Onychomycosis is an infectious disease caused by fungal microorganisms such as dermatomycetes, molds and yeast-like fungi belonging to the genus Candida.In fact, there are up to 50 species of fungi that can lead to the development of a pathological condition of the nail, but they all fall into these three large groups.In addition, in 90% of cases, the cause of nail plate disease is fungi belonging to the group of dermatomycetes, of which there are up to 20 different species.Yeast-like fungi of the Candida genus do not cause nail diseases very often, in about 10% of cases.The remaining small percentage of diseases is due to infection of the nail by fungal fungal microorganisms.Nail fungus sounds like onychomycosis in medical terminology.
According to statistics, the prevalence of the disease is quite wide.Athlete's foot affects up to 20% of the world's population.The spread of the disease among the population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of the given person, age, gender and occupation.In addition, dermatologists observe a steady increase in the number of cases in both adults and children.The probability of developing nail fungus increases with age (the disease occurs more often among people over 65).
Symptoms of nail fungus
The symptoms of nail fungus depend on the type of pathogen causing the infection and the degree of damage to the nail plate.The age of the patient can affect the speed of recovery.It is known that the phalanges of the nail are much less often affected in childhood than in the elderly.
The symptoms vary depending on the shape of the fungus:
- Symptoms of normotrophic nail fungus.The color of the affected plate changes, but its thickness and shine remain unchanged.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 size of the spots increases, gradually covering the entire area of the disc.The nail completely changes its color and remains of normal thickness.Onycholysis is another symptom of normotrophic nail fungus.This consists of the plate not being able to grow to the nail bed.As a result, the patient can easily remove it - accidentally or on purpose.
- Symptoms of hypertrophic nail fungus.In addition to discoloration, this form of the disease is characterized by a thickening of the disc exceeding 2 mm or more.This growth occurs due to the increased growth of skin scales under the nail.A loss of gloss occurs, the affected plates become dull and crumble.As a result, the nail is severely deformed.The more advanced the stage of the disease, the greater the degree of deformation.Onychomycosis - acquiring a shape similar to a bird's claw of the nail is a common symptom of the hypertrophic type of the disease.The lateral parts of the nail are the most damaged.The set of symptoms accompanying this form of nail fungus leads to the fact that a person feels pain when walking.The color of the nail becomes dark yellow or gray.
- Symptoms of atrophic nail fungus.First, patients notice a change in the color of the disc;it will be brownish gray.The normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the disc is destroyed.The final stage of the atrophic form of the fungus is exposure and complete necrosis of the nail bed.(see also: Causes and symptoms, outcome and prevention of necrosis) Above the surface of the bed, the patient discovers layers of loose skin scales.Atrophy of the plate occurs in stages, starting from the outer end towards the growth zone and the nail fold.The growth zone remains intact longer than the rest of the nail.
- Symptoms of lateral and distal nail fungus.These two types of fungal lesions have in common that they are often diagnosed in symbiosis and cause the same changes in some parts of the nail plate.The affected part of the disc loses its normal color and becomes dull.It has transverse grooves that are yellowish in color.When nail fungus occurs due to an infection caused by mold and fungal microorganisms, the nail plates may turn blue-green or black.The nail itself begins to crumble, the sides become rough.Over time, the affected parts die, so the shape of the disc is deformed.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 a bed with skin flakes on top.If the clinical picture of distal nail fungus is complemented by lateral onchomycosis, the ridges surrounding the nail become swollen, reddened and thickened.A man is in pain.If the pathology is aggravated by a bacterial infection, pus may come out from under the nail if you press it lightly.
- Symptoms of proximal nail fungus.This rare alteration of the nail plate mainly affects the area on the side of the skin fold.The main cause of proximal nail fungus is removal of the eponychium (cuticle).The nail plate begins to whiten in the area next to the growth zone.The fungus finds its spores and mycelium precisely in the tunnels of the nail located in this zone.As the fungus multiplies, it surrounds the entire nail and destroys it completely.
- Symptoms of full toenail fungus.If the lateral, distal, or proximal form of the disease is not treated, a complete nail fungus develops.The nail loses its color, begins to crumble, breaks and is completely destroyed.
- Symptoms of white superficial nail fungus.Opal white spots appear in the area of the back pad, which completely cover the entire nail as the fungus grows.The spots tend to coalesce and may visually resemble scattered fine dust.
Despite the differences in the clinical manifestations of different forms of fungal infections, a number of common symptoms can be identified, including:
- Nail crumbling;
- Change the plate color;
- Dissection of the phalanx of the nail;
- Painful sensations that appear as the pathological process progresses;
- Skin itching may occur in the area around the nail.
Causes of nail fungus
Nail fungus always appears as a result of an infection caused by fungal microorganisms.Most often they are dermatomycetes.A distinctive feature of the fungi belonging to this group is increased keratophilicity.The wide range of proteolytic enzymes they contain help them pass through the skin and nails.Dermatomycetes first infect the skin of the feet and then spread to the nail plates.
There are three possible ways for them to penetrate deep into the nail:
- From below the distal (free, lateral) edge of the nail.In this case, the pathological process is localized under the plate - in the bed, and not in the nail itself.As the fungus grows, subungual hyperkeratosis develops.This leads to deterioration and subsequent separation of the connections between the bed and the plate.From the bed, the fungus penetrates the nail and slowly destroys it.
- Through the back of the nail, fungi penetrate much less often into its depth.This distribution method is available only for dermatomycetes with pronounced keratolytic abilities.In this case, the process of destroying the nail itself takes place much faster.
- The rarest route of spread is through the proximal spine.From the last 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 change in the nail is caused by fungi belonging to the genus Candida, it will first participate in the pathological process with swelling and thickening of the proximal ridge.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 due to the following provoking factors:
- Mechanical damage.
- Exposure to chemical factors, such as: regular contact with detergents containing synthetic components, constant contact with water, use of degreasing agents, etc.
- Wearing objects made of synthetic materials, wearing uncomfortable narrow shoes.As a result, a favorable moist and warm environment is created in which fungi multiply rapidly.
- The sympathetic type of autonomic regulation, in which a person suffers from increased sweating.This factor depends on the individual characteristics of the organization.
- Flat feet or a narrow space between the toes as anatomical features of foot development.Such deformations lead to the fact that the aeration of the foot deteriorates significantly.
- Nail growth rate.
- Non-observance of personal hygiene rules.
- Disturbances in the functioning of the immune system.Moreover, nail fungus is not the only disease in which the defenses are reduced.Other organs are also susceptible to fungal infections.
- Varicose veins.
- The climatic characteristics of the area where a person lives.Fungal infections are more common in people living in temperate or cold climates.The fact is that you often have to wear warm clothes, thick and tight shoes there, thus creating favorable conditions for the fungus to work.Residents of subtropical countries are also at risk, as the development of the fungus is facilitated by high humidity and, in general, ambient temperature.
- Age-related changes in the human body.Onychomycosis is more commonly diagnosed in older and older adults.However, dermatologists and mycologists notice a growing trend among adolescents and children.Thus, statistics show that for every 10 years of life lived, the risk of infection increases by 2.5 times.While the probability of a fungal infection is 3% in childhood, this rate increases to 50% in the elderly.Experts attribute such indicators to the fact that with advancing age, the rate of growth of the plate slows down, the nutrition of the bed deteriorates, and angiopathy develops.
- Not.It turned out that men get sick almost three times more often than women.However, men are less likely to seek professional help.
- The costs of the profession.Athlete's foot is more often found in miners serving workers at nuclear power plants and workers in metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas pollution, the greater the risk of infection.In this regard, visits to specialist doctors related to fungal infections of people working in saunas, spas and laundries are becoming more and more frequent.Frequent visitors of mycologists are massage therapists, orthopedists, employees of rest homes and other representatives of the service staff.
- Associated pathologies.The greatest danger in this regard is diabetes, foot deformities, overweight, gastrointestinal diseases, metabolic disorders, thyroid pathologies, any peripheral angiopathy, such as lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus fivefold.(Also read: HIV causes, symptoms, diagnosis and prevention)
- Taking antibacterial drugs, corticosteroids and cytostatics.
As for direct routes of infection, this most often occurs in the following cases:
- Visiting saunas and baths, swimming pools and public showers - all public places where people walk barefoot for some time;
- Use of common (even family) household items such as washcloths, slippers, pumice stone, carpets;
- Performing cosmetic procedures, especially pedicures, in beauty salons where hygiene standards are not followed.
It is worth knowing that the greatest danger from this point of view 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 athlete's foot dangerous?
It is wrong to perceive nail fungus as a purely aesthetic problem.This is a serious disease that requires professional treatment.After all, onychomycosis is one of the most common chronic diseases.Untreated athlete's foot is dangerous due to the following complications:
- The spread of mycosis of the skin and its appendages in immunodeficiency conditions.
- The development of diabetic foot in the background of diabetes mellitus.
- Formation of erysipelas of the lower limbs.
- The development of elephantism.
- Formation of lymphostasis.
- Development of invasive mycosis in patients receiving immunosuppressive or cytostatic therapy.
- Damaged nail growth and its rotation into the surrounding tissues, accompanied by severe pain and an inflammatory reaction.
- The 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 (that is, an infection caused by molds), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.
Stages of nail fungus
Athlete's foot never affects the nail at the same time.
The disease often progresses slowly, passing through several stages of development:
- The early or initial stage is a marginal lesion.In this case, the pathological changes are practically invisible.The manifestation of the process is expressed in the appearance of narrow gray stripes, which are located in the area of the free edge of the nail.
- Stage of normotrophic change of the nail plate.When thickening has not yet occurred and there is no subungual hyperkeratosis, but traces of the fungus are visible.They look like stripes and sectors of damaged disks.The fragility of the phalanx increases, its color changes.Sometimes a serous substance can come out from under the nail.
- The stage of the 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, thins, stops growing, or deforms.As a result, the nail was completely lost.
The initial stage of nail fungus
Most often, the infection is preceded by damage to the skin of the feet.There is an itchy feeling in the folds between the fingers, 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 the route of infection, which are described above.
Usually, the initial stage is not available for self-diagnosis, since there are no obvious clinical symptoms.The stripes and spots on the nails are practically indistinguishable to the naked eye.Detection of the disease is possible under laboratory conditions.
Advanced nail fungus
Advanced athlete's foot is characterized by complete damage to the nail phalanx.With a long-term lack of therapy, the probability of not only the complete destruction of the nail, but also the damage to the skin and the spread of the disease to the nails of the hand increases.
The main indicators of the advanced stage of the disease are crumbling, separation and deformation of the nail.The thinning of the nail body and the change in color occur gradually over the years.A rapid transition to the full stage of the disease is possible only against the background of existing systemic diseases, which most often occur in old age.The final stage is the destruction or severe deformation of the nail plate, as well as the development of serious complications that can be caused by athlete's foot.
How to get rid of nail fungus
The modern pharmaceutical industry offers a wide range of effective drugs to those diagnosed with nail fungus to cope with this problem.There are local and general means of action.
It is the abundance of available antifungal drugs that makes it difficult to choose a drug independently.After all, the fungus can affect not only toenails, but also mucous membranes, any organs and tissues.Therefore, it is very important to get a comprehensive diagnosis and receive medical recommendations for the treatment of nail fungus.
The therapeutic tactic is based on four points:
- Settlement of the affected area;
- Time elapsed since the onset of the disease;
- The nature of the pathological changes caused by the disease;
- Presence of concurrent pathology.
Modern drugs not only destroy fungal organisms and stop their development, but also tend to accumulate in the thickness of the nail plate and remain there for a long time.This makes it possible to significantly reduce the duration of therapy, up to 8-16 weeks.This time will be enough to completely get rid of the problem.What is important is an integrated approach to therapy, a combination of local treatment and oral medication.This raises the question of how to choose medicine and how to get rid of nail fungus?Below we will consider all modern types of drugs.
Antifungal nail polish
If the nail fungus has not reached its advanced stage, only local therapy can be used.Special varnishes or solutions containing antimycotic components can be used for this purpose.
In addition, you can use patches with an exfoliating effect to achieve a therapeutic effect.To make your nails more attractive, apply nail polish over medicated nail polish.
In order to achieve the maximum effect of treating nail fungus with varnish, you must follow certain rules:
- You should not complete the treatment on your own until you receive laboratory data indicating the absence of fungus in the nail;
- The application of the varnish should be regular and without skipping;
- Treatment can last up to a year and is a necessary measure to get rid of the fungal organism.
Toenails can accumulate the drug to a greater extent than fingernails.Lacquers should not be combined, as their therapeutic effect will be lower.
There are also certain contraindications for therapy with antifungal varnishes:
- Lactation period;
- carrying a fetus;
- Individual intolerance to the components of the drug;
- Childhood.
Reddening of the skin around the nail is sometimes possible.
Rules for using antimycotic varnishes:
- Use a nail file to 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 soap-soda bath to steam the nail;
- Apply the remedy;
- It should be removed once a week with a common solvent.
Medicines to remove nails affected by fungus
Before applying the nail remover, you should steam your feet in water with one teaspoon of liquid soap and baking soda per 1000 ml.The feet are then dried, and the skin around the affected nail must be fixed with adhesive tape.The product should be applied in a thick layer, but without rubbing, to the affected area.The top of the nail is also fixed with adhesive plaster.
After 4 days, the patch is removed, the feet are steamed, and the fungal nail is simply scraped off with manicure tools.
Antifungal tablets
Systemic antibacterial agents are needed in cases where nail fungus has reached an advanced stage.Only the doctor can choose the optimal treatment regimen.There are many pills that you can use to get rid of the fungus, but some of them are not compatible with hormonal contraceptives, some cannot be taken in childhood, and some are prohibited in case of liver problems.
Local treatment with cream, spray, ointment
If the therapy was chosen correctly and the symptoms of the fungal infection were completely eliminated and the scheme was completed, then the affected nail tissue is eventually replaced with a healthy one.
However, complete recovery can only be verified by performing tests that patients undergo 14 and 30 days after the end of therapy.If the skin of the legs begins to peel and turn red during the treatment, 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 tools
Oils: tea tree and lavender.As for lavender oil, it eliminates irritation, and tea tree oil helps fight bacteria.However, it is important that the oil is natural;only in this case can they achieve the desired effect.
Apple cider vinegar, mouthwash, lemon juice.After mixing the three products, soak your feet in the resulting solution for about a quarter of an hour.It is an excellent supplement to the main antimycotic treatment.
Laser treatment
Treatment of the disease with a laser beam is a method of physiotherapy treatment.To achieve the effect, it can only be used together with antifungal agents.Laser therapy alone cannot completely eliminate nail fungus.The purpose of this procedure is to improve the nutrition of the nail and increase blood circulation.As a result, the antimycotic drug penetrates better into the damaged disc.However, the laser itself cannot kill the fungus.
This method has no contraindications and reduces the risk of relapse of the disease.Laser therapy is a safe and painless way to treat fungal nail infections.
Prevention of nail fungus
If a person's immune system is working properly, nail fungus will not harm him even after an infection, since the immune system neutralizes it by itself.If a fungal infection spreads along the nail plate, you need to choose the best ways to fight it.
This is a rather labor-intensive process, so the following preventive measures can help prevent infection:
- 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 put on another person's shoes;
- You need to keep your feet dry.