Nail fungus (onychomycosis)

Onychomycosis is a disease of the nails of the hands and feet, caused by fungal microflora, which gradually leads to the destruction of the nail plate by changing its structure, color, shape.

There are three types of fungi that cause onychomycosis:

• Dermatomycetes. Dermatomycetes are parasitic fungi whose main representatives are trichophyton, microspores, epidermophyton. In 80-85% of cases, dermatomycetes become the source of nail fungus.
• Fungi Candida of the genus Candida (yeast-like). Candida fungus is present in the microflora of any human body, however, by its nature, it can start to multiply rapidly, which is caused by nail fungus. Candida fungus damages the nail surface in 8-10% of cases.
• მოსილი. Forms are a rare possible cause 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 fungal pathogens. Contact of the skin of the foot with the infected surface causes the fungus to penetrate into the nail of the upper layers of the epithelium and consequently further deformation of the nail plate. Depending on the location of the lesion, the following types of onychomycosis are possible:

• The fungus enters the nail bed from the surface of the nail edge. Since it is almost asymptomatic in the first days of infection, it is difficult for the patient to notice any change. But as the fungus grows at the base of the nail, hyperkeratosis begins to develop. Hyperkeratosis is caused by a change in the color of the nail from light pink to yellow, as well as a weakened connection between the nail surface and the nail bed, leading to delamination, peeling.
• The fungus 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 than the first option.
• by means of the nail fold (the area of skin adjacent to the nail plate). Somewhat less common, although this method of infection can start the inflammatory process of the nail matrix (root zone).

Risk Factors That Can Provide Nail Fungal Infection

• flat feet or other features of structure, foot development;
• varicose veins of the legs;
• reduced immunity due to previous diseases;
• HIV infection;
• increased sweating;
• Wearing shoes and clothing made of synthetic materials;
• Low aeration of the foot. It happens again because of uncomfortable and tight shoes;
• mechanical injury to the foot;
• scratches, abrasions, open wounds;
• Deep nail self-healing;
Frequent use of
• antibiotics;
• Candidiasis (mainly in women);
• Concomitant diseases. Diabetes mellitus, thyroid disorders, dermatological diseases, diseases of the stomach, pancreas, excess weight can also increase the risk of onychomycosis by 6-8 times;

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

• Use of general personal care items (pumice stone, washbasin, slippers, flip flops)
• Visiting public saunas, baths, swimming pools, dressing rooms without shoes.
• 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, the degree of infection, the integrity of the organism. Symptoms of fungal infection of the nail 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 caused by the growth of small scales on the skin that grow on the infected surface of the nail. The lateral parts of the nail plate suffer the greatest destruction; The middle (central) part, on the contrary, thickens. At the edges, the nail begins to fall apart strongly. Due to the hypertrophic lesion, the nail becomes curved, narrow and very thick. In addition, there is a sharp change in the color of the nail, which is accompanied by peeling.
• Normotrophic. This is the simplest form, since 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 a small yellow spot that 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 occupying the entire area of the nail plate. Since a person can quickly detect discoloration, onychomycosis can be diagnosed at a fairly early stage of the disease.
• atrophic (onycholic). The atrophic form of onychomycosis is accompanied by a sharp change in the color of the nail from pink to gray, with further destruction of the nail structure. Characterized by rapid progression, which eventually leads to complete separation of the nail plate from the nail bed. In other words, the patient can accidentally attach or cut out an infected nail and remove it completely. The final stage of atrophic fungi is necrosis of the nail tissue.
• lateral and distal. The lateral form is often diagnosed with the distal type of fungus. The symbiosis of these varieties causes a change in the color of the nail plate, the appearance of longitudinal yellowish grooves begins, followed by an increase in the area of nail damage. At 4-5 weeks, in the absence of proper treatment, the nail cells begin to die and the nail strongly decays. The final stage of lateral damage to the nail by the fungus is the full impact on the nail bed, which is dangerous because of the risk of infection of the mucous membrane.
The complete form of
• onychomycosis. Whole nail fungus is a lack of treatment for any of the above types of onychomycosis. Please note that the nail changes color very quickly, peeling, crumbling and then completely rejecting the nail bed. In this case it is necessary to consult not only a dermatologist, but also a surgeon.

Stages of onychomycosis

To prevent toenail fungus infection, it is important to remember that infection, like subsequent nail deformity, never occurs overnight. From a medical point of view, this is the primary lesion, the normotrophic stage, and the hypertrophic stage of the disease.

Initially, only the edges of the nail are affected; 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. Infection of the skin of the foot occurs before direct damage to the nail. The patient feels itching, itching and tingling, may appear painful palms. Over time, the fungus moves from the foot to the nail. If you notice changes at this stage and consult a specialist, there is a chance to completely 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 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 larger (more than 5 mm). Most often they are expressed in the form of thin vertical stripes with a yellowish tinge. The first manifestation of toenail fungus is an exact discoloration: 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 with the formation of a small varnish under the nail, which then grows very quickly. It can be accompanied by an inflammatory process that runs parallel to the formation of purulent sacs. The nail plate thickens, collapses, peels, then becomes sharply thinner, and finally, the nail cells die and its complete peeling occurs.

Important: The risk of hypertrophic nail damage also lies in the possibility of damage to nearby skin and transition to chronic flatulence. But such a development of events is possible only in the absence of timely medical intervention and further 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 directly to the destruction of spores, but also to the accumulation of the active substance in the nail plate itself. This prevents recurrences and protects the feet from possible future injuries.

Before choosing this or that medicine, you must go through a microbiological culture to identify the type of nail fungus, get a complete diagnosis and consult a dermatologist.

The following methods are used to diagnose onychomycosis in most modern dermatological clinics:

• KOH microscopy
• High-precision PCR diagnosis

Before prescribing a particular medication, a dermatologist should consider the nature of the fungal infection, the type of onychomycosis, the time since the infection, and much more.

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

Medications

Stains, ointments and tablets are the most common antifungal remedies.

In the early stages of fungi it is recommended to use topical preparations, among which anti-fungal spots play an important role.

Important: If your doctor prescribes an antifungal varnish, you should never skip the procedures as otherwise the desired effect will not be achieved.

In addition to stains, there are special ointments and gels that have the same antifungal action. Ointments also belong to topical preparations. Most often, experts prescribe ointments. For some time the ointment should be applied to the affected areas of the nail and foot. The exact time of treatment is prescribed by a specialist.

There are also antifungal pills. Unlike ointments and varnishes, tablets are a general-purpose treatment that is taken orally. Antifungal pills are most often prescribed: Tablets are most often prescribed not at the initial stage of infection but at a later date when the fungus has already entered the normotrophic phase.

Fungal laser treatment

Currently, some clinics offer laser treatment for nail fungus. Penetrating the subcutaneous surface, the laser beam ignites it in the growth zone, thus not only killing the fungus, but also stimulating the growth of new nail. Scientists' research has shown that with systematic heating of the nail plate at a temperature of 60-70 degrees, fungal microorganisms die. A similar thermal effect is achieved without damaging the surrounding tissues only with the help of laser radiation, since the laser beam has a length that responds only to mycosis-affected cells. Although laser exposure method promises complete elimination of nail fungus, 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 too lazy to go to the doctor, there are remedies from the arsenal of traditional medicine

Experts advise to resort to folk methods only in conjunction with systemic traditional treatments. Such funds can be used as a preventive measure to avoid the likelihood of recurrence of the fungus in the future.

Here are some recipes whose effectiveness in treating nail fungus is likely but not necessarily necessary. However, in the absence of other options to fight onychomycosis, it is forbidden to use these simple recommendations.

1. Damaged areas of the nail plate are treated with 5% iodine solution twice a day. Iodine use may cause minor tingling and burning. In case of increased discomfort, such treatment should be discontinued and other methods of treatment should be used.
2. 20% tincture 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 rapid regeneration of damaged cells and nail repair. The effect of propolis becomes noticeable only after a few uses.
3. One of the most well-known ways to fight fungi is to use kombucha. To prepare the compress you need to cut a small piece of ripe kombucha, apply a bandage or gas bandage to connect the fungus to the affected nail and leave it overnight. In the morning, open the bandage and remove any dead particles. It is then necessary to treat the affected area and the skin around it with iodine solution or any other disinfectant. It is recommended to continue nail processing with a comb for 3-4 weeks.

Prevention of fungal infection of nails

• Preventing any disease, including onychomycosis, is easier said than done. To protect yourself from nail fungus and reduce the risk of infection, you should consider simple preventive measures that will help you maintain good health.
• First and foremost, it is about 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 pumice for heel care.
• If you notice excessive sweating of the feet, you should change shoes or use special cooling insoles. These inus have a porous structure, which is why they normalize air circulation.
• Check your feet regularly for micro-cracks, scratches and cuts. In case of scratches, place treatment with antiseptics (alcohol solution of iodine and others) is required.

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