The so-called fungus on the nails (onychomycosis) is one of the most common infectious dermatological diseases and at the same time one of the most difficult to cure. The absence of obvious symptoms of infection in the initial stage of the disease is the reason for the late diagnosis of onychomycosis and, consequently, for delays in treatment.
Types of mushrooms
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 the 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 that are 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 strongly protrudes beyond its edges. Often with this form, deformation of the plaque is observed: it becomes pronounced uneven, grows in width and causes pain when walking, as it grows in soft tissues.
- The atrophic form is manifested by thinning of the nail, which acquires a cloudy color (sometimes with gray-yellow spots, streaks 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 signs of fungus on the nails, hands or other formations, you should urgently consult a dermatologist.
Symptoms
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 luster. The cuticle and skin around the nail may appear excessively dry and become keratinized quickly. At the same stage, scaly patches can be observed in the interdigital spaces and itching of varying severity, from mild and episodic to severe and permanent.
- 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 brittle: when the nail is cut, it is obvious that it "crumbles" and the uneven edges remain at the cutting site. White, yellow, gray or brown spots or streaks appear on the nail and the nail surface acquires an irregular relief. Thickening of the nail can develop to the extent that any manipulation of it (manicure, pedicure) causes pain to a person. At this stage, an unpleasant smell appears from the affected nails (especially with onychomycosis on the legs), which cannot be eliminated with the help of 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 fold of the nail and the soft tissues under the nail. This phase is often characterized by the death of the nail and its loss.
Causes of the fungus
There is only one reason for onychomycosis - infection with pathogenic fungi and their growth and reproduction in the nail tissues.
But the fungus, present almost everywhere, affects only some people. The reason is simple: infection requires not only a pathogen, but also conditions conducive to infection.
These include:
- Decreased local immunity. The skin and nails have their own resources to prevent infection. But when wearing tight and uncomfortable shoes, frequent or regular skin lesions, excessively deep and deep pedicure / manicure, contact with aggressive substances, the protective functions of the skin and nails weaken, which facilitates the penetration of the fungus and its reproduction .
- Work or daily activities that involve prolonged exposure of hands / feet to humid environments. This doesn't have to be direct contact with water or other liquids - wearing rubber shoes and gloves creates warm, humid conditions conducive to pathogenic fungi.
- Failure to comply with the rules of personal hygiene causes subungual fungus. Wearing someone else's shoes, lack of individual shoes when visiting public pools and saunas, premature changing of socks and socks for fresh ones, etc.
Nail fungus: treatment
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, with fungal infections of the nails, an artificial reduction in the thickness of the nail is often used with the help of special nail files. This frees the surface of the nail plate from the denser outer layer, increasing the ability of the medicines' active ingredients to be absorbed deeply.
With a deep nail injury with the involvement of the nail bed tissues in the process, it is advisable to surgically remove the nail plate, which is performed under local anesthesia. After that, treatment is prescribed based 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, interrupting their activity and reproduction and causing the death of the pathogens.
Depending on the degree of spread of the fungus to the tissues surrounding the nail and whether the pathogen has invaded the bloodstream, systemic antifungals for oral administration or effective agents when applied topically (ointments, creams, solutions) may be prescribed.