Nail fungus

Toenail fungus is a disease of an infectious nature, caused by mycotic organisms such as dermatomycetes, molds and yeast-like fungi of the genus Candida.In fact, there are up to 50 types of fungi that can lead to the development of a pathological condition of the nail, but they are all united in these three large groups.Moreover, in up to 90% of cases, the cause of nail plate diseases are fungi belonging to the group of dermatomycetes, of which there are up to 20 different species.Fungi similar to yeast of the genus Candida cause nail diseases not so often, in about 10% of cases.The remaining small percentage of morbidity is due to infection of the nail with mycotic mold organisms.Nail fungus in medical terminology sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite wide.Fungus on the feet affects up to 20% of the total world population.The prevalence of diseases among the population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of a certain person, his age, gender and profession.In addition, dermatologists notice a constant increase in the number of cases in both adults and children.The likelihood of developing toenail fungus increases with age (the disease is more common in the elderly over 65).

Symptoms of toenail fungus

Symptoms of toenail fungus will depend on the type of pathogen causing the infection, as well as the degree of damage to the nail plate.The age of the patient can affect the speed of recovery.It is known that in childhood the phalanges of the nails are affected much less often than in the elderly.

Symptoms vary depending on the form of the fungus:

1. Symptoms of normotrophic nail fungus.The color of the affected plate changes, but the thickness and gloss remain the same.First, stripes and spots appear on the nail - their shape and size vary, the location is the lateral parts of the nail.The color of such spots is ocher-yellow or white;if the disease is not treated, the spots increase in size, gradually covering the entire area of the plate.The nail completely changes color, remains of normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in the inability of the plate to grow to the nail bed.As a result, the patient can easily remove it - accidentally or on purpose.
2. Symptoms of hypertrophic nail fungus.In addition to the color change, this form of the disease is characterized by thickening of the plate in dimensions greater than 2 mm or more.This increase is due to the increased growth of skin scales under the nail.There is a loss of luster, the affected plates become dull and begin to fall apart.As a result, the nail becomes severely deformed.The more advanced the disease, the greater the degree of deformation.Onychomycosis - acquiring a shape of the nail similar to a bird's claw, is a common symptom of the hypertrophic type of the disease.The side parts of the nail are the most damaged.The complex of symptoms accompanying this form of nail fungus leads to the fact that a person begins to feel pain while walking.The color of the nail becomes dark yellow or gray.
3. Symptoms of atrophic nail fungus.First of all, patients notice a change in the color of the plaque;turns brownish-gray.The normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the plaque is destroyed.The final stage of the atrophic form of the fungus is the exposure of the nail bed and its complete necrosis.(read also: Causes and symptoms of necrosis, outcome and prevention) Above the surface of the bed, the patient discovers layers of loose consistency, consisting of skin scales.Atrophy of the plate occurs in stages, starting from the outer end towards the growth zone and the fold of the nail.The growth zone remains intact longer than other parts of the nail.
4. Symptoms of lateral and distal nail fungus.Common to these two types of mycotic lesions is that they are often diagnosed in symbiosis and cause the same changes in parts of the nail plate.The affected part of the plate loses its normal color and becomes dull.Transverse grooves run along it, which have a yellowish color.When nail fungus develops due to infection with mold and mycotic organisms, the nail plates can turn blue-green to black.The nail itself begins to crumble, becomes rough on the sides.Over time, the affected parts die, causing the plate to deform.The nail bed remains partially exposed.The final stage of the disease is characterized by the complete destruction of the nail and the opening of the bed with skin flakes on top.If the clinical picture of distal nail fungus is supplemented with lateral onychomycosis, then the ridges surrounding the nail swell, redden and become thicker.Man suffers from pain.When the pathology is aggravated by a bacterial infection, pus can come out from under the nail if you press it lightly.
5. Symptoms of proximal nail fungus.This rare lesion of the nail plate primarily affects the area lateral to the skin fold.The main cause of fungus on the proximal nails is the removal of the eponychium (cuticle).The nail plate begins to whiten in the area next to the growth zone.The fungus locates its spores and mycelium precisely in the nail tunnels located in this zone.As the fungus multiplies, it surrounds the entire nail and destroys it completely.
6. Symptoms of total nail fungus.If the lateral, distal or proximal form of the disease is not treated, total onychomycosis occurs.The nail loses its color, begins to disintegrate, break and is completely destroyed.
7. Symptoms of white superficial nail fungus.Opal-white spots appear in the area of the back cushion, which, as the fungus multiplies, completely covers the entire nail.The spots tend to coalesce and can visually resemble scattered fine powder.

Despite existing differences in the clinical manifestations of different forms of fungal infection, several common symptoms can be identified, including:

• Nail crumbling;
• Changing the color of the board;
• Dissection of the nail phalanx;
• Painful sensations that occur as the pathological process progresses;
• Itchy skin may appear in the area around the nail.

Causes of toenail fungus

Toenail fungus always occurs as a result of infection with mycotic organisms.Most often, they are dermatomycetes.Increased keratophilicity is a characteristic feature of fungi included in this group.They help them penetrate the skin and nails with the wide range of proteolytic enzymes they possess.First, dermatomycetes infect the skin of the feet and then spread to the nail plates.

There are three possible ways in which they penetrate deep into the nail:

1. Under the distal (free, lateral) edge of the nail.In this case, the pathological process will be localized under the plate - in the bed, and not in the nail itself.As the fungus multiplies, subungual hyperkeratosis develops.This leads to deterioration of the connections between the bed and the plate, followed by their separation.From the bed, the fungus penetrates the nail and slowly destroys it.
2. Through the dorsal part of the nail, fungi penetrate much less often into its depths.This way of distribution is available only to dermatomycetes with pronounced keratolytic abilities.In this case, the process of destroying the nails will take place much faster.
3. The rarest route of spread is through the proximal ridge.From the final part of the matrix, the fungus penetrates under the nail plate and into the bed, or settles in the matrix, destroying the collagen structures of the nail phalanx from there.If the nail lesion is caused by fungi of the genus Candida, then the proximal ridge with its swelling and thickening will be involved in the pathological process first.However, more often such an inflammatory process affects the nails.

In order for the fungus to penetrate the nail area, it must first be damaged and destroyed.

This happens under the influence of the following provoking factors:

• Mechanical injuries.
• Exposure to chemical factors, such as: regular contact with detergents containing synthetic components, constant contact with water, application of degreasers, etc.
• Wearing things made of synthetic materials, wearing uncomfortable tight shoes.As a result, a favorable moist and warm environment is created in which fungi multiply rapidly.
• Sympathetic type of autonomic regulation, in which the person suffers from increased sweating.This factor refers to the individual characteristics of the body.
• Flat feet or narrow spaces between the toes, as anatomical characteristics of foot development.Such deformations lead to the fact that the ventilation of the feet deteriorates significantly.
• Nail growth rate.
• Non-observance of personal hygiene rules.
• Disorders in the functioning of the immune system.Moreover, nail fungus is not the only disease with a decrease in protective forces.Other organs are also susceptible to mycotic damage.
• Varicose veins.
• Climatic characteristics of the area where a person lives.Yeast infections are more common in people living in temperate or cold climates.The fact is that there you often have to wear warm clothes, thick and tight shoes, thus creating favorable conditions for the functioning of fungi.Residents of subtropical countries are also at risk, because the development of the fungus is facilitated by high humidity and temperature of the environment in general.
• Age-related changes in the human body.Toenail fungus is more commonly diagnosed in the elderly and the elderly.However, dermatologists and mycologists notice an increasing trend of incidence among adolescents and children.So, statistics show that every 10 years of life lived increases the risk of infection by 2.5 times.While in childhood the probability of a mycotic infection is 3%, in the elderly this figure increases to 50%.Experts attribute such indicators to the fact that as we age, the rate of plaque growth slows down, bed nutrition deteriorates and angiopathy develops.
• Rod.It was found that men get sick almost three times more often than women.However, men are less likely to seek qualified help.
• Expenses of the profession.Fungi on the feet are more often found in miners who serve as workers in nuclear power plants and in workers in metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas pollution, the higher the risk of infection.In this regard, visits to specialists for fungal infections of workers in saunas, bathrooms and laundries are becoming more frequent.Frequent visitors of the mycologist are massage therapists, orthopedists, employees of rest homes and other representatives of the service staff.
• Associated pathologies.The greatest danger in this sense is diabetes mellitus, foot deformities, excess body weight, gastrointestinal diseases, metabolic disorders, thyroid pathologies, any peripheral angiopathy, for example, with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus by 5 times.(read also: Causes, symptoms, diagnosis and prevention of HIV)
• Taking antibacterial drugs, corticosteroids and cytostatics.

As for the direct routes of infection, this most often happens in the following cases:

1. Visiting saunas and baths, swimming pools and public showers - all public places where people walk barefoot for some time;
2. Use of common (even within family) household items, such as washcloths, slippers, pumice stones, rugs;
3. Performing cosmetic procedures, especially pedicures, in beauty salons where hygiene standards are not respected.

It is worth knowing that the greatest danger in this regard is wooden floors, benches and other objects made of this natural material.The fact is that the wood has a porous structure and it is almost impossible to wash the fungal mycelium from it.

Why is foot fungus dangerous?

It is wrong to see toenail fungus as a purely aesthetic problem.This is a serious disease that requires qualified treatment.After all, onychomycosis is one of the most common chronic diseases.Untreated foot fungus is dangerous due to the following complications:

• The spread of mycosis of the skin and its appendages in the development of the state of immunodeficiency.
• Development of diabetic foot on the background of diabetes mellitus.
• Development of erysipelas of the lower extremities.
• The development of elephantism.
• Development of lymphostasis.
• Development of invasive mycosis in patients undergoing immunosuppressive or cytostatic therapy.
• Disruption of nail growth and its rotation into the surrounding tissues, which is accompanied by severe pain and an inflammatory reaction.
• Development of eczema.
• Addition of bacterial infection and development of inflammation.
• Loss of the nail plate, exposure of the nail bed.
• The development of aspergillosis (ie, a mold infection), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophyte onychomycosis.

Stages of toenail fungus

Foot fungus never affects the nail all at once.

The disease often progresses slowly, passing through several stages of development:

1. The early or initial stage is a marginal lesion.In this case, all pathological changes are practically invisible.The manifestation of the process is expressed in the appearance of narrow gray stripes located in the area of the free edge of the nail.
2. Stage of normotrophic lesion of the nail plate.When it has not yet thickened and there is no subungual hyperkeratosis, but the traces created by the fungus are visible.They look like stripes and sectors of damaged plates.The fragility of the phalanx increases and its color changes.Sometimes serous contents can come out from under the nail.
3. Stage of hypertrophic lesion.First, onychauxis is formed - a subungual lesion, the nail thickens, and hypertrophy increases.The plate changes color and, depending on the type of pathogen, crumbles, peels, becomes thinner, stops growing or is deformed.As a result, the nail is completely lost.

The initial stage of toenail fungus

Most often, the infection is preceded by damage to the skin of the feet.There is a feeling of itching in the interdigital folds, cracks, blisters and maceration may appear.As it penetrates deeper into the nail, the fungus begins to affect one or the other of its edges.This largely depends on the type of pathogen and route of infection, which are described above.

As a rule, the initial stage is not available for self-diagnosis, because there are no obvious clinical signs.Stripes and spots on the nails are practically indistinguishable to the naked eye.Disease detection is possible in laboratory conditions.

Advanced toenail fungus

Advanced foot fungus is characterized by total damage to the nail phalanx.With long-term absence of therapy, the probability of not only the complete destruction of the nail, but also damage to the skin, as well as the spread of the disease to the nails of the hands, increases.

The main indicators of the advanced stage of the disease are crumbling, separation and deformation of the nails.Thinning of the nail body and change in its color occur gradually over many years.A rapid transition to the overall stage of the disease is possible only against the background of existing systemic diseases, which most often occurs in old age.The last stage is the destruction of the nail plate or its severe deformation, as well as the development of serious complications that can cause foot fungus.

How to get rid of toenail fungus

The modern pharmaceutical industry offers people diagnosed with toenail fungus a wide variety of effective drugs to solve the problem.There are means of local and general action.

It is precisely the abundance of available antimycotics that makes it difficult to choose a drug on your own.After all, fungi can affect not only toenails, but also mucous membranes, all organs and tissues.That is why it is so important to undergo a comprehensive diagnosis and get medical recommendations regarding the treatment of nail fungus.

Therapeutic tactics are based on four points:

• Accounting of the affected area;
• The time that has passed since the onset of the disease;
• The nature of the pathological changes caused by the disease;
• Presence of accompanying pathology.

Modern drugs not only destroy fungal organisms and stop their development, but tend to accumulate in the thickness of the nail plate, remaining there for a long time.This allows you to significantly reduce the duration of therapy, up to 8-16 weeks.This time will be enough to get rid of the problem completely.An integrated approach to therapy, combining local treatment with oral medications, is important.The question is how to choose a medicine and get rid of nail fungus?Below we will consider all modern types of drugs.

Antifungal nail polish

When toenail fungus has not reached an advanced stage, only topical therapy can be used.For this purpose, specialized varnishes or solutions containing antimycotic components can be used.

In addition, to achieve a therapeutic effect, you can use patches that have an exfoliating effect.To make your nails look more attractive, you can apply nail polish over medical nail polish.

In order to achieve the maximum effect from the treatment of nail fungus with varnish, you must follow certain rules:

• You should not complete the treatment yourself until you have laboratory data indicating the absence of nail fungus;
• Applying varnish should be regular and without skipping;
• Treatment can last a year and is a necessary measure to eliminate the mycotic organism.

Toenails have the ability to accumulate medicine to a greater extent than fingernails.You should not combine varnishes, because their therapeutic effect will be lower.

There are also certain contraindications for therapy using antifungal varnishes:

1. Lactation period;
2. Birth of a fetus;
3. Individual intolerance to the components of the drug;
4. childhood.

Sometimes reddening of the skin around the nail is possible.

Rules for using antimycotic varnishes:

• Using a nail file, you must remove as much of the affected nail as possible;
• Degrease the surface of the nail with a solution based on water and alcohol or use a bath with soap and soda to steam the nail;
• Apply the medicine;
• Once a week it must be removed with a common solvent.

Medicines to remove nails affected by fungi

Before applying the nail remover, it is necessary to scald the feet in water, where there is a teaspoon of liquid soap and soda per 1000 ml.Then the feet are dried, and the skin around the affected nail should be fixed with an adhesive patch.The agent is applied to the affected area in a thick layer, but without rubbing.The upper part of the nail is also fixed with an adhesive patch.

After 4 days, the patch is removed, the feet are steamed, and the nail affected by the fungus is simply scraped off with a manicure tool.

Antifungal tablets

Systemic antibacterial agents are needed in cases where toenail fungus has reached an advanced stage.Only a doctor can choose the optimal treatment regimen.There are many pills that can get rid of fungus, but some of them are incompatible with hormonal contraceptives, some cannot be taken in childhood, and some are prohibited for use if you have liver problems.

Local treatment with cream, spray, ointments

If the therapy is correctly selected and the symptoms of the fungal infection are completely eliminated, and the scheme is completed, then the affected nail tissue will eventually be replaced by a healthy one.

However, full recovery can only be confirmed by performing tests that patients undergo 14 and 30 days after the end of therapy.If during the treatment the skin on the legs begins to peel and turn red, this is a manifestation of an allergy that occurs in response to the use of the drug.Therefore, it is important to stop the treatment in time.

Other means

Oils: tea tree and lavender.As for lavender oil, it can remove irritation and tea tree oil helps fight bacteria.However, it is important that the oil is natural;only in this case can they have the desired effect.

Apple cider vinegar, mouthwash, lemon juice.After mixing these three products, it is necessary to soak the feet in the resulting solution for about a quarter of an hour.This is an excellent addition to the main antifungal treatment.

Laser treatment

Treatment of diseases with a laser beam is a method of physiotherapeutic treatment.It can only be used in combination with antifungal drugs to achieve the effect.Laser therapy alone will not completely eliminate nail fungus.This procedure aims to improve nail nutrition and increase blood circulation.As a result, the antimycotic drug penetrates the damaged plate better.However, the laser alone cannot kill the fungus.

This method has no contraindications and reduces the risk of disease recurrence.Laser therapy is a safe and painless way to fight fungal nail infections.

Prevention of toenail fungus

If a person's immune system is functioning properly, toenail fungus will not harm him even after infection, because the immune system will neutralize it on its own.If the fungal infection does spread along the nail plate, then it is necessary to choose the best methods to fight it.

This is quite a labor-intensive process, so the following preventive measures can help prevent infection:

• You should avoid walking barefoot on the beach;
• Closed rubber slippers are optimal shoes for saunas and baths;
• Socks for everyday wear should be made of cotton fabric;
• It is forbidden to wear other people's shoes;
• Your feet should be dry.