Nail fungus (onychomycosis)

14 March 2021

Onychomycosis is a disease of the nails and feet, caused by representatives of the fungal flora, which gradually leads to the destruction of the nail with changes in structure, color, and shape.

Onychomycosis includes three types of fungi:

Dermatomycetes. Dermatomycetes is a parasitic fungus, represented mainly by Trichophyton, Microsporum, Epidermophyton. In 80-85% of cases, the skin bacteria become the source of nail fungus.
The fungus belongs to the genus Candida (yeast genus). Candida fungus is present in the microflora of any human body, however, in essence, it can begin to multiply rapidly, causing nail fungus. Candida fungus infects the nail surface in 8-10% of cases.
Landmark. Mold is the rarest cause of nail fungus; they are infected only in 5-6% of cases.

What causes nail fungus disease

In 100% of cases, onychomycosis occurs due to an damaged fungal pathogen. The contact of the skin of the foot with the infected surface leads to fungal penetration through the upper layers of the epithelium into the nail, and thus, further deforming the nail. According to the site of the lesion, the following types of onychomycosis are possible:

The fungus penetrates the nail bed through the edge surface of the nail. Because in the first days of infection there are almost no symptoms, so it is difficult for the patient to notice any changes. But when the fungus grows in the nail itself, the hyperkeratosis begins to develop. Hyperkeratosis is caused by the color change of the nail from pale pink to yellowish, the bond between the nail surface and the nail layer is weakened, leading to flaking and flaking.
The fungus can enter the nail through the free surface of the nail plate. This occurs when the spores have a high degree of keratolysis (rapid destruction of the keratin). In this case, the infection of the nail occurs much faster than the first option.
Across the nail fold (the area of skin adjacent to the nail plate). It is slightly less common, however, with this method of infection, the inflammatory process of the foundation (the root zone) can begin.

Risk factors for nail fungal infections

flat feet or other features of the growth or development of the foot;
;
reduced immunity due to previous diseases;
HIV infection;
increased sweating;
wears shoes and clothes made of synthetic materials;
low leg aeration. Occurs again due to uncomfortable and tight shoes;
mechanical damage to the foot;
scratches, scratches, open wounds;
self-cuts ingrown nails;
frequently used antibiotics;
candidiasis (mainly in women);
comorbidities. Diabetes, thyroid disorders, dermatological diseases, stomach diseases, pancreatic diseases, being overweight can also increase the risk of onychomycosis up to 6-8 times;

Well, in addition to these factors, there are also ways that you can get a nail fungus infection directly.

Use general toiletries (pumice stones, towels, slippers, flip flops)
Visiting public saunas, showers, swimming pools, changing rooms without wearing shoes.
Wear someone else's shoes
Failure to comply with salon sterilization standards (especially pedicure).

Symptoms, types of onychomycosis

Symptoms of the disease depend on many factors: age, form of onychomycosis, degree of infection, systemic condition. Symptoms of a nail fungus infection are accompanied by itching, burning, and skin irritation.

At present, dermatologists distinguish five main types of nail fungus lesions:

hypertrophy. 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 an increase in small scabs that develop on the infected surface of the nail. The lateral parts of the foundation plate suffer the greatest damage; the middle part (center), on the contrary, thickens. At the edges, the nail begins to shatter violently. Due to the enlarged lesion, the nail becomes curved, narrow and very thick. In addition, there is a marked change in the color of the nail, accompanied by flaking.
Normotrophic. This is the easiest form of action, because the nail, when it gets a fungus, doesn't thicken and stays the same. Only the color of the nail plate changes. The fungus begins with the appearance of a small yellow spot, then grows rapidly in size. If you do not consult a specialist and do not initiate treatment, over time the stain will increase in size, gradually taking up the entire area of the nail. Since a person can quickly detect a color change, onychomycosis can be diagnosed at a fairly early stage of the disease.
Teo (Psychotic drugs). The atrophic form of onychomycosis is accompanied by a marked change in the color of the nail from pink to gray, with subsequent destruction of the structure of the nail. Characterized by rapid progression, eventually leading to complete detachment of the foundation plate from the nail bed. In other words, the patient can accidentally hook or pry off the infected nail and "remove" completely. The last stage of fungal atrophy is the necrotic nail tissue.
Side and Away. The lateral form is often diagnosed in combination with the distal fungus. The symbiosis of these varieties leads to discoloration of the nail plate, beginning with the appearance of pale yellow longitudinal grooves, followed by an increase in the area of the nail wound. Within 4-5 weeks, without proper treatment, the nail cells begin to die and the nail itself will be drastically crumbled. The final stage of fungal lateral toenail damage is the completely exposed nail, dangerous with the risk of infection on the mucous membranes.
Overall form of onychomycosis. Systemic onychomycosis is a lack of treatment for any of the above onychomycosis. Please note that the nail changes color very quickly, flakes, scabs and then completely rejects the nail. In this case, it is necessary to consult not only a dermatologist, but also a surgeon.

Stages of onychomycosis

To avoid a fungal toenail infection, it is important to remember that an infection never occurs, nor does nail deformation happen overnight. Medically, this is the primary injury, the normal stage, and the hypertrophic stage of the disease.

At an early stage, the foundation is only affected at the edges; At the same time, the size of the affected area does not exceed 2-3 mm. In rare cases, the free margin of the nail may be affected. Before the nail can be damaged directly, the skin on the feet becomes infected. Patients can feel itchy, scratchy and may appear calluses, pain. Over time, the fungus will spread from the foot to the nail. If you notice changes at this point and consult a therapist, you will have a chance to completely preserve and restore the nail in no time.

The autotrophic stage is the next stage of the disease. An intermediate process in which thickening of the nail plaque has not yet begun, but the affected areas of the nail have been noticed. Affected areas may be small (2-4 mm), or they may reach larger sizes (more than 5 mm). Usually they are manifested as thin vertical stripes with a yellowish color. The first manifestation of toenail fungus is color change: it can be quickly noticed and promptly treated.

The last stage of onychomycosis is the hypertrophic stage of the disease. It begins with the formation of a small spot under the nail, then grows very rapidly. It may be accompanied by an inflammatory process parallel to the formation of purulent sacs. The nail layer thickens, scabs, flakes, then visibly thins, and finally, the nail cells die and completely flake off.

Important: the risk of hypertrophic nail damage lies in the ability to damage neighboring skin and transition to a chronic stage. But the development of such events is possible only in the absence of timely medical intervention and subsequent treatment of nail fungus.

Antifungal nail fungus

The most common are different antifungal drugs. The mechanism of action of such drugs is not only reduced to the direct destruction of the spores, but also reduces the accumulation of the active substance in the nail itself. This avoids recurrence and protects the leg from possible future injuries.

Before choosing a drug, you must go through a microbiological culture to identify the nail fungus, undergo a full diagnosis and consult a dermatologist.

In most modern dermatology clinics the following methods are used to diagnose onychomycosis:

KOH Microscope
Highly accurate PCR diagnosis

A dermatologist, before prescribing a particular drug, must take into account the nature of the fungal infection, the type of onychomycosis, the time that has elapsed since the moment of infection and more.

Most commonly used treatments: medications, lasers, and traditional medicine.

Medicines

Among the anticonvulsants, the most popular are varnishes, ointments, and pills.

In the early stages of fungus, the use of topical preparations is recommended, in which antifungal varnishes occupy an important place.

Important: If the doctor has prescribed an anti-fungal varnish, never skipped the procedures, as otherwise, the desired effect will not be given.

In addition to varnish, there are special ointments and gels that have similar antifungal effects. Ointment also belongs to topical preparations. Usually, experts prescribe ointments. Ointment should be applied to the affected areas of the nails and feet for a period of time. Exact treatment times are indicated by a specialist.

There's also an antifungal. Unlike ointments and varnishes, pills are all-purpose medications that are taken by mouth. The commonly prescribed antifungal drugs are: Tablets are usually prescribed not at the initial stage of infection but for days after that, when the fungus has entered its normal stage of growth.

Laser Treatment of Fungi

Currently, some clinics offer laser nail fungal hardware treatments. Going deep into the surface under the nail, the laser beam heats it to the growing area, thereby not only killing the fungus, but also stimulating the growth of new nails. Research by scientists has shown that with the systematic heating of the nail plate to 60-70 degrees, the fungal microorganisms die. The same thermal effect without damaging the surrounding tissues can only be achieved with the help of laser radiation, since long laser beams react only to cells affected by fungi. Despite the fact that laser therapy does promise to completely get rid of nail fungus, dermatologists still recommend several such sessions as a rule. Compared to drug treatment, this method is much more expensive, and therefore not suitable for everyone.

And for those who are lazy to go to the doctor, there are remedies from the traditional medicine store

Experts recommend switching to using folk methods combined with an ongoing traditional full body treatment. Such funds can be used as preventive measures to eliminate the possibility of future fungus recurrence.

Here are some recipes that may be effective in treating nail fungus, but are completely unnecessary. However, in the absence of other opportunities to combat onychomycosis, the use of these simple recommendations cannot be forbidden.

Affected areas of the nail plate are treated with a 5% iodine solution twice a day. When iodine is applied, you may feel a little tingling and burning sensation. If discomfort increases, treatment should be discontinued and switched to other treatments.
20% alcohol is made from propolis, which is then applied to the fungal skin and nails. Propolis effect is that it promotes the rapid regeneration of damaged cells and nail repair. The effect of propolis becomes noticeable only after a few applications.
One of the most famous ways to fight fungus on your own is by using kombucha. To prepare a gauze pad, you need to cut a small portion of ripe kombucha, use a bandage or gauze to tie the fungus to the affected nail and leave it on overnight. In the morning, remove the bandage and remove any dead nails. After that, it is necessary to treat the affected area and the surrounding skin with the iodine solution or any other disinfectant. You should continue to cook nails with kombucha for 3-4 weeks.

Prevention of fungal nail infections

Any disease, including onychomycosis, is easier to prevent than cure. To protect yourself from nail fungus and minimize the risk of infection, you should follow simple precautions that will keep you healthy.
First of all, the observance of personal hygiene, especially in public places. This also applies to your own apartment and even more so for public places like saunas and showers. Always wear separate sandals, using loofahs and pumice stones for heel care.
If you find your feet sweat a lot, change your shoes or use a special refreshing insole. These pads have a porous structure, so they normalize air circulation.
Regularly check your foot for cracks, scratches, and minor cuts. If scratch is found, you will need to disinfect the place with an antiseptic (a solution of iodine alcohol and others).

Toenail fungus, like many diseases, may not appear immediately, so it's important to keep track of the condition of your nails and feet. And it's best to carefully follow all prescribed precautions - these simple actions in the future will save time and money spent on treatment.