and dry to help treatment work better.
• Monitor the nail for improvement or any side effects from medications.
• Schedule follow-up telemedicine visits as recommended to track progress.
• Seek in-person care if new symptoms develop or if the infection worsens despite treatment.

FAQs

Can nail fungus go away on its own without treatment?

Nail fungus usually does not go away without treatment. It often gets worse over time and can spread to other nails or skin. Treating it early helps prevent complications.

Is nail fungus contagious to other family members?

Yes, nail fungus can spread through shared items like towels, shoes, or nail clippers. Good hygiene and not sharing personal items help reduce the risk.

How long does treatment for nail fungus take?

Treatment can take several weeks to months because nails grow slowly. It’s important to keep using the medicine as directed, even if the nail looks better.

Can children use the same antifungal medicines as adults?

Some antifungal medicines are safe for children, but the provider will recommend the best option based on age and health. Always follow the healthcare provider’s advice.

What should I do if the nail looks worse after starting treatment?

Contact your healthcare provider through telemedicine or in person. Sometimes the infection needs a different treatment or further evaluation.

Sources

1. Onychomycosis — MedlinePlus, U.S. National Library of Medicine.
2. Fungal Nail Infection (Onychomycosis) — Centers for Disease Control and Prevention (CDC).
3. Nail Fungus (Onychomycosis) — Mayo Clinic.
4. Onychomycosis: Diagnosis and Treatment — National Library of Medicine, NIH.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has concerning symptoms or the condition worsens, seek direct evaluation by a healthcare professional.