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 absence of obvious symptoms of infection in the early stages of the disease is the reason for the late diagnosis of onychomycosis and, consequently, the delay in treatment.
A type of fungus
Onychomycosis is caused by a pathogenic fungus of the genus Trichophyton, which penetrates the tissue of the nail plate and nail bed, gradually destroying it 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 maintains its normal thickness, but is painted in unusual colors for healthy nails (cloudy 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 strongly protrudes beyond its borders. Often with this form, deformation of the plate is observed - it becomes wavy, grows wide and causes pain when walking, because it grows into soft tissue.
- The atrophic form is indicated by the thinning of the nail, which acquires a cloudy 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. Getting rid of 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 immediately seek advice from a dermatologist.
symptoms
Manifestations of onychomycosis can be divided into three groups, which differ depending on the severity of damage to the nail plate.
- I level (initial). At the advanced stage of the disease, the nail retains its normal thickness and color, but the surface becomes matte and loses its shine. The cuticles and skin around the nails may appear too dry and become keratinized quickly. At the same stage, scaly spots in the interdigital space and itching of varying severity can be observed - from mild and episodic to severe and permanent.
- Stage II (developing). In the second stage, visual signs of infection appear on the nails. The nail plate begins to thicken, but at the same time it becomes brittle - when cutting the nail, it is clear that it "crushes", and uneven edges remain at the cut site. White, yellow, gray or brown spots or stripes appear on the nail, and the nail surface acquires an uneven relief. Nail thickening can develop to the point that any manipulation (manicure, pedicure) causes pain to a person. At this stage, an unpleasant smell appears from the affected nails (especially with onychomycosis on the feet), which cannot be eliminated with the help of hygiene procedures.
- Stage III (severe). At this stage of onychomycosis, the nail completely loses its function and quality, and the fungal infection spreads to the nail folds and the soft tissue under the nail. This stage is most often characterized by nail death and loss.
Fungal cause
There is only one reason for onychomycosis: infection with pathogenic fungi, and their growth and reproduction in the nail tissue.
But fungus, found almost everywhere, only affects some people. The reason is simple: infection requires not only pathogens, but also conditions conducive to infection.
This includes:
- Reduces local immunity. Skin and nails have their own resources to prevent infection. But when wearing tight and uncomfortable shoes, frequent or common skin injuries, too 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.
- Occupational or daily activities that involve prolonged exposure of hands/feet to wet environments. This does not need to be in direct contact with water or other liquids - wearing rubber shoes and gloves creates warm and moist conditions that are ideal for pathogenic fungi.
- Failure to follow the rules of personal hygiene causes subungual fungus. Wearing other people's shoes, lack of individual shoes when visiting public swimming pools and saunas, changing socks and stockings prematurely for fresh ones, etc.
Nail fungus: treatment
The treatment of onychomycosis is complicated by the peculiarity of the nails themselves, their density does not allow medicinal substances to penetrate into their inner layer.
Therefore, with fungal infections of the nails, an artificial reduction in nail thickness is often used with the help of a special nail file. This frees the surface of the nail plate from the densest outer layer, which increases the ability of the active ingredients of the medicine to be absorbed deep inside.
With a deep wound on the nail with the involvement of the nail bed tissue in the process, it is advisable to surgically remove the nail plate, which is performed under local anesthesia. After that, treatment is prescribed according to the severity of the disease.
Until now, the only way to get rid of onychomycosis is the use of 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 extent of spread of the fungus to the tissues around the nail and whether the pathogen has invaded the bloodstream, systemic antimycotics for oral administration, or agents that are effective when used topically (ointment, cream, solution) may be prescribed.