Clinical diagnosis and, if necessary, confirmatory culture. Treatment tailored to your case: topical, oral or combined. Monthly follow-up until the nail grows back healthy.
Onychomycosis is an infection of the nail caused by dermatophytes, yeasts or moulds. It mainly affects toenails in Valencia due to the combination of heat, moisture and darkness inside footwear. It can start as a small yellow spot at the tip and progress to a thick, deformed nail or one that has become detached from the nail bed.
It is not a question of hygiene: anyone can catch it in swimming pools, changing rooms or through sports shoes. Diabetes, circulatory problems, prolonged wear of closed shoes and repeated trauma to the nail increase the risk.
Not all yellowish nails are fungal infections — they may be, but they could also be psoriasis, chronic trauma, vascular disorders or nail tumours. Before starting a treatment that lasts for months, it is worth confirming the diagnosis. During the consultation, I assess the lesion clinically and, in doubtful cases, take a sample for culture or PCR. Only then can we know which fungus you have and which treatment works best.
The cure for onychomycosis is not immediate. Once the fungus is under control, the healthy nail has to grow from the base — a process that takes between 6 and 12 months for toenails. During this time, two areas are visible: the old affected part and the new healthy part that is growing. Patience is part of the treatment.
Preventive measures are key to avoiding relapses: dry your feet thoroughly after showering, wear breathable footwear, cotton or technical fibre socks, and, if necessary, antifungal powder in your shoes.
Yes. The fungus is transmitted through direct contact with damp surfaces (swimming pools, communal showers, changing rooms) and by sharing shoes, socks or nail clippers. It is advisable not to walk barefoot in communal areas and to disinfect nail clippers after each use.
Because the affected nail does not heal — a new, healthy nail has to grow from the base. Toenails grow between 1 and 1.5 mm a month, so replacing a whole nail takes 9–12 months. Treatment stops the infection, but the final result is only achieved once the new nail has grown out completely.
They may help in very mild, newly detected cases. Once the fungus has penetrated the nail matrix or is affecting several nails, pharmacy products rarely manage to eradicate it. The difference with prescription antifungals lies in their concentration and ability to penetrate.
A culture or PCR test confirms which fungus you have and guides the treatment. If we are going to use oral antifungals, I also request basic liver function tests, as these drugs are metabolised in the liver. Patients with diabetes, liver failure or those taking certain medications require prior assessment.
Yes. Onychomycosis has a high relapse rate if preventive measures are not maintained. That is why, after treatment, I insist on taking care of your footwear and socks, ensuring they are dried properly, and having regular check-ups if you have had previous infections.
No, but they are related. Athlete’s foot (tinea pedis) is a skin infection of the foot caused by the same type of fungus. It often precedes onychomycosis: the skin fungus eventually colonises the nails. If you have athlete’s foot, treating it promptly prevents it from developing into nail fungus.
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