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Medical dermatology
Nail fungus and nail condition treatment in Richardson, TX
Thick, discolored, brittle or painful nails, diagnosed and treated by a board-certified dermatologist who sees every patient herself.
Dr. Kelsie Riemenschneider
MD, FAAD · Board-certified dermatologist. You will see her at every visit.
Overview
What causes nail problems
Dermatologists treat conditions of the nails as well as the skin and hair. The most common is nail fungus, called onychomycosis, which makes nails thick, yellow or white, and crumbly. It usually starts in one toenail and spreads slowly, often alongside athlete's foot.
Not every thick or discolored nail is fungus. Psoriasis, eczema, injury, tight shoes and aging can cause similar changes, and antifungal medication will not help those. That is why testing a nail clipping before starting treatment matters. A new dark streak under a nail should always be examined, because it can occasionally be a sign of melanoma.
When to see a dermatologist
Nails are thick, discolored, crumbling or lifting from the nail bed
The skin around a nail is painful, swollen, red or draining
Over-the-counter treatments have not worked
You notice a new dark streak or spot under a nail
You have diabetes or poor circulation and see changes in your nails or feet
Nail conditions we treat
Nail fungus.Thick, yellow, brittle toenails or fingernails.
Ingrown toenails. A nail edge that grows into the skin and causes pain, swelling or infection.
Nail psoriasis. Pitting, thickening, discoloration or lifting of the nails.
Brittle, splitting nails. Nails that peel, split or break easily.
Nail infections.Red, swollen, tender skin around the nail, called paronychia.
Dark streaks and growths. Pigmented bands, warts and cysts in or around the nail.
Treatment
How we treat nail fungus and nail conditions
Nails grow slowly, so treatment takes time and the right diagnosis saves months. Dr. Riemenschneider confirms the cause first, then chooses treatment based on how many nails are involved, your health and your other medications.
Testing. A nail clipping or scraping sent to the lab to confirm fungus before treatment starts, and a biopsy for a dark streak when needed.
Oral antifungal medication. Pills such as terbinafine (Lamisil), often the first choice for toenail fungus, usually taken for about three months.
Prescription nail solutions. Topical antifungals such as efinaconazole (Jublia) or ciclopirox for milder cases, or when pills are not a good fit.
In-office care. Treatment for ingrown nails and nail infections, thinning of thick nails and injections for nail psoriasis.
Your visit
What to expect at your visit
Tell us what you have noticed. When it started, any injury, and what you have tried. Please remove nail polish before your visit.
Dr. Riemenschneider examines your nails and the skin around them. She often takes a small clipping for testing.
You leave with a plan. Treatment may start the same day or once your test results are back.
In network with most major health plans. See every plan we accept
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The medication works within a few months, but the nail looks normal only after the damaged part grows out. That takes about 6 months for a fingernail and 12 to 18 months for a toenail.
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They are well tolerated by most people. Dr. Riemenschneider reviews your medications and health history first, and may order a blood test before or during treatment.
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Yes, it can. Keeping feet dry, treating athlete's foot promptly, wearing sandals in locker rooms and replacing old shoes all lower the chance.
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Usually not. Dark lines are often caused by a mole in the nail bed, an injury or a medication, and they are common in darker skin tones. A new, widening or changing streak should be examined soon, because melanoma can start under a nail.
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Yes, please. Polish and artificial nails hide the nail surface and make it hard to examine or test.
Related care Psoriasis Warts and molluscum Rashes and hives Skin cancer screening All medical dermatology
Reviewed by Dr. Kelsie Riemenschneider, MD, FAAD, board-certified dermatologist. Last reviewed October 2026. Source: American Academy of Dermatology.
Address 702 W Arapaho Rd, Suite 104, Richardson, TX 75080
Hours Monday to Friday, 8 AM to 5 PM
Phone 214-833-5300