Nail mycosis is diagnosed in 20-30% of people. The pathology is much more difficult to treat than fungal skin infections. To achieve a good effect from therapy, it is recommended to use systemic and local antifungal drugs for 18 months or more. In some cases, repeated therapy is necessary.
Nail fungus treatment
Causes of fungal nail infections, classification, pathogenesis
Onychomycosis is an infectious pathology that manifests itself as damage to the nail plate due to the penetration of the fungal flora. It can occur on both fingernails and toenails.
Nail damage is caused by the following pathogens:
- foot damage - dermatomycetes, candida albigeni, non-dermatomycete molds;
- nail fungus - dermatomycetes, C. parapsilosis, mold fungal agents.
The nail complex can be affected by one fungal agent or 2-3 types of pathogens at once.
Factors causing pathology:
- age over 50;
- long-term work in dangerous jobs that worsen immune status;
- regular sweating of the feet due to improper choice of shoes;
- traumatic damage to the nail complex, which stimulates the inflammatory process and the proliferation of pathogenic microbes;
- immunodeficiencies causing tumor processes, autoimmune diseases, diabetes mellitus and other conditions;
- Nail dystrophy in dermatological diseases.
All these factors can lead to the appearance of fungal infections.
Symptoms and stages of the disease in adult patients
Onychomycosis is localized on the fingers or toes. The clinical picture of the disease is manifested by changes in the color, transparency and shape of the nail plate. Symptoms of fungal infection may differ depending on the type of pathology. The following types of onychomycosis are distinguished:
- Marginal damage is the very first initial stage of the pathology, caused by the entry of a pathogenic agent from the outside; almost imperceptible changes in the nail plate appear in the area of its free part, not adjacent to the nail bed; Yellowish-gray streaks and patterns (areas of nail abrasion) are noted.
- Normotrophic variety: the nail plate has damaged stripes or sectors, but at the same time maintains its original thickness and shape; the nail becomes brittle and acquires a yellow-gray tint; the plaque becomes thinner and grows more slowly.
- Hypertrophic appearance - observed in patients who have not treated onychomycosis; the nail plate thickens in the area of the free part of the nail or in the place of nail folds; They also highlight the complete damage of the plate, when it uniformly changes color, transparency and thickness.
- White superficial variety: occurs most often after prolonged therapy with systemic antifungal drugs; appears as whitish or yellowish cloudiness on the surface of the nail.
- Distorting proximal appearance: the nail plate takes on a wavy shape (similar to a washboard), the color and transparency remain the same.
- Onycholytic variety: the plate becomes brittle, fragile, thin; occurs against the background of a type of hypertrophic or normotrophic onychomycosis.
- Atrophic type: thinning of the nail, fragility; appears when the plate is polished frequently.
Based on the clinical picture, the doctor determines the type of pathology, makes a diagnosis and prescribes therapy.
Fungal manifestations in childhood
Symptoms of onychomycosis in children are most often observed when the fungus affects the skin of the feet and hands. Nail changes:
- The normotrophic type of the disease is manifested by the degeneration of the plaque with its normal thickness and shape. The nails of young patients become streaked, dull and have a whitish-yellow tint. The plate starts to peel off in the base area.
- Mycotic leukonychia: resembles pinpoint spots that merge over time and cover the entire surface of the nail.
- Atrophic and onycholytic type: the nail begins to separate from the nail bed and shorten.
- Distal-lateral mycosis: transverse furrows of a brownish tint appear (tunnels created by the pathogen).
Hypertrophic and proximal (wavy deformation) types of the disease are rare in children.
Advanced nail fungus: what are the possible complications?
The infection can spread to all parts of the body (neck, torso, arms, legs), if the patient has reduced immunity or has chronic diseases (diabetes mellitus, thyroid pathologies). A generalized course is caused by prolonged absence of treatment.
Deformation of the nail is often accompanied by its growth in the lateral fold of the nail bed. This pathology requires surgical intervention, as it causes severe pain and swelling.
Which doctor should I go to for nail fungus?
If symptoms of onychomycosis appear, it is recommended to consult a doctor. Your doctor will perform an examination and refer you to a dermatologist or podiatrist. It is not possible to cure the disease on your own or ignore its symptoms, as this can lead to serious deformations of the nail plate. A pronounced change in the shape of the nail requires surgical treatment.
If you suspect fungus, see a doctor
Diagnostic methods
To make a diagnosis it is necessary to confirm the presence of a fungal agent in the nail plate. For this purpose, the microscopy method is used. The patient is taken a piece of material from the free part of the nail, from the plate itself and from the subungual area. If a pathogen is identified, the material is resampled for analysis. If fungi are detected again, therapy is started.
In some cases sowing is indicated. It is most often performed after a course of therapy. Culture shows the ability of fungi to cause relapse.
In addition to culture and microscopy, before antifungal therapy, the patient may be prescribed:
- general blood tests, urinalysis,
- liver enzymes,
- alkaline phosphatase,
- bilirubin,
- TSH.
These studies will help identify chronic diseases and prevent possible complications resulting from taking medications.
How does a podiatrist or dermatologist treat nail fungus?
Treatment of nail fungus should be done in a timely manner. Therapy is prescribed after diagnosis. To increase the effectiveness of treatment, you must follow all your doctor's recommendations. Otherwise, there is a high probability of relapse of the disease.
Complex therapy includes systemic drugs that treat nail fungus, as well as local drugs that help relieve symptoms more quickly.
Systemic therapy consists of antifungal drugs used in the form of tablets and capsules. They penetrate the bloodstream, killing fungal agents from the inside. Systemic therapy, if taken correctly, prevents relapses as it stops the source of the infection.
Local preparations are applied directly to the nail plate. They improve the appearance of the nail, locally kill fungal spores and promote rapid renewal.
In addition to local and systemic therapy, surgical or aesthetic correction is indicated in advanced cases. Surgical treatment is most often prescribed for inflammation after the growth of the nail plate. Cosmetic correction is used when the nail is severely deformed.
Attention! Nail fungus should not be treated with folk remedies. This can lead to complications.
The best effective remedies against fungi
Local therapy is less effective, so it is often combined with systemic drugs. Topical remedies for nail fungus include:
- ointments,
- creams,
- paints.
To use topical medications, you must first remove the affected parts of the nail plate. For this purpose, keratolytic patches are indicated. They are divided into:
- Urea.
- Salicylic (quinozole-salicylic patch, quinozolodimexide patch).
Sometimes the affected nail plates are removed by cleaning (removal of hardware with diamond cutters and other methods).
After removing the affected nail, local therapy begins. If the nail plate is preserved after softening or mechanical cleaning, apply varnish. The most common of this group of external agents are drugs containing the following substances:
- Amorolfine, indicated for application twice a week; The course of therapy lasts six months (hands), one year (feet).
- The active ingredient is ciclopirox; applied every other day during the first month, then in the second month of therapy it is indicated once a week; the course lasts up to six months.
In addition to paint, the use of creams and ointments is allowed. Effective substances:
- Clotrimazole in the form of ointment or cream;
- Bifonazole - in the form of cream, spray;
- Ketoconazole and other drugs.
Often, an ointment or cream for nail fungus containing the substance Terbinafine is used. The effectiveness of this product is quite high.
Forecast
The prognosis for timely treatment is favorable. Correctly prescribed therapy can completely eliminate the symptoms of the disease. If the pathology is not treated, severe deformations of the nail plate and the spread of the infection to the skin are possible.
How to prevent the occurrence of pathologies
The onset of onychomycosis can be prevented by following simple hygiene rules. It is recommended to shower every day and dry your feet thoroughly with a towel. You should clean the bathroom or shower with antiseptic solutions and change your clothes (especially socks and tights). For the treatment of humid environments, products containing chlorine are recommended.
It is advisable to avoid visiting public baths and saunas or carrying personal shoes, to reduce the likelihood of infection. For prevention, the use of antifungal sprays after the visit is allowed.
The pathogen can be contracted on the beach. Therefore, after a beach holiday, you should wash your feet, treat them with an antifungal spray or other external preparations.
You cannot wear someone else's shoes or socks - this can be a source of infection. When you try on shoes or boots in a store, you should wear booties or socks (and then put them in the washing machine right away). Be sure to use antifungal sprays to prevent infection.
You should choose shoes based on the weather. Your feet shouldn't sweat. The size of the boots or shoes must be adequate so that the foot does not get pinched. Excessive pressure and trauma cause the proliferation of fungal agents. If a family member has been diagnosed with fungus, the whole family must be treated at the same time.
The fungus causes reduced immunity. For this reason, chronic diseases (diabetes mellitus, thyroid diseases, immunodeficiencies, ENT diseases) should be treated promptly.
Today onychomycosis is successfully treated. Pharmacies have a large arsenal of antifungal drugs, both systemic and local. Treatment must be prescribed by a doctor to prevent complications and further relapses of the pathology. Lamisil can be used as a universal option.
How to treat toenail and fingernail fungus with Terbinafine?
Terbinafine can treat nail fungus and is found in many medications. It is available in the form of cream, spray and tablets. A variety of forms of the drug allows you to treat nail fungus at home.
Systemic therapy is indicated with 250 mg tablets once a day for 12 weeks. Together with the compresses, you need to apply the cream to the affected areas twice a day. The course of local therapy lasts up to 2 weeks or more. It is better to apply the cream until the nail is completely renewed.