The so-called nail fungus (onychomycosis) is one of the most common infectious dermatological diseases, and also one of the most difficult to treat. The absence of obvious symptoms of infection in the initial stage of the disease is the reason for late diagnosis of onychomycosis and, as a result, delay in treatment.
Types of fungi
Onychomycosis is caused by pathogenic fungi of the genus Trichophyton, which penetrate the tissues of the nail plate and nail bed, gradually destroying them and causing negative changes in local immunity.
Depending on the clinical manifestations of nail fungus, three forms of the disease are distinguished:
- Normotrophic - in this case, the nail plate retains its normal thickness, but is colored in colors that are unusual for a healthy nail (dull white, yellow-gray, gray-brown, etc. ).
- The hypertrophic form is characterized by excessive thickening of the nail, which rises above the surface of the nail and strongly protrudes beyond its borders. Often with this form, deformation of the plate is observed - it becomes pronounced lumpy, grows in width and causes pain when walking, while it grows into soft tissues.
- The atrophic form is manifested by thinning of the nail, which takes on a dull color (sometimes with gray-yellow spots, stripes or "air bubbles"). It is important to remember that only an expert knows how to recognize toenail fungus. Removing advanced nail fungus without surgery will be very difficult.
If you find any signs of fungus on your nails, hands or other formations, seek the advice of a dermatologist immediately.
Symptoms
Manifestations of onychomycosis can be divided into three groups, which differ depending on the severity of damage to the nail plate.
- I phase (initial). At this stage of the disease, the nail retains its normal thickness and color, but its surface becomes matte and loses its shine. The cuticle and skin around the nail may appear excessively dry and keratinize quickly. At the same stage, scaly spots can be observed in the interdigital spaces and itching of different intensity - from mild and episodic to strong and permanent.
- II phase (developed). In the second stage, visual signs of infection appear on the nail. The nail plate begins to thicken, but at the same time it becomes fragile - when cutting the nail, it is obvious that it "crumbles", and uneven edges remain at the place of the cut. Spots or stripes of white, yellow, gray or brown color appear on the nail, and the surface of the nail takes on an uneven relief. Thickening of the nail can develop to such an extent that any manipulation with it (manicure, pedicure) causes pain in a person. At this stage, an unpleasant odor appears from the affected nails (especially in the case of onychomycosis on the feet), which cannot be eliminated with the help of hygienic procedures.
- III stage (severe). In this stage of onychomycosis, the nail completely loses its functions and qualities, and the fungal infection spreads to the nail fold and the soft tissues under the nail. This phase is most often characterized by the death of the nail and its loss.
Causes of fungi
There is only one reason for onychomycosis: infection with pathogenic fungi, their growth and reproduction in nail tissues.
But the fungus, present almost everywhere, affects only some people. The reason for this is simple: infection requires not only a pathogen, but also conditions suitable for infection.
This includes:
- Reduced local immunity. Skin and nails have their own means of preventing infection. But when wearing tight and uncomfortable shoes, frequent or regular skin injuries, excessively thorough and deep pedicure/manicure, contact with aggressive substances, the protective function of the skin and nails is weakened, which facilitates the penetration of fungi and their reproduction.
- Professional or daily activities that involve prolonged exposure of hands/feet to wet environments. It does not have to be direct contact with water or other liquids - wearing rubber shoes and gloves creates warm and moist conditions that are suitable for pathogenic fungi.
- Failure to observe the rules of personal hygiene causes subungual fungi. Wearing other people's shoes, lack of individual footwear when going to public pools and saunas, untimely change of socks and socks for fresh ones, etc.
Nail fungus: treatment
The treatment of onychomycosis is complicated by the peculiarities of the nails themselves, whose density does not allow medicinal substances to penetrate into their deep layers.
Therefore, with fungal infections of the nails, artificial reduction of the thickness of the nail with the help of special files is often used. This frees the surface of the nail plate from the densest outer layer, which increases the ability of the active substances of the drugs to be absorbed deeply.
With a deep lesion of the nail with involvement of the nail tissue in the process, it is recommended to surgically remove the nail plate, which is performed under local anesthesia. After that, treatment is prescribed according to the severity of the disease.
To date, the only way to get rid of onychomycosis is to use drugs from the antimycotic group. These drugs selectively act on pathogenic fungi, stopping their activity and reproduction and causing the death of the pathogen.
Depending on the degree of spread of the fungus to the tissues surrounding the nail and whether the pathogen has entered the bloodstream, systemic antimycotics for oral administration or agents that are effective when applied locally (ointments, creams, solutions) can be prescribed.