Nail Fungus & Athlete's Foot

Nail fungus (onychomycosis) and athlete's foot (tinea pedis) are among the most common skin and nail infections in Germany and are usually caused by filamentous fungi (dermatophytes). In many cases, both conditions can be assessed discreetly by telemedicine using photos and a structured medical history. Following a physician's assessment, a private prescription for topical or systemic antifungals may be issued.

Medically reviewed by Adi Zoabi, Approbation als Arzt.
Last reviewed on August 31, 2026. Updated as clinical guidelines change.

Overview

Nail fungus and athlete's foot are among the most common infections of the skin and nails: it is estimated that around one in ten adults in Germany is affected, with the proportion rising markedly with age. Nevertheless, many people put off seeing a doctor – discoloured, thickened nails and flaking skin between the toes are a subject associated with embarrassment. This is precisely where telemedical treatment comes in: you upload photos of your nails or feet, answer a structured medical questionnaire and receive a physician's assessment without having to sit in a waiting room. Following the physician's assessment, a private prescription may be issued for topical antifungals – such as creams, sprays or medicated nail lacquer – or, in cases of extensive nail involvement, for systemic antifungals in tablet form. Left untreated, fungal nail infections do not usually heal on their own but slowly continue to spread. Early, consistent treatment considerably improves the outlook and at the same time protects those around you from infection.

Common causes

In most cases the cause is filamentous fungi (dermatophytes), less commonly yeasts or moulds. They thrive in a warm, moist environment such as that found in closed shoes, sports shoes and the spaces between the toes. Typical places of infection are swimming pools, saunas, changing rooms and hotel carpets, but also shared towels or shoes. The infection frequently begins as athlete's foot between the toes and spreads from there to the nails. Contributing factors include older age, diabetes mellitus, circulatory disorders of the legs, a weakened immune system, heavy sweating and repeated minor nail injuries, for example from tight footwear or sport. A family predisposition also plays a role. Since the contributing conditions usually persist, consistent prevention – dry feet, breathable shoes, hygiene – is crucial alongside treatment in order to avoid relapses.

When to see a doctor

A telemedical assessment is suitable for typical, uncomplicated cases. You should be examined by a doctor in person if large parts of several nails are affected, the diagnosis is unclear or treatment fails to work over months despite consistent use – in these situations, taking a sample to identify the fungus is often advisable. People with diabetes mellitus, circulatory disorders or a weakened immune system should also visit a practice promptly, as foot infections can take a more severe course in these groups. Warning signs of an accompanying bacterial infection include rapidly progressing redness, swelling and warmth of the foot or lower leg, purulent discharge, severe pain and fever – in these cases, go to an emergency department without delay. If there are signs of a severe systemic reaction such as high fever with chills, confusion, shortness of breath or circulatory weakness, call the emergency number 112 immediately.

Symptoms & Indications

Thickened, brittle or crumbling nails Whitish, yellowish or brownish discolouration of the nail plate Detachment of the nail from the nail bed Itchy, reddened and flaking skin between the toes Cracked or macerated skin in the spaces between the toes Burning or a feeling of tightness on the soles of the feet Small blisters on the sole or edge of the foot Unpleasant odour despite regular foot hygiene

Treatment Options

Topical antifungals as cream, gel or spray for athlete's foot
Antifungal nail lacquer for limited involvement of individual nails
Systemic antifungals in tablet form – following a physician's assessment for extensive nail involvement
Regular removal of affected nail material, for example by medical foot care (podiatry)
Consistently keeping the feet and the spaces between the toes dry
Hygiene measures such as disinfecting shoes and hot-washing socks and towels
Treating any accompanying athlete's foot to prevent renewed nail infection

Important Notes

A telemedical photo assessment does not replace microbiological diagnostics: before longer treatment with systemic antifungals, taking a sample (nail clippings or skin scales) at a practice may be advisable or necessary.
If you have diabetes mellitus, circulatory disorders or a weakened immune system, foot infections should be examined promptly by a doctor in person.
If redness spreads rapidly or fever, chills or severe pain occur, go to an emergency department without delay. If there are signs of a severe systemic reaction such as confusion, shortness of breath or circulatory weakness, call the emergency number 112.
Systemic antifungals can have interactions and side effects. Report all pre-existing conditions – especially of the liver – and all medicines you take in full.

HOW IT WORKS

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STEP 03

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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

Can nail fungus or athlete's foot really be assessed from photos?

In many cases, yes: typical changes such as nail discolouration, thickening or flaking skin between the toes can be evaluated well on clear, informative photos. The doctor decides on the basis of your images and information whether treatment via telemedicine is possible. If the findings are unclear, or before tablet therapy, an additional sample taken at a practice may be recommended.

What does treatment cost, and will my insurance cover it?

Billing is carried out as a private service according to the German medical fee schedule (GOÄ). Privately insured patients can usually submit the invoice to their health insurer; reimbursement depends on the individual tariff. Self-payers receive a transparent invoice with no hidden costs. Any medication costs at the pharmacy are additional.

How long does nail fungus treatment take?

Nail fungus requires patience: because the nail grows back slowly, treatment often takes several months, and for toenails sometimes up to a year. Consistent, uninterrupted use of the prescribed therapy is essential. Athlete's foot usually heals much faster with regular treatment, typically within a few weeks.

Will I definitely receive a prescription?

No, a prescription cannot be guaranteed. The doctor reviews your photos and information individually and prescribes a medicine only if it is medically appropriate and justifiable via telemedicine. Otherwise, you will receive a recommendation on how to proceed – for example, a visit to a dermatology practice.

Is nail fungus contagious – and does my household need to take precautions?

Yes, fungal infections of the skin and nails are transmissible, mainly via shared floors, towels or shoes. Wear bathing shoes in swimming pools, saunas and changing rooms, and do not share towels or nail scissors. Socks and towels should be washed at high temperatures to prevent reinfection.