How to prepare for a video visit about Nail Fungus (Onychomycosis)

Audience: pediatric

Nail fungus, also called onychomycosis, is a common condition where fungi infect the nails, causing changes in color, thickness, or shape. In children, it may be less common but still important to recognize and treat early. A video visit with a healthcare provider can help assess the nail and discuss treatment options without needing to visit a clinic in person. To get the most from your telemedicine appointment, it helps to prepare by having good lighting, clean nails, and a list of symptoms or concerns. During the visit, the provider may ask about symptoms, medical history, and show the affected nails clearly on camera. While telemedicine can guide diagnosis and treatment, some cases may need in-person care for tests or treatments. This guide helps families understand how to prepare, what to expect, and when to seek urgent care.

Red flags — go in person / ER

• Nail pain, redness, swelling, or pus around the nail — seek urgent medical care.
• Rapid spreading of nail changes to other nails or nearby skin — contact your healthcare provider promptly.
• Fever or signs of infection beyond the nail area — get immediate in-person evaluation.

What telemedicine can do

• Initial assessment of nail changes and symptoms.
• Providing education on nail care and hygiene.
• Discussing treatment options and prescribing medications if appropriate.
• Monitoring treatment progress through follow-up video visits.

What telemedicine cannot do

• Performing laboratory tests like nail clippings or cultures.
• Managing severe infections requiring surgical or emergency care.
• Diagnosing other skin or systemic conditions that mimic nail fungus without physical examination.

What is Nail Fungus (Onychomycosis)?

Nail fungus is an infection that affects the fingernails or toenails. It often makes nails look discolored, thick, brittle, or crumbly. In children, it may happen after injury or exposure to fungi in moist environments. It usually grows slowly and can affect one or more nails.

How to Prepare for Your Video Visit

Before your video visit, make sure the child’s nails are clean and dry. Find a well-lit area to show the nails clearly on camera. Have a list of symptoms ready, such as when changes started, any pain, or other skin problems. Also, note any medicines or allergies your child has. This helps the provider understand the situation better.

What to Expect During the Telemedicine Appointment

The healthcare provider will ask questions about the nail changes and overall health. They will want to see the nails closely using the camera. Sometimes, they may suggest tests or treatments based on what they see. They might also give advice on how to care for the nails and prevent spread.

When Telemedicine is Not Enough

If the infection looks severe, painful, or is spreading quickly, the provider may recommend an in-person visit. Some tests, like nail clippings for lab analysis, usually need to be done face-to-face. Also, if the child has other health conditions affecting the skin or immune system, more detailed care may be needed.

Tips to Help Your Child During Treatment

Treating nail fungus can take weeks or months. Encourage good hygiene, keep nails trimmed, and avoid sharing towels or shoes. Follow the treatment plan given by your provider carefully. Watch for any side effects or worsening symptoms and report them promptly.

How to prepare for your tele-visit

• Clean and dry the child's nails before the visit.
• Find a bright, quiet place with good internet connection for the video call.
• Have the child’s medical history and current medications ready to share.
• Prepare a list of symptoms, including when nail changes began and any pain or discomfort.
• Ensure the device camera can focus clearly on the affected nails.
• Have a family member assist in showing the nails if needed.

After your tele-visit

• Follow the treatment plan and medication instructions given by the provider.
• Keep nails trimmed and clean to support healing.
• Avoid sharing personal items like towels or shoes to prevent spread.
• Schedule follow-up video visits as recommended to monitor progress.
• Contact your healthcare provider if symptoms worsen or new red flags appear.

FAQs

Can nail fungus go away without treatment?

Nail fungus usually does not clear up on its own and may get worse over time. Treatment helps to eliminate the infection and prevent it from spreading.

Is nail fungus contagious to other family members?

Yes, nail fungus can spread through shared items like towels or shoes. 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 follow the full treatment plan even if nails start to look better.

Can I use home remedies instead of medicine?

Some home remedies may help, but they are often less effective than prescribed treatments. Always discuss any home remedies with your healthcare provider before trying them.

When should I see a doctor in person?

If the nail infection is painful, spreading quickly, or if you notice signs of a more serious infection like fever or pus, seek in-person medical care promptly.

Sources

1. Onychomycosis — MedlinePlus, U.S. National Library of Medicine.
2. Nail Fungus (Onychomycosis) — Mayo Clinic.
3. Fungal Nail Infections — Centers for Disease Control and Prevention (CDC).
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 you have concerns about your child's health, please seek evaluation by a healthcare professional in person.