Nail fungus (onychomycosis)

Onychomycosis is a disease of the nails of the hands and feet, caused by representatives of the fungal microflora, gradually leading to the destruction of the nail plate with a change 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 the dermatomycetes that become the source of nail fungus.
• Fungi of the genus Candida (like yeast). Candida fungi are present in the microflora of every human body, however, by its nature, it can begin to multiply rapidly, causing nail fungus. Candida fungi infect the nail surface in 8-10% of cases.
• I moldy. Molds are the rarest possible causes of nail fungus; become infected only in 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 leads to the penetration of the fungus through the upper layers of the epithelium into the nail, and, consequently, to the further deformation of the nail plate. Depending on the location of the lesion, the following types of onychomycosis are possible:

• Fungi enter the nail bed through the edge surface of the nail. Since in the first days of infection it is almost asymptomatic, it is difficult for the patient to notice any change. But as the fungus grows on the nail bed, hyperkeratrosis begins to develop. Hyperkeratrosis is caused by a change in the color of the nails from light pink to yellow, the connection between the nail surface and the nail bed is also weakened, which leads to delamination, peeling.
• Fungi can enter the nail through the free surface of the nail plate. This occurs when the spores have a high keratolytic capacity (rapidly destroying keratin). In this case, the nail infection occurs much faster compared to the first option.
• Through the folding of the nails (the area of skin adjacent to the nail plate). Somewhat somewhat less common, however, with this method of infection, the inflammatory process of the nail matrix (root area) can begin.

Risk factors that can provoke fungal nail infection

• flat feet or other structural features, foot development;
• varicose veins of the legs;
• decreased immunity due to previous illnesses;
• HIV infection;
• increased sweating;
• wearing shoes and clothing made of synthetic materials;
• low foot aeration. Occurs again due to uncomfortable and tight shoes;
• mechanical leg injury;
• scratches, abrasions, open wounds;
• self-removal of an ingrown nail;
• frequent use of antibiotics;
• candidiasis (mainly in women);
• associations. Diabetes mellitus, thyroid dysfunction, dermatological diseases, diseases of the stomach, pancreas, excess weight can also increase the risk of onychomycosis up to 6-8 times;

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

• Use of general hygiene items (pumice stone, sink, slippers, flip)
• Visiting public saunas, baths, swimming pools, undressing barefoot.
• Wearing someone else'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, condition of the body as a whole. Symptoms of nail fungus infection are accompanied by itching, burning and irritation of the skin.

Currently, dermatologists distinguish five main 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 the small skin scales that grow on the infected surface of the nail. The lateral parts of the nail plate are subject to the greatest destruction; the middle (central) part, on the contrary, thickens. At the edges, the nail begins to break strongly. Due to hypertrophic damage, the nail becomes curved, narrow and very thick. In addition, there is a sharp change in the color of the nail, accompanied by skin.
• Normotrophic. It forms the lightest form, as the nail, when touched by the fungus, does not thicken, but remains the same. Only the color of the nail plate changes. The fungus begins with the appearance of a small yellow dot, which then rapidly increases in size. If you do not consult a specialist and do not start treatment, over time the stain will increase in size, gradually capturing the entire area of the nail plate. Since a person can quickly detect a discoloration, onychomycosis can be diagnosed at a fairly early stage of the disease.
• Atrophic (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. It is characterized by rapid progression, eventually leading to complete detachment of the nail plate from the nail bed. In other words, the patient may accidentally fixate or remove the infected nail and "remove" it completely. The final stage of atrophic fungus is necrosis of nail tissue.
• Lateral and distal. The lateral form is often diagnosed along with the distal type of fungus. The symbiosis of these varieties leads to a change in the color of the nail plate, beginning with the appearance of longitudinal yellow grooves, followed by an increase in the area of the nail lesion. Within 4-5 weeks, in the absence of proper treatment, the nail cells begin to fade, and the nail itself is strongly destroyed. The final stage of lateral nail lesion from a fungus is a complete exposure of the nail bed, which is dangerous with the risk of infection in the mucosa.
• Total form of onychomycosis. Total nail fungus is the lack of treatment for any of the above types of onychomycosis. Please note that the nail changes color very quickly, is layered, crushed and then completely removed from the nail bed. In this case, it is necessary to consult not only a dermatologist, but also a surgeon.

Stages of Onychomycosis

To prevent yourself from being infected with toenail fungus, it is important to remember that infection, as well as subsequent nail deformity, never occurs overnight. Medically, this is the primary lesion, the normotrophic stage and the hypertrophic stage of the disease.

In the initial stage, the nail is affected only at the edges; at the same time, the size of the affected area does not exceed 2-3 mm. In rare cases, the free edge of the nail may be affected. Before directly damaging the nail, the skin of the foot becomes infected. The patient feels itching, rubbing and corns, painful calluses may appear. Over time, the fungus passes from the foot to the nail. If you notice changes at this point and consult a specialist, there is a chance to fully maintain and restore the nail plate in a short time.

The normotrophic stage is the next stage of the disease. An intermediate process in which the thickness of the nail plate has not yet begun, but the affected areas of the nail are already visible. Affected areas may be small (2-4 mm), or may reach larger sizes (more than 5 mm). Most often they are expressed in the form of thin vertical lines with a yellow color. The first manifestation of toenail fungus is precisely the color change: it can be noticed quickly and treatment can start on time.

The final stage of onychomycosis is the hypertrophic stage of the disease. It starts with the formation of a small spot under the nail, which then grows very quickly. It can be accompanied by an inflammatory process that goes hand in hand with the formation of purulent sacs. The nail plate thickens, crumbles, exfoliates, then becomes thinner, and finally, the nail cells die and its complete exfoliation.

Important: the risk of hypertrophic nail damage also lies in the possibility of damage to nearby skin and the transition to a chronic plan. But such a development of events is possible only in the absence of timely medical intervention and subsequent treatment of nail fungus.

Treatment of nail fungus

The most common are various antifungal drugs. The mechanism of action of such drugs is reduced not only to the destruction of spores directly, but also to the accumulation of the active substance in the nail plate itself. This avoids repetitions and protects the feet from possible future injuries.

Before choosing one or the other medicine, you should definitely go through a microbiological culture by identifying the type of nail fungus, undergo a thorough diagnosis and consult a dermatologist.

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

• microscopy KOH
• High-precision PCR diagnostics

A dermatologist, before prescribing a specific medicine, should consider the nature of the fungal infection, the type of onychomycosis, the time elapsed since the moment of infection and much more.

Most used treatment methods: medicine, laser and traditional medicine.

Medications

Among the medicinal antifungal drugs, the most common are paints, oils and tablets.

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

Important: If a doctor has prescribed an antifungal spray, the procedures should never be skipped, as otherwise, it will not have the desired effect.

In addition to varnishes, there are special oils and gels that have the same antifungal effect. Ointments also belong to the current preparations. Most often, experts prescribe oils. The ointment should be applied to the affected areas of the nail and foot for a period of time. The exact time of treatment is prescribed by a specialist.

There are also antifungal pills. Unlike oils and paints, tablets are general-purpose medicines that are taken orally. The most commonly prescribed antifungal tablets are: The tablets are most often prescribed not in the initial stages of infection, but at a later date, when the fungus has already entered the normotrophic stage.

Laser mushroom treatment

Currently, some clinics offer hardware treatment of nail fungus using a laser. Penetrating the subungual surface, the laser beam heats it up to the growth area, thus destroying not only the fungus, but also stimulating the growth of a new nail. Research by scientists has shown that with systematic heating of the nail plate to a temperature of 60-70 degrees, fungal microorganisms die. A similar thermal effect without damaging the surrounding tissues can only be achieved with the help of laser radiation, as the laser beam has a length that reacts only to cells affected by mycoses. Despite the fact that the method of laser exposure to 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 are remedies from the arsenal of traditional medicine

Experts advise you to turn to popular methods exclusively in conjunction with traditional continuous systemic treatment. Such funds can be used as preventive measures to eliminate the likelihood of recurrence of the fungus in the future.

Here are some recipes, the effectiveness of which in the treatment of nail fungus is possible, but by no means necessary. However, in the absence of other opportunities to combat onychomycosis, it is not forbidden to use these simple recommendations.

1. Affected areas of nail plate are treated with 5% iodine solution twice a day. When iodine is applied, a tingling and burning sensation may be felt. If the discomfort intensifies, such treatment should be discontinued and other methods of treatment reversed.
2. A 20% solution is made from propolis, which is then applied to areas of the skin and nails affected by the fungus. The action of propolis is that it promotes rapid regeneration of damaged cells and nail restoration. The effect of propolis becomes visible only after a few applications.
3. One of the most popular ways to fight the fungus itself is to use kombucha. To prepare a compress, you need to cut a small piece of baked kombucha, use a bandage or gauze bandage to connect the fungus to the affected nail and leave it overnight. In the morning, remove the bandage and remove dead nail particles. After that, it is necessary to treat the affected area and the skin around it with an iodine solution or some other disinfectant. It is recommended to continue nail processing with kombucha for 3-4 weeks.

Prevention of fungal nail infection

• Every disease, including onychomycosis, is easier to prevent than to cure. In order to protect yourself from nail fungus and minimize the risk of infection, you need to follow simple preventative measures that will help you stay healthy.
• First of all, is the observance of personal hygiene, especially in public places. This also applies to your apartment, and even more so to public places such as saunas and baths. You should always wear individual slippers, use your sole and pumice stone for heel care.
• If you notice excessive sweating of the feet, you should change your shoes or use a special refreshing insole. These layers have a porous structure, due to which they normalize air circulation.
• Check your feet regularly for micro cracks, scratches and cuts. If scratches are found, you should treat the site with antiseptics (iodine alcohol solution and others).

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