Struggling with thick, discolored, or crumbling nails? Our board-certified dermatologists provide effective treatment for nail fungal infections using proven oral medications, advanced topical therapies, and long-term prevention strategies.
Schedule Your ConsultationNail fungus, medically known as onychomycosis, is one of the most common nail disorders, affecting approximately 10% of the general population and up to 50% of adults over age 70. This persistent infection is caused by dermatophyte fungi—the same organisms responsible for athlete's foot and ringworm—that invade the nail bed and plate.
At Paradise Medical Center in Westchester, Miami, our dermatologists specialize in diagnosing and treating all types of nail fungal infections. We understand that nail fungus is more than a cosmetic concern—it can cause pain, affect your ability to walk comfortably, and spread to other nails or family members if left untreated.
Miami's warm, humid climate creates ideal conditions for fungal growth, making our residents particularly susceptible to nail infections. Athletes, swimmers, and those who frequently visit gyms, pools, or nail salons are at higher risk. People with diabetes, peripheral vascular disease, or weakened immune systems also face increased susceptibility and greater complications from untreated infections.
The key to successful treatment is accurate diagnosis—not all nail changes are caused by fungus. Conditions like nail psoriasis, trauma, and other disorders can mimic fungal infection. Our dermatologists use laboratory testing to confirm the diagnosis before starting treatment, ensuring you receive the right therapy from the start.
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Nail fungus develops gradually, and early signs are often overlooked. Recognizing the symptoms early leads to faster, more effective treatment. Our dermatologists evaluate the following indicators during your consultation.
Nails turn yellow, white, brown, or greenish. Discoloration usually starts at the tip or side of the nail and gradually spreads toward the cuticle as the infection progresses deeper into the nail bed.
Infected nails become abnormally thick, making them difficult to trim. The nail shape may become distorted, curved, or ragged. In severe cases, the nail lifts away from the nail bed (onycholysis).
As fungus breaks down the nail structure, nails become brittle, crumbly, and prone to breaking. Debris may accumulate under the nail, producing a foul odor and increasing discomfort in shoes.
Many nail conditions look similar to fungal infections but require entirely different treatments. Using antifungal medications on non-fungal nail conditions wastes time and money while delaying proper care. Our dermatologists use proven diagnostic methods to confirm the presence of fungus before starting any treatment protocol.
Our experienced dermatologists evaluate the appearance, pattern, and distribution of nail changes. The location of discoloration, degree of thickening, and involvement of surrounding skin all provide diagnostic clues that guide our testing approach.
We collect nail clippings or scrapings from the affected nail and examine them under a microscope using potassium hydroxide (KOH) preparation. This quick in-office test reveals fungal elements and helps confirm the diagnosis within minutes.
When standard testing is inconclusive, a nail biopsy with PAS staining provides definitive diagnosis. This is particularly useful when distinguishing nail fungus from nail psoriasis or other inflammatory conditions that can look identical.
Nail psoriasis causes pitting, ridging, and discoloration that closely mimics fungal infection. Approximately 50% of psoriasis patients develop nail changes, and the two conditions can even coexist, requiring combined treatment approaches.
We offer a full spectrum of treatments tailored to the type, severity, and location of your nail fungal infection. Treatment selection depends on the number of nails affected, the degree of involvement, your health status, and potential medication interactions.
Oral antifungals like terbinafine (Lamisil) and itraconazole (Sporanox) are the gold standard for nail fungus treatment, with cure rates of 70–80%. Terbinafine is typically taken daily for 6 weeks (fingernails) or 12 weeks (toenails). These medications work by accumulating in the nail bed and killing the fungus as the new nail grows in. We monitor liver function before and during treatment to ensure safety. According to the American Academy of Dermatology, oral antifungals remain the most effective treatment option available.
For milder infections affecting less than 50% of the nail, or for patients who cannot take oral medications, prescription topical antifungals such as efinaconazole (Jublia) and tavaborole (Kerydin) offer a non-systemic alternative. These newer formulations penetrate the nail plate more effectively than older products, though treatment takes 48 weeks and cure rates are lower than oral therapy (15–18%).
For stubborn or severe infections, combining oral and topical antifungals improves cure rates significantly. We may also use nail debridement—carefully trimming and thinning the affected nail—to improve medication penetration and accelerate results. This multimodal approach is particularly effective for infections involving multiple nails.
Laser therapy offers a promising adjunctive treatment for nail fungus. Laser energy penetrates the nail plate to target and disrupt fungal cells without damaging surrounding tissue. While results vary, laser treatment can be combined with topical antifungals for enhanced outcomes, especially for patients who prefer to avoid systemic medications.
Nail fungus frequently coexists with athlete's foot or other fungal skin infections. Treating both conditions simultaneously is essential to prevent reinfection. Our dermatologists evaluate the surrounding skin and develop a comprehensive plan to address all active fungal infections.
Recurrence is one of the biggest challenges with nail fungus treatment. Even after successful treatment, the fungus can return if preventive measures aren't followed. Our dermatologists work with you to develop a long-term prevention strategy.
Keep feet clean and dry, especially between the toes. Wear moisture-wicking socks and alternate shoes daily to allow them to dry completely. Use antifungal powder or spray in shoes. Wear protective footwear in public pools, locker rooms, and showers to avoid reexposure.
Keep nails trimmed short and filed smooth. Use your own nail clippers and tools—never share them. Disinfect clippers with rubbing alcohol after each use. If you visit nail salons, ensure instruments are properly sterilized, or bring your own tools.
For patients with high recurrence risk—such as those with diabetes, poor circulation, or a history of repeated infections—we may recommend periodic use of topical antifungal agents on the nails and feet to prevent new infections from taking hold.
Nail fungus treatment typically takes 3 to 6 months for fingernails and 6 to 12 months for toenails. Oral antifungal medications are usually prescribed for 6 to 12 weeks, but the nail must grow out completely for full clearance. Toenails grow slowly—about 1 millimeter per month—so patience is essential. We monitor your progress with follow-up visits to ensure the treatment is working.
Yes, nail fungus can be permanently cured with proper treatment. Oral antifungal medications achieve cure rates of 70–80%. However, recurrence is possible, especially without preventive measures. Risk factors like warm footwear, communal showers, and poor nail hygiene can lead to reinfection. Our dermatologists develop individualized prevention plans to minimize recurrence risk.
Toenail fungus is caused by dermatophyte fungi (most commonly Trichophyton rubrum) that thrive in warm, moist environments. Risk factors include wearing closed-toe shoes for extended periods, walking barefoot in public pools or locker rooms, aging, diabetes, peripheral vascular disease, and weakened immunity. Miami's humid climate creates particularly favorable conditions for these fungi.
Yes, nail fungus is contagious and can spread through direct contact or contaminated surfaces like floors, shoes, and nail tools. It can also spread from one nail to another or from athlete's foot to the toenails. Sharing nail clippers, shoes, or towels increases transmission risk. Prompt treatment and good hygiene practices help prevent spreading the infection.
Don't let nail fungus affect your confidence or comfort. Schedule a consultation with our dermatologists today.
Call (786) 738-9515