Nail fungus (lat. onychomycosis) – in other words – fungal infection of the nails.This disease can affect both fingernails and toenails.The cause is mainly the so-called dermatophytes, less often - various fungi Candida (yeast) or mold.
Changes in color, thickening and fragility of nails are symptoms of fungus, but also other diseases of the skin and nails, so if such changes are detected, you should consult a dermatologist and perform bacteriological tests for the presence of fungi, as well as cultures.
It is estimated that about 50% of people with rough and discolored nails have nail fungus.
Causes and symptoms of nail fungus
Nail fungus usually appears after a toenail fungus infection.According to research, up to 42% of people suffer from foot fungus, and 21% from nail fungus.More often it affects men (with the exception of candidiasis), rarely children, but very often the elderly.This disease affects all races equally.
The most common nail fungus infections in temperate climates are caused by dermatophytes, namely Trichophyton rubrum (70% of nail fungus cases), Trichophyton mentagrophytes (20% of all nail fungus cases), Trichophyton interdigitale, Epidermophyton floccosum, Trichophyton violaceum, Trichophyton violacum, Trichophyton violacum, Trichophyton violacum, Trichophyton violacum, Trichophyton violacum, Microsporumchogyum and Trichophytonverrucosum.There are more cases of fungal infections of other varieties in the world, in addition to dermatophytes and yeasts, namely Fusarium spp., Scopulariopsis brevicaulis, Aspergillus spp.In some countries, Aspergillus spp.is the cause of up to 15% of fungal disease cases.
You can become infected with fungi, for example:
- in the pool,
- in the sauna,
- by wearing other people's shoes or wearing other people's socks,
- by using other people's manicure tools.
- Fungus often appears between the toes.
What is nail fungus?
Fungus that has appeared on the skin of the feet can penetrate under the skin and nails if the nails are damaged.It could be a cut or a cut nail that is too short.Nail disease usually affects weak nails, and the weakness is facilitated, in particular, by using nail polish and false nails.
In addition, some patients are susceptible to this type of infection due to various existing diseases.One of them is immune disorders (immunosuppressive conditions), which are associated, for example, with HIV infection or chronic treatment with immunosuppressive drugs after organ transplantation, or with certain autoimmune diseases.
Another group of problems associated with an increased risk of nail fungus is hormonal disorders (Cushing's disease or syndrome, hypothyroidism and others).This disease is more common in the presence of metabolic diseases, for example, diabetes, which is a disease that contributes to various infections, not only fungi.
Fungus occurs more often in obese people with anemia (anemia), disorders in the circulatory system that cause ischemia of the nail plate, as well as in patients with gastrointestinal disorders.
Nail fungus often affects patients treated with chemotherapy for malignant tumors, taking antibiotics (especially unaccompanied in the form of taking probiotics), as well as in patients who, for various reasons, take steroid drugs known for their immunosuppressive effects, that is, disrupting the function of the immune system.
There are four main types of nail fungus, regardless of which part of the nail is affected.The most common type of fungus affects the far (distal) part of the nail, including the supracungual plate, which is the skin located in front, under the nail plate.
Symptoms of nail fungus
Interestingly, nail fungus may initially be asymptomatic;in this case, only increased fragility and slight changes in the color of the nail plate occur.Only after some time, characteristic, noticeable changes in the appearance of the nails begin to appear.
Symptoms of nail fungus are, first of all, changes in the nails, especially in the early stages of the development of the disease.The first changes usually appear on the free edge (front) of the nail plate or on the side.
As nail fungus continues to grow, it can also cause problems with physical activity (such as exercise), as well as with walking and standing.Then the patient complains of paresthesia (numbness), pain, discomfort, and loss of physical fitness.Characteristic changes in the nail during the fungus include:
- change in color - nails become white, yellow, brown, greenish,
- peeling and flaking of the nail plate, fragility increases significantly,
- nail plate wrinkles,
- thickening of the nail plate, which is a symptom of excessive keratinization,
- unpleasant foot odor.
Fungus can manifest itself with various symptoms.Two different patients infected with the same type of fungus may experience different changes in the nails.
Toenail fungus can have quite distinctive features.It can be caused by the so-called.mold fungus.This form of fungus is often found in older people and is associated with disruption of the blood supply to the nails (trophic disorders).The nail plate of the thumb thickens, becomes deformed, acquires a greenish-yellow color, and a significant thickening of the epidermis is observed under the plate.As a rule, without treatment, nail fungus lasts for years.Unfortunately, even with proper and long-term treatment, the disease can recur.
The above symptoms usually indicate a fungus.In addition to the characteristic appearance of the nail, the detection of fungus on the skin of the feet and hands, which usually accompanies a fungal nail infection, can be helpful in diagnosing nail fungus.However, the diagnosis is not always clear.
In some cases, additional laboratory analysis may be required.The doctor takes a sample and examines it under a microscope.Another additional test to diagnose nail fungus is a fungal culture taken.Thanks to this, it is possible to determine the type and sensitivity of their tests to certain drugs.
If the doctor suspects nail fungus in a particular patient, he should also take into account other diseases that may have the same picture, namely:
- nail psoriasis - may look the same, but the characteristic difference of this disease is that it often affects all nails, symmetrically;in addition, psoriasis is usually accompanied by typical skin changes;
- nail thrush (or candidiasis) is another type of nail fungus, unlike the classic one, associated with infection with dermatophytes;it is characterized by the appearance of purulent discharge from under the nail fold, as well as pain;
- trophic changes caused by impaired blood supply to the nail plate;usually starts in the proximal part of the plate (that is, at its base);
- lichen planus is a disease characterized by the appearance of papules (changes) on the skin and mucous membranes, the simultaneous presence of which, as a rule, makes it quite easy to distinguish lichen from fungus;The nail plate with lichen is characterized by longitudinal corrugation.
When pressed, purulent contents appear.If candidal changes do not disappear for a long time, the nail plate becomes gray-yellow-brown, loses its shine, becomes rough, and peels.
Candidiasis of the nail plate and ridge must be distinguished from felon, which is a bacterial infection, which differs mainly because it is limited to only one finger and is more acute, with greater pain.In addition, candidiasis can be confused with "ordinary" nail fungus and nail psoriasis.
To make a definitive diagnosis of thrush, it is necessary to perform a culture (Candida fungal culture).It is impossible to recognize the mushrooms of this family in direct preparation, that is, by examining secretions taken from a sick place, without culture.
As a conclusion to the discussion on the symptoms of nail fungus, it is appropriate to remember the psychological problems that may be faced by patients suffering from this disease.This includes decreased self-esteem and deterioration in social relationships.This problem can especially affect those whose nails are affected by fungus.
Methods for treating nail fungus
Treatment for nail fungus is mandatory.Lack of treatment for nail fungus leads to a chronic and progressive course of the disease.Spontaneous recovery cannot occur.Therefore, if any suspicious changes appear in the area of the nails of the hands or feet, you must visit a dermatologist.
Even if it turns out that the cause of the disorder is not a fungal infection, only a dermatologist will be able to determine what disease the patient is suffering from.
Unfortunately, the treatment of the disease under discussion is difficult and not always effective.This happens because a frustrated patient simply stops taking the medication prescribed to him.For the treatment to be effective, it must last several months, even after the symptoms disappear.
In the early stage of the fungus, when the changes in the nail are still small, fungicide ointment will be enough.When the fungus is advanced, oral agents are usually used.Recurrence of the fungus is quite common, so after recovery you should follow the dermatologist's recommendations and keep your feet clean.Many patients refuse treatment immediately after symptoms disappear, and this is wrong because it can lead to relapse and the need to start treatment again.
Treating nail fungus at home is usually ineffective.
Changes in the nails should be checked by a dermatologist.Things you can do yourself to help with therapy are to practice good foot hygiene, wash and dry your feet thoroughly, don't cut your nails too short and don't share manicure tools, towels, socks or shoes with others.
In general, the treatment for nail fungus depends on the type of infection, the clinical type of the disease, the number of infected nails, and the degree of damage to the plate.In some cases, systemic treatment through oral agents is necessary.Sometimes local treatment, that is, ointments and creams, is sufficient.Undoubtedly, a combination of systemic and local treatment increases the success rate of nail fungus therapy.Unfortunately, even with the use of the latest medications, the percentage of nail fungus recurrence remains high.In the future, photodynamic and laser therapy may be used in the treatment of this disease.
An effective remedy for the treatment of nail fungus
Local medication without oral medication should be used only in cases where the lesion occupies less than half of the distal (distant) part of the nail plate, and also when the patient does not tolerate systemic treatment well.This is a rare case - as a rule, local treatment, unfortunately, is not enough.
As a rule, local medicines that are used as the only treatment for nail fungus cannot cure it completely, because they do not penetrate deep enough into the plate.
True, it is believed that the solution penetrates all layers of the nail, but they remain ineffective if used in monotherapy (as the only drug).However, these drugs can be used as "adjuvant" therapy, in addition to oral drugs, or as a preventive measure for relapse in patients who have previously treated nail fungus with systemic (oral) drugs.
Medicines for the treatment of nail fungus
Oral treatment in cases of nail fungus is almost always necessary.The latest generation of oral antifungal drugs has recently replaced the previous generation in the treatment of nail fungus.The effectiveness of new products lies in their ability to penetrate deep into the nail plate within a few days after the start of treatment.
Through its use, it is possible to reduce the duration of therapy, while at the same time achieving a higher percentage of recovery and fewer side effects.
In the case of therapy using this method, patients should equip themselves with patience and calmly wait until a healthy nail grows after the treatment is completed.This may continue for some time.
Removes nail fungus
Removing nails affected by fungus is also considered a solution to the problem.For nail fungus, surgical treatment can be used.Here we are talking about mechanical or chemical removal of the infected nail plate.Chemical removal of plates can be done using a 40-50% urea solution.This is a painless and effective method in cases where the nails are very thick.
Removal of the nail plate should be considered as an adjunctive treatment in patients undergoing oral therapy.The combination of oral treatment, local (lubrication), as well as surgical intervention provides a higher percentage of cure and at the same time is the most effective and cheapest option (minimum relapse, short-term treatment).
During the treatment of nail fungus, it is not necessary to restrict activities in a broad sense, but it is recommended to avoid places where infection can occur, for example, public swimming pools.