The so-called nail fungus (onychomycosis) is one of the most common infectious dermatological diseases and at the same time one of the most difficult to treat. The lack 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 painted in colors 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 bed and greatly protrudes beyond its borders. Often with this form, deformation of the plate is observed - it becomes pronounced, increases in width and causes pain when walking, as it grows in the soft tissues.
- The atrophic form is manifested by thinning of the nail, which acquires a dull color (sometimes with gray-yellow spots, stripes or "air bubbles"). It is important to remember that only a specialist knows how to identify toenail fungus. Removing advanced nail fungus without surgery will be very difficult.
If you find any signs of fungus on the nails, hands or other formations, you should urgently seek advice from a dermatologist.
Symptoms
The manifestations of onychomycosis can be divided into three groups, which differ depending on the severity of the damage to the nail plate.
- I stage (initial). At this stage of the development of the disease, the nail retains its normal thickness and color, but its surface becomes dull and loses its shine. The cuticle and skin around the nail may appear too dry and keratinize quickly. At the same stage, scaly spots can be observed in the interdigital spaces and itching of varying severity - from light and episodic to strong and constant.
- II stage (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 "falls apart", and uneven edges remain at the place of cutting. White, yellow, gray or brown spots appear on the nail orstripes, and the surface of the nail acquires an uneven relief. The thickening of the nail can develop to such an extent that any manipulation with it (manicure, pedicure) causes pain to a person. At this stage, an unpleasant odor appears from the affected nails (especially in onychomycosison the legs) that cannot be eliminated using 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 stage is most often characterized by the death of the nail and its loss.
Fungal agents
There is only one cause of onychomycosis: infection with pathogenic fungi and their growth and reproduction in the nail tissues.
But fungi, present almost everywhere, affect only some people. The reason for this is simple: infection requires not only a pathogen, but also conditions favorable to infection.
They include:
- Reduced local immunity. Skin and nails have their own resources to prevent infection. But when wearing narrow and uncomfortable shoes, frequent or regular skin injuries, excessively deep and deep pedicure / manicure, contact with aggressive substances, the protective functions of the skin and nails weaken, which facilitates the penetration of fungi and their reproduction.
- Occupational or daily activities that involve prolonged exposure of hands/feet to wet environments. It doesn't have to be direct contact with water or other liquids - wearing rubber shoes and gloves creates warm and moist conditions favorable for pathogenic fungi.
- Non-observance of personal hygiene rules provokes under-nail fungus. Wearing other people's shoes, the lack of individual shoes when visiting public pools and saunas, the untimely replacement of socks and stockings with new ones, etc.
Nail fungus: treatment
The treatment of onychomycosis is complicated by the peculiarities of the nails themselves, the density of which does not allow medicinal substances to penetrate into their deep layers.
Therefore, in case of fungal nail infections, artificial reduction of the thickness of the nail with the help of special nail 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 deeply absorbed.
In the case of a deep lesion of the nail with the involvement of the tissues of the nail bed in the process, it is recommended to remove the nail plate surgically, which is performed under local anesthesia. After that, treatment is prescribed depending on the severity of the disease.
To date, the only way to get rid of onychomycosis is the use of drugs from the group of antifungals. These drugs selectively act on pathogenic fungi, stopping their activity and reproduction and causing the death of pathogens.
Depending on the extent of spread of the fungus in the tissues around the nail and whether the pathogen has entered the bloodstream, systemic antimycotics for oral administration or agents that are effective for local administration (ointments, creams, solutions) may be prescribed.