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 stage of the disease is the reason for late diagnosis of onychomycosis and, as a result, delays in treatment.
types of mushrooms
Onychomycosis is caused by pathogenic fungi of the genus Trichophyton, which penetrate into 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 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 (cloudy white, yellowish-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, a deformation of the plate is observed: it becomes pronounced bumpy, grows in width and causes pain when walking, as it turns into soft tissues.
- The atrophic form is manifested by the 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. Removing 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 seek the advice of a dermatologist.
Symptoms
Manifestations of onychomycosis can be divided into three groups, which differ depending on the severity of damage to the nail plate.
- Stage (initial). At this stage of the development of the disease, the nail retains its normal thickness and color, but its surface becomes matte and loses its shine. The cuticle and skin around the nail may appear excessively dry and rapidly keratinize. At the same stage, scaly spots 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 cutting the nail, it obviously "crumbles" and ragged edges remain at the cut site. White, yellow, gray or brown spots or stripes appear on the nail, and the nail surface becomes irregular in relief. Nail thickening can develop to the extent that any manipulation of it (manicure, pedicure) causes a person pain. At this stage, an unpleasant odor appears from the affected nails (especially with onychomycosis on the legs), which cannot be eliminated with the help of hygiene procedures.
- Stage III (severe). At this stage of onychomycosis, the nail completely loses its functions and qualities, and the fungal infection spreads to the nail fold and the soft tissues under the nail. This stage is most 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 a few people. The reason for this is simple: infection requires not only a pathogen, but also the conditions that lead 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 thorough and deep pedicure / manicure, contact with aggressive substances, the protective functions of the skin and nails are weakened, which facilitates the penetration of the fungus and its reproduction.
- Occupational 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, moist conditions that are favorable for fungal pathogens.
- Non-compliance with the rules of personal hygiene provokes subungual fungi. Wearing someone else's shoes, lack of individual shoes when visiting public swimming pools and saunas, untimely changing of stockings and socks for new ones, etc.
Nail fungus: treatment
The 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, artificial reduction of the thickness of the nail with the help of special nail files is often used. This frees the surface of the nail plate from the denser outer layer, which increases the deep absorption capacity of the active substances of the drugs.
With a deep injury to the nail with the involvement of the tissues of the nail bed 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.
To date, the only way to get rid of onychomycosis is the use of drugs from the group of antifungals. These drugs act selectively on pathogenic fungi, stopping their activity and reproduction and causing the death of 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 agents that are effective when applied topically (ointments, creams, solutions) may be prescribed.