What Happens After a Telemedicine Visit for Nail Fungus (Onychomycosis) in Children

Audience: pediatric

If your child has a nail fungus infection, also called onychomycosis, a telemedicine visit can help start the process of care. During the visit, a healthcare provider will ask about symptoms and may look at pictures or video of the affected nails. After the visit, you will usually get advice on how to care for your child's nails and may receive a prescription for medicine to treat the infection. Treatment often takes several weeks or months because nail fungus can be stubborn. It's important to follow the care plan and watch for any signs that the infection is getting worse or causing other problems. If any serious symptoms develop, you should seek in-person care promptly. Telemedicine is a helpful first step but does not replace the need for in-person exams if the condition is severe or does not improve.

Red flags — go in person / ER

• Increased pain, redness, swelling, or pus around the nail — seek urgent in-person care.
• Rapid spread of infection to other nails or skin — contact healthcare provider promptly.
• Signs of fever or feeling very unwell with nail infection — go to emergency care immediately.

What telemedicine can do

• Initial evaluation of nail changes suggestive of fungus.
• Providing education on nail care and hygiene.
• Prescribing antifungal medications when appropriate.
• Monitoring mild to moderate cases through follow-up visits.

What telemedicine cannot do

• Severe infections with pain, swelling, or pus requiring drainage.
• Cases needing laboratory tests or nail sampling not available via telemedicine.
• Emergencies involving systemic symptoms like fever or spreading infection.
• Situations requiring surgical nail removal or other in-person procedures.

What to Expect Right After Your Telemedicine Visit

After your telemedicine appointment, the healthcare provider will usually send you a care plan. This plan may include instructions on how to keep your child's nails clean and dry, tips to avoid spreading the infection, and information about medicines that can help. You might get a prescription for antifungal creams, ointments, or pills. Sometimes, the provider may suggest visiting a local clinic or lab for nail samples if the diagnosis is unclear.

How Long Does Treatment Take?

Treating nail fungus often takes a long time—sometimes several months—because nails grow slowly. Medicines need time to work as the infected nail grows out and is replaced by a healthy nail. It's important to use the medicine exactly as directed and to be patient. Stopping treatment too early can cause the infection to come back.

Monitoring Your Child's Progress

Keep an eye on your child's nails during treatment. Look for signs that the nails are improving, such as less discoloration or thickening. If the infection seems worse, or if new symptoms like pain, swelling, or redness appear, contact your healthcare provider. They may recommend an in-person visit for a closer look.

When to Seek In-Person Care

If your child develops severe pain, swelling, or pus around the nail, or if the infection spreads quickly, these are signs that in-person care is needed. Also, if your child has other health problems like diabetes or a weak immune system, an in-person exam may be safer and more effective.

Preventing Nail Fungus from Returning

After treatment, help your child avoid getting nail fungus again by keeping nails clean and dry, trimming nails regularly, and avoiding sharing nail tools or shoes. Wearing breathable socks and shoes can also help. Good foot hygiene is key to prevention.

How to prepare for your tele-visit

• Have clear photos or videos of the affected nails ready to show during the visit.
• List any symptoms your child has noticed, such as nail changes or discomfort.
• Prepare a list of current medications and any allergies your child has.
• Note any other health conditions your child has, like diabetes or immune problems.
• Write down questions or concerns you want to discuss with the provider.

After your tele-visit

• Follow the healthcare provider’s instructions for medication use carefully.
• Keep your child’s nails clean and dry as advised.
• Watch for any changes in the nails or new symptoms.
• Attend any scheduled follow-up telemedicine visits to track progress.
• Seek in-person care if red flags or worsening symptoms appear.

FAQs

How do I know if my child really has nail fungus?

Nail fungus often causes thick, discolored, or brittle nails. However, other conditions can look similar. A healthcare provider can often make a good guess based on pictures and history, but sometimes further tests are needed.

Can my child catch nail fungus from someone else?

Yes, nail fungus can spread through shared nail tools, shoes, or walking barefoot in damp public places. Good hygiene and not sharing personal items help prevent spread.

Are antifungal medicines safe for children?

Many antifungal medicines are safe for children when used as directed. Your healthcare provider will choose the best option based on your child's age and health.

What if the nail fungus doesn’t get better with treatment?

If the infection does not improve after several months of treatment, your provider may suggest an in-person visit for further evaluation or different treatment options.

Can nail fungus go away on its own?

Nail fungus usually does not go away without treatment and can get worse over time. Early treatment helps prevent complications.

Sources

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

This telemedicine guidance is for education only and is not a substitute for in-person medical care. If your child's symptoms are severe, worsening, or if you have concerns, please seek care from a healthcare professional in person.