Nail fungus (onychomycosis)

Onychomycosis is a disease of the nails of the hands and feet, caused by the representation of the fungal microflora, gradually leading to the destruction of the nail plate with changes in its structure, color, shape.

The causative agents of onychomycosis include three types of fungi:

• Dermatomycetes. Dermatomycetes are parasitic fungi, the main representatives of which are Trichophyton, Microsporum, Epidermophyton. In 80-85% of cases, it is dermatomycetes that are the source of nail fungus.
• Fungi of the genus Candida (such as yeast). Candida fungi are present in the microflora of the human body, however, naturally, they can begin to multiply rapidly, causing nail fungus. Candida fungi infect the nail surface in 8-10% of cases.
• Moldy. Mold is the most rare causative agent of nail fungus; they are infected in only 5-6% of cases.

Causes of nail fungus

In 100% of cases, onychomycosis occurs as a result of damage to the skin by mycotic pathogens. Contact of the skin of the foot with the infected surface causes the penetration of the fungus through the upper layer of the epithelium into the nail, and, consequently, to further deformation of the nail plate. According to the localization of the lesion, the following types of onychomycosis are possible:

• The fungus enters the base of the nail through the edge surface of the nail. Because in the first days the infection is almost asymptomatic, it is difficult for the patient to see changes. But as the fungus grows at the base of the nail, hyperkeratrosis begins to develop. Hyperkeratrosis is caused by a change in nail color from light pink to yellowish, the relationship between the nail surface and the nail base is also weakened, leading to melting, peeling.
• Fungus can enter the nail through the free surface of the nail plate. This occurs when the spores have a high keratolytic ability (destroys keratin quickly). In this case, the nail infection occurs faster than the first option.
• Through the folds of the nail (the area of skin adjacent to the nail plate). It is quite rare, however with this method of infection, the process of inflammation of the nail matrix (root zone) can be initiated.

Risk factors that can cause fungal nail infections

• flat feet or other structural features, foot expansion;
• varicose veins on the legs;
• decreased immunity due to previous illness;
• HIV infection;
• increased sweating;
• wear shoes and clothing made of synthetic materials;
• low foot ventilation. Happens again because of uncomfortable and tight shoes;
• mechanical damage to the foot;
• scratches, abrasions, open wounds;
• self -removal of nails that grow inwards;
• frequent use of antibiotics;
• candidiasis (especially in women);
• comorbidities. Diabetes mellitus, disorders of the thyroid gland, dermatological diseases, diseases of the stomach, pancreas, being overweight can also increase the risk of onychomycosis up to 6-8 times;

Well, in addition to these factors, there are also ways in which you can directly be infected with nail fungus.

• Use of general personal hygiene items (pumice stone, wipes, slippers, slippers)
• Visit the public sauna, bath, swimming pool, dressing room without shoes.
• Wear other people's shoes
• Non -compliance with sterilization standards in beauty salons (especially pedicures).

Symptoms, forms of onychomycosis

Symptoms of the disease depend on many factors: age, form of onychomycosis, degree of infection, overall body condition. Symptoms of a nail fungus infection are accompanied by itching, burning, and skin irritation.

Currently, dermatologists distinguish five major forms of nail fungus damage:

• Hypertrophic. It is characterized by a sharp thickening of the nail plate. The thickness of the nail can exceed 3-4 mm - this is due to an increase in small skin scales that grow on the surface of the infected nail. The lateral parts of the nail plate suffered the greatest destruction; the middle (middle) part, on the other hand, thickens. At its edges, the nails began to crumble violently. Due to hypertrophic damage, the nails become curved, narrow and very thick. In addition, there is a sharp change in the color of the nails, accompanied by exfoliation.
• Normotrophic. This is the simplest form, because the nail, when exposed to the fungus, does not thicken, but remains the same. Only the color of the nail plate changes. The fungus begins with the appearance of small yellow spots, which then grow rapidly. If you do not consult a specialist and do not start treatment, over time the stain will grow larger, gradually capturing the entire area of the nail plate. Because one can detect discoloration quickly, onychomycosis can be diagnosed at an early stage of the disease.
• Atropic (Onycholytic). The atrophic form of onychomycosis is accompanied by a sharp change in nail color from pink to gray, with subsequent destruction of the nail structure. Characterized by rapid development, eventually resulting in the complete release of the nail plate from the base of the nail. In other words, the patient is inadvertently able to bind or pull out the infected nail and “remove” it completely. The final stage of atrophic fungi is necrosis of nail tissue.
• Lateral and distal. The lateral form is often diagnosed along with the distal fungal type. The symbiosis of this variety leads to discoloration of the nail plate, beginning with the appearance of longitudinal yellowish grooves, followed by an increase in the area of nail lesions. Within 4-5 weeks, without proper treatment, nail cells begin to die, and the nail itself is violently destroyed. The final stage of lateral nail lesions by fungi is complete exposure to the nail, which is dangerous with the risk of infection of the mucous membranes.
• Number of forms of onychomycosis. Total nail fungus is a lack of treatment for one of the above types of onychomycosis. Please note that nails change color quickly, flake off, crumble and then push completely off the nail bed. In this case, it is necessary to consult not only a dermatologist, but also a surgeon.

Stages of Onychomycosis

To avoid getting infected with toenail fungus, it is important to remember that the infection, as well as subsequent nail deformities, never occur overnight. Medically, these are the primary lesions, the normotrophic stage and the hypertrophic stage of the disease.

In the early stages, the nails are only exposed to the edges; at the same time, the size of the affected area does not exceed 2-3 mm. In rare cases, the edges of the free nail may be affected. Before damage to the nails directly, the skin of the feet becomes infected. Patients feel itching, rubbing and corns, painful calluses may appear. Over time, the fungus passes from foot to foot. If you notice changes at this time and see a specialist, it is possible to maintain and restore the nail plate completely in a short time.

The normotrophic stage is the next stage of the disease. The intermediate process in which the thickening of the nail plate has not yet begun, but the affected part of the nail is already felt. The affected area can be small in size (2-4 mm), or can reach a larger size (more than 5 mm). Often it is expressed in the form of thin vertical stripes with a yellowish tint. The first manifestation of toenail fungus is precisely a discoloration: it can be noticed quickly and treatment can be started in a timely manner.

The final stage of onychomycosis is the hypertrophic stage of the disease. It begins with the formation of small spots under the nail, which then grow rapidly. It may be accompanied by an inflammatory process parallel to the formation of purulent sacs. The nail plate thickens, collapses, peels off, then becomes thinner, and finally, the nail cells die and exfoliate completely.

Important: the danger of hypertrophic nail damage also lies in the possibility of damage to nearby skin and transition to a chronic plane. But the development of such an event is only possible if there is no timely medical intervention and subsequent treatment of nail fungus.

Nail fungus treatment

The most widespread are various antifungal drugs. The mechanism of action of such drugs is reduced not only to the direct destruction of spores, but also the accumulation of active substances in the nail plate itself. This prevents recurrence and protects the foot from possible future injuries.

Before choosing one or another drug, you must go through a microbiological culture by identifying the type of nail fungus, undergo a full diagnosis and consult a dermatologist.

In most modern dermatology clinics, the following methods are used to diagnose onychomycosis:

• KOH Microscopy
• High -precision PCR diagnostics

A dermatologist, before prescribing a particular medication, must take into account the nature of the fungal infection, the type of onychomycosis, the time elapsed since the moment of infection, and more.

The most commonly used treatment methods: medicine, laser and traditional medicine.

Medicine

Among the medicinal antimycotic drugs, the most widespread are varnishes, ointments and tablets.

In the early stages of the fungus, the use of topical preparations is recommended, among which antifungal varnishes occupy an important place.

Important: If the doctor prescribes antifungal varnish, the procedure should not be delayed, because otherwise there will be no desired effect.

In addition to varnishes, there are also special ointments and gels that have the same antifungal effect. Ointments are also included in topical preparations. Often, specialists prescribe ointments. The ointment should be applied on the affected part of the nails and feet within a certain period of time. The exact time of treatment is set by a specialist.

There are also antifungal pills. Unlike ointments and varnishes, tablets are general purpose medications taken orally. The most commonly prescribed antifungal pills are: Tablets are most often prescribed not in the early stages of infection, but later in life, when the fungus has already entered the normotrophic phase.

Laser Fungus Treatment

Currently, some clinics offer equipment treatment of nail fungus using lasers. Penetrating to the subungual surface, the laser beam heats it to the growth zone, thus not only killing the fungus, but also stimulating the growth of new nails. Research by scientists shows that by heating the nail plate system systematically to a temperature of 60-70 degrees, fungal microorganisms die. A similar thermal effect without damaging the surrounding tissue can only be achieved with the help of laser radiation, because the laser beam has a length that only responds to the cells affected by mycoses. Although the method of laser exposure on lesions promises complete elimination of nail fungus, dermatologists, as a rule, recommend several sessions of such treatment. Compared to drug therapy, this method is much more expensive, and therefore not suitable for everyone.

And for those who are too lazy to see a doctor, there is medicine from the warehouse of traditional medicine

Experts advise to use folk methods exclusively in conjunction with continuous systemic traditional treatments. The funds can be used as a preventive measure to eliminate the possibility of recurrence of the fungus in the future.

Here are some recipes, its effectiveness in the treatment of nail fungus is possible, but not at all necessary. However, if there is no other opportunity to combat onychomycosis, it is not forbidden to use this simple recommendation.

1. The affected part of the nail plate is treated with 5% iodine solution twice a day. When iodine is used, a slight tingling and burning sensation may be felt. If discomfort increases, such treatment should be discontinued and other treatment methods should be discontinued.
2. 20% tingtur is made from propolis, which is then applied to the skin and nail areas affected by the fungus. The action of propolis is that it promotes the regrowth of damaged cells and rapid recovery of nails. The effect of propolis becomes noticeable after only a few applications.
3. One of the most well -known methods of combating fungus is by using kombucha. To prepare the compress, you need to cut a small piece of cooked kombucha, use a bandage or gauze bandage to tie the fungus to the affected nail and leave overnight. In the morning, remove the bandage and remove the dead nail particles. After that, it is necessary to treat the affected area and the skin around it with a solution of iodine or other disinfectant. It is recommended to continue processing nails with kombucha for 3-4 weeks.

Prevention of nail fungus infections

• Any disease, including onychomycosis, is easier to prevent than to cure. To protect yourself from nail fungus and minimize the risk of infection, you should follow simple preventative measures that will help you stay healthy.
• First of all, keep yourself clean, especially in public places. This also applies to your own apartment, and even more so in public places such as saunas and baths. You should always wear individual slippers, use your own loofah and pumice stone for heel care.
• If you notice excessive sweat on your feet, you should change your shoes or use special refreshing soles. The sole has a porous structure, by which it normalizes air circulation.
• Check your feet regularly for cracks, scratches and micro -wounds. If there are scratches, you need to treat the spot with an antiseptic (alcoholic solution of iodine etc. ).

Nail fungus, like many other diseases, may not appear immediately, so it is very important to monitor the condition of the nails and skin of the feet. And it is best to carefully follow all the prescribed preventive measures - these simple actions in the future will save time and money spent on treatment.