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 from 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 fingernails and toenails.
Damage to the nail plates is caused by the following pathogens:
- foot damage - dermatomycetes, Candida albigens, non-dermatomycetes fungi;
- 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 the same time.
Factors provoking pathology:
- age over 50 years;
- prolonged work in dangerous jobs that worsen the immune status;
- regular sweating of the feet due to improper shoe selection;
- traumatic damage to the nail complex, which stimulates the inflammatory process and the proliferation of pathogenic microbes;
- immunodeficiencies that provoke tumor processes, autoimmune diseases, diabetes mellitus and other conditions;
- dystrophy of the nail plates in dermatological diseases.
All of these factors can lead to 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. Symptoms of a 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 an external pathogen; barely noticeable changes in the nail plate appear in the area of its free part, not adjacent to the nail bed; yellowish-gray stripes and patterns (areas of nail abrasion) are observed.
- Normotrophic variety - the nail plate has stripes or damaged sectors, but at the same time retains its original thickness and shape; the nail becomes brittle and acquires a grayish-yellow hue; the plaque becomes thinner and grows more slowly.
- Hypertrophic appearance – observed in patients who have not treated onychomycosis; the nail plate thickens in the region of the free part of the nail or in the place of nail folds; They also highlight complete damage to the plate, when it uniformly changes color, transparency and thickness.
- White superficial variety - most often occurs after prolonged therapy with systemic antifungals; appears as whitish or yellowish opacities on the surface of the nail.
- Appearance of proximal deformation - the nail plate takes on a wavy shape (similar to a washboard), the color and transparency remain the same.
- Onycholitic variety - the plaque becomes fragile, brittle, thin; occurs against the background of a hypertrophic or normotrophic type of onychomycosis.
- Atrophic type - thinning of the nail, fragility; appears when the plate is frequently polished.
Based on the clinical picture, the doctor determines the type of pathology, makes a diagnosis and prescribes therapy.
Manifestations of fungi in childhood
Symptoms of onychomycosis in children are most often observed when the skin of the feet and hands is affected by the fungus. Nail changes:
- The normotrophic type of the disease is manifested by degeneration of the plaque with normal thickness and shape. The nails of young patients become striated, opaque and yellow-white in color. The board starts to peel off in the base area.
- Mycotic leukonychia - looks like 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 - brownish transverse grooves 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 provoked by prolonged absence of treatment.
Deformation of the nail is often 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 see to treat nail fungus?
If symptoms of onychomycosis appear, it is recommended to consult 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 deformations 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 the diagnosis, it is necessary to confirm the presence of a fungal agent on the nail plate. For this purpose, 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 zone. If a pathogen is identified, the material will be resampled 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. Culture shows the ability of fungi to cause relapses.
In addition to culture and microscopy, before antifungal therapy, the patient may be prescribed:
- general blood test, urine test,
- liver enzymes,
- alkaline phosphatase,
- bilirubin,
- TSH.
These studies will help identify chronic diseases and prevent possible complications arising from medication use.
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 a relapse of the disease.
Complex therapy includes systemic medications that treat nail fungus, as well as local medications that help relieve symptoms faster.
Systemic therapy consists of antifungal medications used in the form of tablets and capsules. They penetrate the bloodstream, killing the fungal agents from within. Systemic therapy, administered correctly, prevents relapses by interrupting 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 following ingrowth 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.
Top 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. For this purpose, keratolytic adhesives are recommended. They are divided into:
- Urea.
- Salicylic (Quinozolo-salicylic patch, Quinozolodimexide patch).
Sometimes the affected nail plates are removed by cleaning (removing hardware with diamond cutters and other methods).
After removing the affected nail, local therapy begins. If the nail plate remains preserved after softening or mechanical cleaning, apply varnish. The most common of this group of external agents are medicines with the following substances:
- Amorolfine, recommended 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 an ointment or cream;
- Bifonazole - in the form of a cream, spray;
- Ketoconazole and other medications.
A nail fungus ointment or cream containing the substance terbinafine is often 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 deformation of the nail plate and spread of infection to the skin is possible.
How to prevent the occurrence of pathology
The occurrence of onychomycosis can be avoided by following simple hygiene rules. It is recommended to take a 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). Products containing chlorine are recommended for treating humid environments.
It is advisable to avoid going to public baths and saunas, or taking personal shoes, which will reduce the likelihood of infection. For prevention, the use of antifungal sprays after the visit is allowed.
The pathogen can be contracted at the beach. Therefore, after a beach vacation, you should wash your feet, treat them with 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, you should put on ankle boots or socks (and put them in the wash immediately). Be sure to use antifungal sprays to prevent infections.
You should choose shoes according to the weather. Feet should not sweat. The size of the boots or shoes must be appropriate so that the foot does not get trapped. Excessive pressure and trauma cause the proliferation of fungal agents. If a family member has been diagnosed with fungus, the entire family should be treated 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 recurrences of the pathology. Lamisil can be used as a universal option.
How to treat toenail and fingernail 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 medicine 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, you need 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.