Onychomycosis is a disease of the nails on the hands and feet, caused by representatives of the fungal microflora, which gradually leads to the destruction of the nail plate with a change in its structure, color, shape.
The causes of onychomycosis include three types of fungi:
- Dermatomycetes. Dermatomycetes are parasitic fungi, whose main representatives are Trichophyton, Microsporum, Epidermophyton. In 80-85% of cases, dermatomycetes are the source of fungus on the nails.
- Fungi of the genus Candida (like yeast). The fungus Candida is present in the microflora of any human body, but by its nature it can begin to multiply rapidly, causing fungus on the nails. The fungus Candida infects the nail surface in 8-10% of cases.
- Moldy. Molds are the rarest possible causes of nail fungus; they become 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 leads to the penetration of the fungus through the upper layers of the epithelium into the nail, and consequently to further deformation of the nail plate. According to the location of the lesion, the following types of onychomycosis are possible:
- The fungus enters the nail through the marginal surface of the nail. Because the infection is almost asymptomatic in the first days, it is difficult for the patient to notice any changes. But as the fungus grows in the nail layer itself, hyperkeratrosis begins to develop. Hyperkeratrosis occurs by changing the color of the nail from light pink to yellowish, the connection between the surface of the nail and the nail bed is also weakened, leading to delamination, peeling.
- The fungus can enter the nail through the free surface of the nail plate. This happens when spores have a high keratolytic ability (they quickly destroy keratin). In this case, the nail infection happens much faster than the first option.
- Through the crease of the nail (the area of skin along the nail plate). It is somewhat rarer, however, with this method of infection can begin the inflammatory process of the nail matrix (root zone).
Risk factors that can cause fungal nail infection
- flat feet or other structural features, foot development;
- varicose veins on legs;
- decreased immunity due to previous illnesses;
- HIV infection;
- increased sweating;
- wearing shoes and clothes made of synthetic materials;
- low foot aeration. It reappears due to uncomfortable and tight shoes;
- mechanical damage to the feet;
- scratches, scuffs, open wounds;
- only ingrown nail removal;
- frequent use of antibiotics; candidiasis (mainly in women);
- concomitant diseases. Diabetes mellitus, thyroid dysfunction, dermatological diseases, diseases of the stomach, pancreas, overweight can also increase the risk of onychomycosis up to 6-8 times;
Well, in addition to these factors, there are ways you can get directly infected with nail fungus.
- Use of general personal hygiene items (blue, washbasin, slippers, flip flops)
- Visiting public saunas, bathrooms, swimming pools, locker rooms without shoes.
- Wearing someone else's shoes
- Non-compliance with sterilization standards in beauty salons (especially pedicures).
Symptoms, forms of onychomycosis
The symptoms of the disease depend on many factors: age, form of onychomycosis, degree of infection, condition of the organism as a whole. Symptoms of nail fungus infection are accompanied by itching, burning and skin irritation.
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 the increase of small scales of the skin that grow on the infected surface of the nail. The lateral parts of the nail plate were subjected to the greatest destruction; the middle (central) part, on the contrary, thickens. At the edges, the nail begins to crumble greatly. Due to the hypertrophic damage, the nail becomes curved, narrow and very thick. In addition, there is a sharp change in nail color, followed by peeling.
- Normotrophic. This is the easiest form, because the nail, when affected 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 spot that then grows rapidly. If you do not consult a specialist and do not start treatment, the stain will increase in size over time, gradually covering the entire area of the nail plate. Because a person can quickly detect a change in color, 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 the color of the nail from pink to gray, with subsequent destruction of the nail structure. It is characterized by rapid progression, which eventually leads to complete separation of the nail plate from the nail. In other words, the patient may accidentally pinch or tear off an infected nail and completely “remove” it. The final stage of atrophic fungi 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, starting with the appearance of longitudinal yellowish grooves, followed by an increase in the surface area of the nail lesion. Within 4-5 weeks, in the absence of proper treatment, the nail cells begin to die off and the nail itself crumbles badly. The final phase of the lateral nail lesion with the fungus is complete exposure of the nail bed, which is dangerous with the risk of infection on the mucous membrane.
- Total form of onychomycosis. Total nail fungus is a disadvantage of treating any of the above types of onychomycosis. Keep in mind that the nail changes color very quickly, peels, crumbles and then completely falls off the nail. In this case, it is necessary to consult not only a dermatologist, but also a surgeon.
Stages of onychomycosis
To prevent you from becoming infected with toenail fungus, it is important to remember that infection, as well as subsequent nail deformity, never occurs overnight. In medical terms, 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 damaging the nail directly, the skin of the foot becomes infected. The patient feels itching, rubbing and corns, painful blisters may appear. Over time, the fungus spreads from the feet to the nail. If you notice changes at this time and consult a specialist, there is a chance that you will completely preserve 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 thickening of the nail plate has not yet begun, but the affected areas of the nail are already noticeable. Affected areas may be small (2-4 mm) or may reach larger sizes (more than 5 mm). They are most often expressed in the form of thin vertical stripes with a yellowish color. The first manifestation of the fungus on the toenails is just a change in color: it can be noticed quickly and treatment can be started on time.
The final stage of onychomycosis is the hypertrophic stage of the disease. It starts by creating a small stain under the nail that 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, peels, and then it suddenly becomes thin and finally, the nail cells die off and its complete peeling occurs.
Important: the danger of hypertrophic nail damage also lies in the possibility of damage to nearby skin and transition to a chronic plane. But such a development is possible only in the absence of timely medical intervention and subsequent treatment of nail fungus.
Treatment of nail fungus
Various antifungal drugs are the most common. The mechanism of action of such drugs is reduced not only to the destruction of direct spores, but also to the accumulation of the active substance in the nail plate itself. This avoids recurrences and protects the legs from possible future injuries.
Before choosing one or the other drug, you must definitely go through a microbiological culture with the identification of the type of fungus on the nails, go through a complete diagnosis and consult a dermatologist.
In the most modern dermatological clinics, the following methods are used to diagnose onychomycosis:
- KOH microscopy
- High-precision PCR diagnostics
Before prescribing a particular medication, a dermatologist must consider the nature of the fungal infection, the type of onychomycosis, the time elapsed since the time of infection, and more.
Most commonly used treatment methods: drugs, laser and traditional medicine.
Medications
Varnishes, ointments and tablets are the most common antifungal drugs.
In the initial stages of the fungus, the use of local preparations is recommended, among which antimycotic varnishes occupy an important place.
Important: If your doctor has prescribed an antifungal varnish, you should never skip the procedures, otherwise the desired effect will not occur.
In addition to varnishes, there are special ointments and gels that have the same antifungal effect. Fats also belong to local preparations. Most often, experts prescribe fats. The ointment should be applied to the affected areas of the nails and feet for a certain period of time. The exact time of treatment is prescribed by a specialist.
There are also antifungal tablets. Unlike ointments and varnishes, tablets are general-purpose medications that are taken orally. The most commonly prescribed antifungal tablets are: The tablets are usually prescribed not in the initial stages of infection, but later, when the fungus has already entered the normotrophic phase.
Laser treatment of fungi
Currently, some clinics offer hardware treatment of nail fungus with laser. Penetrating into the subungual surface, the laser beam heats it up to the growth zone, which not only kills the fungus, but also stimulates the growth of a new nail. Research by scientists has shown that by systematically heating the nail plate to a temperature of 60-70 degrees, fungal microorganisms die. A similar thermal effect without damaging the surrounding tissues can be achieved only with the help of laser radiation, since the laser beam has a length that reacts only to cells affected by mycoses. Despite the fact that the method of laser exposure to the lesion promises complete removal of fungus on the nails, dermatologists usually 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 lazy to visit a doctor, there are medicines from the arsenal of traditional medicine
Experts advise turning to folk methods exclusively in combination with ongoing systemic treatment. Such agents can be used as preventive measures to eliminate the likelihood of recurrence of fungi in the future.
Here are a few recipes whose effectiveness in treating nail fungus is likely, but not needed at all. However, in the absence of other options to combat onychomycosis, it is not forbidden to use these simple recommendations.
- Affected areas of the nail plate are treated with 5% iodine solution twice a day. When iodine is applied, slight tingling and stinging may be felt. If the discomfort intensifies, such treatment should be discontinued and other methods of treatment instituted.
- Propolis is used to make 20% tincture, which is then applied to the areas of skin and nails affected by fungi. The effect of propolis is that it promotes rapid regeneration of damaged cells and nail regeneration. The effect of propolis becomes noticeable after only a few applications.
- One of the most well-known ways to fight fungus on your own is to use kombucha. To prepare the compress, you need to cut off a small piece of ripe kombucha, use a bandage or gauze bandage to tie the fungus to the affected nail and leave it overnight. In the morning, untie the bandage and remove the dead nail particles. After that, the affected area and the skin around it should be treated with iodine solution or any other disinfectant. It is recommended to continue nail treatment with kombucha for 3-4 weeks.
Prevention of fungal nail infection
- Any disease, including onychomycosis, is easier to prevent than to cure. To protect yourself from nail fungus and reduce the risk of infection, you should follow simple preventative measures to help you stay healthy.
- First of all, it is respect for personal hygiene, especially in public places. This also applies to your own apartment, and even more so to public places such as saunas and baths. You should always wear individual slippers, use your own loofah and blue to care for the heel.
- If you notice excessive foot sweating, you should change your shoes or use special refreshing insoles. These inserts have a porous structure, which is why they normalize air circulation.
- Regularly inspect your feet for micro cracks, scratches and cuts. If scratches are found, the area should be treated with an antiseptic (alcoholic iodine solution and others).