Nail fungus is diagnosed in 20-30% of people. The pathology is much more difficult to treat than fungal skin infections. To obtain a good effect of therapy, it is recommended to use systemic and local antifungal drugs for 18 months or more. In some cases, repeated therapy is required.
Nail fungus treatment.
Causes of fungal infections of the nail plates, classification, pathogenesis.
Onychomycosis is an infectious pathology that manifests itself as damage to the nail plate due to the penetration of fungal flora. It can occur on both fingernails and toenails.
Damage to the nail plates is caused by the following pathogens:
- foot damage: dermatomycetes, Candida albigens, non-dermatomycete molds;
- nail fungus: dermatomycetes, C. parapsilosis, mold fungal agents.
The nail complex can be affected by a fungal agent or by 2 or 3 types of pathogen at the same time.
Factors that cause pathology:
- age over 50 years;
- prolonged work in dangerous jobs that worsen the immune status;
- regular sweating of the feet due to improper selection of shoes;
- traumatic damage to the nail complex, which stimulates the inflammatory process and the proliferation of pathogenic microbes;
- immunodeficiencies that cause tumor processes, autoimmune diseases, diabetes mellitus and other conditions;
- Nail plate dystrophy in dermatological diseases.
All of these factors can cause the appearance of fungal infections.
Symptoms and stages of pathology in adult patients.
Onychomycosis is located 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. The symptoms of fungal infection may differ depending on the type of pathology. The following types of onychomycosis are distinguished:
- Marginal damage is the first initial stage of pathology, caused by the entry of a pathogen from the outside; Almost imperceptible changes appear on the nail plate in the area of its free part, not adjacent to the nail bed; Yellowish-gray stripes and patterns (areas of nail abrasion) are noticeable.
- Normotrophic variety - the nail plate has stripes or sectors of damage, but at the same time retains its original thickness and shape; the nail becomes brittle and acquires a yellowish-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 the nail folds; They also highlight the total damage to the plate, when it uniformly changes color, transparency and thickness.
- White superficial variety: most commonly occurs after prolonged therapy with systemic antifungal medications; It appears as whitish or yellowish opacities on the nail surface.
- Appearance of proximal deformation: the nail plate acquires a wavy shape (similar to a washboard), the color and transparency remain the same.
- Onycholytic variety: the plaque becomes fragile, brittle and thin; occurs against the background of a hypertrophic or normotrophic type of onychomycosis.
- Atrophic type: thinning of the nail, fragility; It 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.
The symptoms of onychomycosis in children are most often seen 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 ridged, dull and have a whitish-yellow tint. The plate begins to come off in the base area.
- Fungal leukonychia: looks like point 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 brown 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 suffers from chronic diseases (diabetes mellitus, thyroid pathologies). A generalized course is provoked by a prolonged absence of treatment.
The deformation of the nail is usually accompanied by its growth into the lateral fold of the nail bed. This pathology requires surgery, as it causes severe pain and swelling.
Which doctor should I go to if I have nail fungus?
If symptoms of onychomycosis appear, it is recommended to visit a doctor. The doctor will perform an examination and refer you to a dermatologist or podiatrist. You cannot treat the disease yourself or ignore the symptoms of the disease, as this can lead to serious deformation of the nail plate. A pronounced change in the shape of the nail requires surgical treatment.
If you suspect a 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, the microscopy method is used. A piece of material is taken from the patient from the free part of the nail, from the plate itself and from the subungual area. If a pathogen is identified, a sample of the material is taken again for testing. If fungi are detected again, therapy is started.
In some cases, sowing is indicated. It is most often performed after a course of therapy. The culture shows the ability of the fungi to cause relapses.
In addition to culture and microscopy, before antifungal therapy, the patient may be prescribed:
- general blood test, urinalysis,
- liver enzymes,
- alkaline phosphatase,
- bilirubin,
- TSH.
These studies will help identify chronic diseases and prevent possible complications from taking medications.
How does a podiatrist or dermatologist treat nail fungus?
Treatment of nail fungus must be carried out in a timely manner. Therapy is prescribed after diagnosis. To increase the effectiveness of treatment, it is necessary to follow all the 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 medications used in tablet and capsule form. They penetrate the bloodstream and kill fungal agents from the inside. Systemic therapy, if taken correctly, prevents relapses by stopping the source of 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 cosmetic 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 home remedies. This can lead to complications.
The best effective remedies for fungus.
Local therapy is less effective, so it is often combined with systemic medications. Topical remedies for nail fungus include:
- ointments,
- creams,
- varnishes.
To use topical medications, you must first remove the affected parts of the nail plate. Keratolytic patches are indicated for this. They are divided into:
- Urea.
- Salicylic (quinozolo-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 remains after softening or mechanical cleaning, apply varnish. The most common of this group of external agents are medications with the following substances:
- Amorolfine, indicated for application twice a week; The course of therapy is 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 varnish, 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 medications.
An ointment or cream containing the substance terbinafine is often used for nail fungus. The effectiveness of this product is quite high.
Forecast
The prognosis with timely treatment is favorable. Correctly prescribed therapy can completely eliminate the symptoms of the disease. If the pathology is not treated, severe deformation of the nail plate and spread of infection to the skin are possible.
How to prevent the appearance of pathology.
The appearance of onychomycosis can be prevented by following simple hygiene rules. It is recommended to shower every day and dry your feet well 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 spaces, products containing chlorine are recommended.
It is advisable to avoid visiting public baths and saunas, or wearing personal shoes, which will reduce the likelihood of infection. For prevention, it is allowed to use antifungal sprays after a visit.
The pathogen can be contracted on the beach. Therefore, after a beach holiday, it is worth washing your feet, treating 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 trying on shoes or boots in a store, it is necessary to put on booties or socks (and then wash them immediately). Be sure to use antifungal sprays to prevent infection.
You should choose shoes according to the weather. Feet should not sweat. The size of boots or shoes must be appropriate so that the foot is not pinched. Excessive pressure and trauma cause the proliferation of fungal agents. If a family member has been diagnosed with a fungus, the entire family should receive treatment at the same time.
The fungus causes reduced immunity. For this reason, chronic diseases (diabetes mellitus, thyroid pathologies, immunodeficiencies, ENT diseases) must be treated in a timely manner.
Today, onychomycosis is treated quite successfully. Pharmacies have a large arsenal of antifungal drugs, both systemic and local. Treatment must be prescribed by a doctor to prevent complications and new relapses of the pathology. Lamisil can be used as a universal option.
How to treat toenail and handnail fungus with terbinafine?
Terbinafine can cure nail fungus and is found in many medications. It is available in the form of a cream, spray and tablets. A variety of forms of the drug allow you to treat nail fungus at home.
Systemic therapy is indicated with 250 mg tablets once daily for 12 weeks. Along with the pills, it is necessary to apply the cream to the affected areas twice a day. The course of local therapy is up to 2 weeks or more. It is best to apply the cream until the nail is completely renewed.