Nail fungus is diagnosed in 20-30% of people. The pathology is much more difficult to treat than fungal infections of the skin. To obtain a good effect from therapy, it is recommended to use systemic and local antifungal medications for 18 months or more. In some cases, repeated therapy is required.
Treatment of nail fungus
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;
- fingernail fungus - dermatomycetes, C. parapsilosis, mold fungal agents.
The nail complex can be affected by one fungal agent or 2-3 types of pathogen at the same time.
Factors provoking pathology:
- age over 50 years;
- long-term work in hazardous work that worsens immune status;
- regular sweating of 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 provoke tumor processes, autoimmune diseases, diabetes mellitus and other conditions;
- dystrophy of the nail plates in dermatological diseases.
All these factors can lead to the appearance of fungal infections.
Symptoms and stages of pathology in adult patients
Onychomycosis is localized 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 fungal infection may differ depending on the type of pathology. The following types of onychomycosis are distinguished:
- Marginal damage is the very first initial stage of pathology, caused by the entry of a pathogen from the outside; almost imperceptible 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 noted.
- 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 yellow-gray tint; the plate becomes thinner and grows more slowly.
- Hypertrophic appearance - observed in patients who have not treated onychomycosis; the nail plate thickens either in the area of the free part of the nail or in the place of the nail folds; They also highlight complete damage to the plate, when it evenly changes color, transparency and thickness.
- White superficial variety - occurs more often after prolonged therapy with systemic antifungal drugs; appears as whitish or yellowish opacities on the surface of the nail.
- Proximally deforming appearance - the nail plate takes on a wave-like shape (similar to a washboard), color and transparency remain the same.
- Onycholytic variety - the plate becomes fragile, brittle, thin; occurs against the background of a hypertrophic or normotrophic type of onychomycosis.
- Atrophic type - thinning of the nail, brittleness; 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 fungus 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 plate with its normal thickness and shape. The nails of young patients become striated, dull, and have a whitish-yellow tint. The plate begins 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 - transverse grooves of a brownish 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 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 ingrowth 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 for nail fungus?
If symptoms of onychomycosis appear, it is recommended to visit a physician. The doctor will conduct an examination and refer you to a dermatologist or podologist. 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, consult 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 purpose, the microscopy method is used. A piece of material is taken from the patient from the free part of the nail, the plate itself, and the subungual zone. If a pathogen is identified, the material is re-sampled for testing. If fungi are detected again, therapy is started.
In some cases, seeding is indicated. It is performed more often after a course of therapy. Culture shows the ability of fungi to cause relapse.
In addition to culture and microscopy, before antifungal therapy, the patient can be prescribed:
- general blood test, urine test,
- 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 should be carried out in a timely manner. Therapy is prescribed after diagnosis. To increase the effectiveness of treatment, you must follow all the doctor’s recommendations. Otherwise, there is a high probability of relapse of the disease.
Complex therapy includes systemic medications that treat nail fungus, as well as local medications that help relieve symptoms more quickly.
Systemic therapy consists of antifungal medications that are used in the form of tablets and capsules. They penetrate the bloodstream, killing fungal agents from the inside. Systemic therapy, which is taken correctly, prevents relapse, as it stops 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 its rapid renewal.
In addition to local and systemic therapy, surgical or cosmetic correction is indicated in advanced cases. Surgical treatment is prescribed more often for inflammation after 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 patches are indicated. They are divided into:
- Urea.
- Salicylic (Quinozolo-salicylic patch, Quinozolodimexide patch).
Sometimes the affected nail plates are removed by cleaning (hardware removal with diamond cutters and other methods).
After removing the affected nail, local therapy begins. If the nail plate is preserved 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), a 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, it is allowed to use creams and ointments. Effective substances:
- Clotrimazole in the form of ointment or cream;
- Bifonazole - in the form of a cream, spray;
- Ketoconazole and other medications.
An ointment or cream for nail fungus 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 are possible.
How to prevent the occurrence of pathology
The occurrence of onychomycosis can be prevented by following simple hygiene rules. It is recommended to take a shower every day and dry your feet thoroughly with a towel. You should clean the bathroom or shower room with antiseptic solutions and change clothes (especially socks and tights). Chlorine-containing products are recommended for treating wet rooms.
It is advisable to avoid visiting public baths and saunas, or take personal shoes with you, which will reduce the likelihood of infection. For prevention, it is permissible to use antifungal sprays after a visit.
The pathogen can be contracted on the beach. Therefore, after a beach holiday, you should wash your feet, treat 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, you must put on ankle boots or socks (and then immediately put them in the wash). 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 does not get pinched. Excessive pressure and trauma provoke the proliferation of fungal agents. If one family member has been diagnosed with a fungus, the entire family should be treated at the same time.
The fungus provokes reduced immunity. For this reason, chronic diseases (diabetes mellitus, thyroid pathologies, immunodeficiencies, ENT diseases) should 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 should be prescribed by a doctor to prevent complications and further relapses 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 cream, spray and tablets. A variety of forms of the drug allows you to treat nail fungus at home.
Systemic therapy is indicated with tablets of 250 mg once a day for 12 weeks. Along with the tablets, 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 better to apply the cream until the nail is completely renewed.