Toenail fungus

Toenail fungus is a contagious disease, caused by mycotic organisms such as dermatomycetes, molds and fungi such as Candida genus yeast.In fact, there are up to 50 species of fungi that can lead to the development of pathological nail conditions, but they are all combined into these three large groups.In addition, up to 90% of cases, the cause of nail plate disease is a fungus belonging to the dermatomycete group, of which there are up to 20 different species.Yeast-like fungi of the genus Candida cause nail disease not so often, in about 10% of cases.The remaining small percentage of morbidity occurs due to nail infections with molds of mycotic organisms.Nail fungus in medical terms sounds like onychomycosis.

According to statistics, the prevalence of this disease is quite wide.Athlete's foot affects up to 20% of the world's population.The prevalence of diseases among the population is influenced by many factors: the climatic conditions in which the population lives, the social status of a person, his age, gender, and profession.In addition, dermatologists noted a continuous increase in the number of cases among adults and children.The likelihood of developing toenail fungus increases with age (this disease is more common among the elderly over 65).

Symptoms of toenail fungus

Symptoms of toenail fungus depend on the type of pathogen causing the infection, as well as the extent of damage to the nail plate.The age of the patient can affect the speed of recovery.It is known that in childhood the nail phalanges are affected much more 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 shine remain the same.First, stripes and spots appear on the nail - the shape and size vary, the location is the side 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 is completely discolored, normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists of the inability of the plate to grow into 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 discoloration, this form of the disease is characterized by a thickening of the plate in dimensions exceeding 2 mm or more.This increase occurs due to increased skin scale growth under the nail.There is a loss of shine, the affected plates become dull and begin to crumble.As a result, the nails become severely deformed.The more advanced the stage of the disease, the greater the degree of deformation.Onychomycosis - The acquisition of a shape by the nail similar to a bird's claw, is a common symptom of the hypertrophic type of disease.The side of the nail is the most damaged.The symptom complex that accompanies this form of nail fungus leads to the fact that a person begins to experience pain when walking.The nail color becomes dark yellow or gray.
3. Symptoms of atrophic nail fungus.First of all, the patient notices a change in the color of the plate;It becomes gray-gray.The usual shine disappears, the surface of the nail becomes pale and dull.As the disease progresses, the plate is destroyed.The final stage of the atrophic form of the fungus is the exposure of the nail bed and its complete necrosis.(Also read: causes and symptoms of necrosis, results and prevention) on the surface of the bed, the patient finds a layer of loose consistency, which consists of skin scales.Atrophy of the plate occurs in stages, starting from the outer tip towards the growth zone and the nail fold.The growth zone lasts longer than the rest of the nail.
4. Symptoms of lateral and distal nail fungus.What these two types of mycotic lesions have in common is that they are often diagnosed in symbiosis and cause similar changes in the nail plate.The affected part of the plate loses its normal color and becomes dull.A transverse groove runs along it, which has a yellowish color.When nail fungus occurs due to infection with mold and mycotic organisms, the nail plate can turn blue-green to black.The nail itself begins to crumble, becoming rough on the sides.Over time, the affected parts die, causing the plate to become deformed.The nail bed is still partially exposed.The last stage of the disease is characterized by the destruction of the nail and the opening of the bed with fragments of skin on top.If the clinical picture of distal nail fungus is supplemented with lateral onchomycosis, then the ridge surrounding the nail swells, becomes red and becomes thicker.A man is in pain.When the pathology is aggravated by a bacterial infection, the PU can come out from under the nail if you lightly press on it.
5. Symptoms of proximal nail fungus.This rare lesion of the nail plate mainly affects the area on the side of the skin fold.The main cause of proximal nail fungus is the removal of the eponychium (cuticle).The nail plate begins to turn white in the area next to the growth zone.This fungus places its spores and mycelium right in the nail tunnel located in this zone.When the fungus multiplies, it surrounds the entire nail and completely destroys it.
6. Symptoms of total nail fungus.If the lateral, distal or proximal forms of the disease are not treated, then total onychomycosis occurs.Nails lose their color, begin to crumble, break and be completely destroyed.
7. Symptoms of white superficial nail fungus.Opal-white dots appear in the back cushion area, which, when the fungus multiplies, completely covers the entire nail.The spots tend to coalesce and visually may resemble scattered fine powder.

Although there are differences in clinical manifestations in various forms of fungal infection, some common symptoms can be identified, including:

• Nails fall off;
• Change the color of the plate;
• Nail phalanx surgery;
• Painful sensations that occur when the pathological process progresses;
• Itchy skin may occur in the area surrounding the nail.

Causes of toenail fungus

Nail fungus always appears as a result of infection by mycotic organisms.Most often they are dermatomycetes.Increased keratophilicity is a distinctive feature of fungi included in this group.They are helped to penetrate the skin and nails by the various proteolytic enzymes they possess.First, dermatomycetes infect the skin of the feet, and then spread to the nail plate.

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

1. From below the distal edge (free, lateral) of the nail.In this case, the pathological process will be localized under the plate - on the bed, and not on the nail itself.As the fungus develops, subungual hyperkeratosis develops.This leads to a deterioration in the relationship 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 back part of the nail, the fungus penetrates its depth more often.This distribution method is available only for dermatomycetes with pronounced keratolytic abilities.In this case, the process of destruction of the nail itself will continue faster.
3. The least common route of spread is through the proximal ridge.From the end of the matrix, the fungus penetrates under the nail plate and into the bed, or settles in the matrix, from there destroying the collagen structure of the nail phalanx.If the nail lesions are caused by fungi of the genus Candida, then the proximal ridge with its swelling and thickening will first be involved in the pathological process.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 factors:

• Mechanical injury.
• Exposure to chemical factors, such as: regular contact with detergents containing synthetic components, continuous contact with water, use of degreasers, etc.
• Wearing things made of synthetic materials, wearing narrow shoes that are uncomfortable.As a result, a good moist and warm environment is created in which fungi multiply quickly.
• A type of sympathetic autonomic regulation, in which a person experiences increased sweating.This factor is related to the individual characteristics of the body.
• Flat feet or a narrow space between the toes, as anatomical features of foot development.Such deformation leads to the fact that the ventilation of the legs deteriorates significantly.
• Nail growth rate.
• Failure to comply with personal hygiene rules.
• Disorders in the function of the immune system.In addition, nail fungus is not the only disease with a decrease in immunity.Other organs are also susceptible to mycotic damage.
• Varicose veins.
• Climate characteristics of the area where a person lives.Most often, fungal infections affect people who live in areas with a temperate or cold climate.The fact is, there you often wear warm clothes, thick and tight shoes, thereby creating good conditions for the fungus to work.Residents of subtropical countries are also at risk, as the development of fungi is facilitated by high humidity and ambient temperature in general.
• Age-related changes in the human body.Most often, toenail fungus is diagnosed in older and older adults.However, dermatologists and mycologists noted an increasing trend in incidence among adolescents and children.Therefore, statistics show that every 10 years of life increases the risk of infection by 2.5 times.Although in childhood the probability of mycotic infection is 3%, in the elderly this figure increases to 50%.Experts attribute such indications to the fact that as we age, the rate of plate growth slows down, bed nutrition deteriorates, and angiopathy develops.
• Gender.It has been found that men get sick almost three times more often than women.However, it is men who seek help more often.
• Professional costs.Fungus on the feet is more often found in miners who serve workers of nuclear power plants, and in workers of 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 regarding fungal infections by workers in saunas, baths, and laundries are becoming more frequent.Frequent visitors of mycology are massage therapists, orthopedists, rest home workers and representatives of other service personnel.
• Associated pathology.The greatest danger in this regard is diabetes mellitus, leg deformities, excess body weight, gastrointestinal diseases, metabolic disorders, thyroid pathology, any peripheral angiopathy, for example, with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus by 5 times.(Also read: causes, symptoms, diagnosis and prevention of HIV)
• Taking antibacterial drugs, corticosteroids and cytostatic drugs.

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

1. Visiting saunas and baths, swimming pools and public baths - any public place where people walk barefoot for some time;
2. Use of common household items (even intra-family), such as washcloths, slippers, pumice stones, carpets;
3. Performing cosmetic procedures, particularly pedicures, in beauty salons where hygiene standards are not adhered to.

Be aware that the biggest danger in this regard is wooden floors, benches and other items made from this natural material.The fact is that 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 see nail 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 athlete's foot is dangerous because of the following complications:

• The spread of mycosis of the skin and its appendages in the occurrence of immunodeficiency.
• The development of diabetic foot against the background of diabetes mellitus.
• Development of erysipelas from the lower legs.
• Elephant development.
• Development of lymphostasis.
• Development of invasive mycosis in patients undergoing immunosuppressive or cytostatic therapy.
• The growth of the nail is affected and its rotation into the surrounding tissue, which is accompanied by severe pain and an inflammatory reaction.
• Development of eczema.
• Increased bacterial infection and the development of inflammation.
• Loss of nail plate, exposure of the nail bed.
• The development of aspergillosis (ie an infection by mold fungi), which is difficult to treat therapeutically.Often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Fungus on the feet never affects the nails all at once.

The disease often develops slowly, through several stages of development:

1. The early or early stages are small lesions.In this case, no pathological changes can be seen.The manifestation of the process is expressed in the appearance of a narrow gray band located in the area of the free edge of the nail.
2. Normotropic wound level of the nail plate.When the thickening has not occurred and there is no subungual hyperkeratosis, but the track made by the fungus can be seen.They look like strips and sectors of damaged plates.Increased phalanx weakness and discoloration.Sometimes serous contents can come out from under the nail.
3. Level of hypertrophic lesion.First, onychauxis is formed - subungual lesions, thickened nails, and increased hypertrophy.These plates change color and, depending on the type of pathogen, collapse, exfoliate, become thinner, stop growing, or become deformed.As a result, the nail is completely gone.

Early stages of toenail fungus

Often, the infection is preceded by damage to the skin of the feet.An itchy sensation occurs in the interdigital folds, cracks, blisters, and maceration may appear.As it penetrates deeper into the nail, the fungus begins to affect one or another of its edges.This largely depends on the type of pathogen and the route of infection, 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 cannot be distinguished with the naked eye.Disease detection is possible in laboratory conditions.

Advanced toenail fungus

Advanced toenail fungus is characterized by total damage to the nail phalanx.In the absence of prolonged therapy, the possibility of not only destroying the nail, but also damaging the skin, as well as the spread of the disease to the nail increases.

The main indicators of the advanced stage of the disease are nail collapse, separation and deformation.Thinning of the nail body and changes in its color occur gradually over the years.A rapid transition to the overall level 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 of the nail plate or its severe deformation, as well as the development of serious complications that fungus on the feet can cause.

How to get rid of toenail fungus

The modern pharmaceutical industry offers people who have been diagnosed with toenail fungus a variety of effective drug options to overcome this problem.There are local and general ways of action.

It is the multitude of antimycotic drugs available that make drug-free options difficult.After all, fungus can affect not only toenails, but also mucous membranes, any organ and tissue.Therefore, it is very important to undergo a comprehensive diagnosis and receive medical recommendations regarding the treatment of nail fungus.

Therapeutic tactics are based on four points:

• Contribute to the affected area;
• The time that has passed since the onset of the disease;
• The nature of the pathological changes provoked by the disease;
• The presence of concomitant pathology.

Modern drugs not only destroy fungal organisms and stop their development, but also tend to accumulate in the thickness of the nail plate, staying 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.What is important is an integrated approach to therapy, combining local treatment with oral medications.This raises the question, how to choose medicine and get rid of toenail fungus?Below we will consider all types of modern medicine.

Antifungal nail polish

When the toenail fungus does not reach an advanced stage, only local therapy can be used.For this purpose, special varnishes or solutions containing antimycotic components can be used.

In addition, to achieve a therapeutic effect, you can use a patch that has a peeling effect.To make your nails look more attractive, you can apply manicure polish on top of medicated polish.

To achieve the maximum effect from treating nail fungus with varnish, you must follow certain rules:

• You cannot complete the treatment yourself until you receive laboratory data showing the absence of fungus on the nails;
• The use of varnish should be regular and without skipping;
• Treatment can last a year and is a necessary step to eliminate mycotic organisms.

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

There are also certain contraindications for therapy using antifungal varnish:

1. Duration of breastfeeding;
2. Contains a fetus;
3. Individual intolerance to drug components;
4. Childhood.

Sometimes redness of the skin area located around the nail is possible.

Rules for using antimycotic varnish:

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

Remedies to remove nails affected by fungus

Before applying nail remover, you need to steam your feet in water, where there is one spoonful of liquid soap and soda per 1000 ml.Then the feet are dried, the skin around the affected nail should be fixed using an adhesive plaster.This product is applied to the affected area in a thick layer, but without rubbing.The top of the nail is also fixed with adhesive plaster.

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

Antifungal tablets

Systemic antibacterial agents are needed in cases where the toenail fungus has advanced.Only a doctor can choose the optimal treatment regimen.There are many tablets that can get rid of fungus, but some of them are not compatible with hormonal contraceptives, some cannot be taken in childhood, and some are forbidden to use if you have liver problems.

Local treatment with creams, sprays, ointments

If the therapy is chosen correctly 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, complete recovery can only be confirmed by performing tests that the patient undergoes 14 and 30 days after the end of therapy.If during the treatment the skin on the feet 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 treatment in time.

Another way

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

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

Laser treatment

Treatment of diseases with laser beams is a method of physiotherapy 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 improve blood circulation.As a result, antimycotic drugs penetrate better into damaged plates.However, the laser itself cannot kill the fungus.

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

Prevention of toenail fungus

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

This is a fairly 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 footwear for saunas and baths;
• Socks for daily wear should be made of cotton fabric;
• It is forbidden to wear other people's shoes;
• You should keep your feet dry.