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Onychomycosis

Yellow toenails due to fungus

Toenail fungus is a contagious disease caused by fungal organisms such as dermatophytes, molds, and yeast-like fungi of the genus Candida.In fact, there are as many as 50 species of fungi that can cause pathological conditions in the nails, but they all fall into these three broad categories.Furthermore, in up to 90% of cases, the cause of nail plate disease is fungi belonging to the dermatophyte group, which has as many as 20 different species.Yeast fungi of the genus Candida are less common causes of nail disease, accounting for about 10% of cases.A small remaining proportion of the incidence is due to fungal infection of the nails.Onychomycosis sounds like onychomycosis in medical terms.

According to statistics, the prevalence of this disease is quite wide.Foot fungus affects 20% of the world's population.The prevalence of the disease in a population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of a given person, age, sex and occupation.Additionally, dermatologists are noticing a continued increase in the number of cases in both adults and children.The likelihood of developing onychomycosis increases with age (the disease is more common in those over 65).

Symptoms of onychomycosis

The symptoms of toenail fungus depend on the type of pathogen causing the infection and the extent of damage to the nail plate.The age of the patient can affect the speed of recovery.It is known that the nail phalanges are affected much less frequently in children than in older adults.

Symptoms vary depending on the form of fungus:

  1. Symptoms of nutritionally normal nail fungus.The color of the affected boards changes, but the thickness and gloss remain the same.First, streaks and spots appear on the nails - they vary in shape and size and are located on the lateral part of the nail.Such spots are ocher-yellow or white in color; if the disease is not treated, the spots will grow in size, gradually covering the entire plate area.Nails are completely discolored and maintain normal thickness.Onycholysis is another symptom of normal vegetative nail fungus.It lies in the plate's inability to grow into the nail bed.Therefore, the patient can easily remove it either intentionally or accidentally.
  2. Symptoms of hypertrophic onychomycosis.In addition to discoloration, this form of the disease is characterized by a thickening of the plates by more than 2 mm or more in size.This increase occurs due to increased growth of skin scales under the nails.Affected boards lose their luster, become dull and begin to crumble.As a result, the nails are severely deformed.The more advanced the disease is, the greater the degree of deformation.Onychomycosis - Nails shaped like bird claws are a common symptom of the hypertrophic form of the disease.The outer part of the nail is the most damaged.The complex symptoms that accompany this nail fungus cause a person to start experiencing pain while walking.Nail color changes to dark yellow or gray.
  3. Symptoms of atrophic onychomycosis.First, the patient notices a change in the color of the plate; it turns brown-gray.The normal luster is lost and the nail surface becomes pale and dull.As the disease progresses, the plates are destroyed.The final stage of the atrophic form of fungus is when the nail bed is exposed and completely necrotic.(Also Read: Causes and Symptoms, Consequences and Prevention of Necrosis) Above the surface of the bed, the patient notices a layer of loose consistency consisting of skin scales.Atrophy of the nail plate occurs in stages, starting from the outer end toward the growth zone and nail fold.The growth zone remains intact longer than the rest of the nail.
  4. Symptoms of lateral and distal onychomycosis.What these two types of fungal lesions have in common is that they are often diagnosed in a commensal state and cause the same changes in parts of the nail plate.The affected portion of the board loses its normal color and becomes dull.The transverse grooves running along it are yellowish in color.When toenail fungus occurs due to mold and fungal infections, the color of the nail plate may change to blue-green to black.The nail itself begins to chip and the sides become rough.Over time, the affected portions will disappear, causing the sheet's shape to deform.The nail bed remains partially exposed.The final stage of the disease is characterized by the complete destruction of the nail and the opening of a bed of peeling skin over the top.If the clinical manifestations of distal nail fungus are accompanied by onychomycosis, the ridges around the nail will become swollen, red, and thickened.A person is suffering.When a bacterial infection becomes more severe, pus may come out by gentle pressure under the nail.
  5. Symptoms of proximal onychomycosis.This rare nail plate lesion primarily affects the area on one side of the skin fold.The main cause of proximal nail fungus is the removal of the nail epithelium (cuticle).The nail plate begins to turn white near the growth zone.The fungus pinpoints its spores and mycelium in the nail tunnels in this area.When the fungus multiplies, it surrounds the entire nail and completely destroys it.
  6. Symptoms of full onychomycosis.Panonychomycosis can occur if lateral, distal, or proximal disease is not treated.Nails lose color, begin to chip, break and become completely destroyed.
  7. Symptoms of superficial white onychomycosis.Milky white spots appear in the back pad area, completely covering the entire nail as the fungus multiplies.These spots tend to coalesce and may visually resemble dispersed fine powder.

Although the clinical manifestations of various forms of fungal infections vary, some common symptoms can be recognized, including:

  • chipped nails;
  • Change plate color;
  • Anatomy of Nail Phalanges;
  • Pain occurs as the pathological process progresses;
  • Itchy skin may occur in the area around the nails.

Causes of Toenail Fungus

Toenail fungus always occurs due to infection by fungal organisms.Most commonly they are dermatophytes.Increased corneal tropism is a distinctive feature of this group of fungi.The variety of proteolytic enzymes they possess helps them penetrate the skin and nails.First, dermatophytes infect the skin of the feet and then spread to the nail plates.

They can penetrate deep into the nail in three ways:

  1. Start just below the distal (free, lateral) edge of the nail.In this case, the pathological process will be localized under the plate - on the bed, and not on the nail itself.As the fungus proliferates, subungual hyperkeratosis occurs.This can cause the connection between the bed and the board to deteriorate, which can then cause them to separate.The fungus invades the nail from the bed and slowly destroys it.
  2. Through the dorsal part of the nail, fungus invades its depth much less frequently.This method of distribution is only suitable for dermatophytes with significant keratolytic abilities.In this case, the process of nail destruction itself proceeds faster.
  3. The rarest route of transmission is through the proximal ridge.The fungus penetrates from the last part of the matrix under the nail plate and into the nail bed, or it settles in the matrix, from where it destroys the collagen structure of the nail phalanges.If nail lesions are caused by fungi of the genus Candida, then the swollen and thickened proximal nail crest is first involved in the pathological process.However, this inflammatory process more commonly affects the nails.

In order for the fungus to penetrate the nail area, it must first be damaged and eliminated.

The occurrence of this situation is affected by the following predisposing factors:

  • Mechanical damage.
  • Exposure to chemical factors, such as: frequent contact with cleaners containing synthetic ingredients, frequent contact with water, use of degreasers, etc.
  • Wear something made of synthetic materials and wear uncomfortable, narrow shoes.Thus, a favorable moist and warm environment is created, allowing the fungus to multiply rapidly.
  • A sympathetic nervous system that causes increased sweating.This factor is related to the individual characteristics of the body.
  • Flat feet, or narrow spaces between the toes, are an anatomical characteristic of foot development.This deformation results in a significant deterioration in foot ventilation.
  • Nail growth rate.
  • Failure to follow personal hygiene rules.
  • Immune system dysfunction.Additionally, onychomycosis is not the only disease that reduces protection.Other organs are also susceptible to fungal damage.
  • Varicose veins.
  • The climatic characteristics of the area where a person lives.More commonly, fungal infections affect people who live in temperate or cold climates.In fact, there you often have to wear warm clothes, thick and tight shoes, thus creating favorable conditions for the fungus to function.Residents of subtropical countries are also at risk, as high humidity and ambient temperatures often promote the growth of the fungus.
  • Age-related changes in the human body.More commonly, toenail fungus is diagnosed in older adults.However, dermatologists and mycologists have noticed an increasing trend in adolescents and children.Therefore, statistics show that for every 10 years of life, the risk of infection increases 2.5 times.In childhood, the chance of fungal infection is 3%, while in older people this number increases to 50%.Experts attribute these indicators to the fact that with age, the growth of the plates slows down, the nutrition of the bed deteriorates, and vascular diseases occur.
  • gender.Studies have found that the prevalence is almost three times higher in men than in women.However, men rarely seek qualified help.
  • The cost of a career.Fungus on the feet is more common among miners and metallurgical workers who serve workers at nuclear power plants.The higher the dust content, air temperature, humidity, ionizing radiation, and gas pollution, the higher the risk of infection.In this regard, sauna, bathhouse and laundromat workers are seeing more and more frequent visits for fungal infections.Frequent clients of mycologists include massage therapists, orthopedic surgeons, nursing home staff and other service personnel representatives.
  • related pathologies.The greatest dangers in this regard are diabetes, foot deformities, overweight, gastrointestinal disorders, metabolic disorders, thyroid pathology, any peripheral vascular disease, such as those with lymphatic stasis or venous insufficiency.HIV infection increases the risk of onychomycosis fivefold.(Also Read: HIV Causes, Symptoms, Diagnosis and Prevention)
  • Antimicrobials, corticosteroids, and cytostatics are administered.

As for the direct route of infection, it most often occurs in the following situations:

  1. Visit saunas, bathhouses, swimming pools, and public showers—any public place where people walk barefoot for a period of time;
  2. Use common (even inside the home) household items such as towels, slippers, pumice stones, rugs;
  3. Perform cosmetic procedures, especially pedicures, in salons that do not adhere to hygiene standards.

It is worth noting that the biggest dangers in this regard are wooden floors, benches and other items made of this natural material.The fact is that wood has a porous structure and it is almost impossible to wash fungal mycelium from there.

Why is foot fungus dangerous?

It is a mistake to view onychomycosis as a purely aesthetic problem.This is a serious disease that requires qualified treatment.After all, onychomycosis is one of the most common chronic diseases.Untreated foot fungus can become dangerous due to the following complications:

  • Transmission of mycoses of the skin and its appendages in conditions of immunodeficiency.
  • Development of diabetic foot in the context of diabetes.
  • Development of erysipelas in the lower limbs.
  • The development of elephant worship.
  • Development of lymphatic stasis.
  • Invasive mycosis occurs in patients receiving immunosuppressive or cytosuppressive therapy.
  • Nail growth and rotation to surrounding tissue is impaired, with severe pain and inflammatory response.
  • Development of eczema.
  • Add the development of bacterial infection and inflammation.
  • The nail plate falls off and the nail bed is exposed.
  • Aspergillosis, a fungal infection, develops and is difficult to treat.Most often, aspergillosis occurs on the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Fungus on the feet never also affects the nails.

The disease usually progresses slowly, going through several stages of development:

  1. The early or initial stages are borderline lesions.In this case, any pathological changes are virtually invisible.Manifestations of this process are the appearance of narrow gray streaks located in the free edge area of the nail.
  2. The nail plate is in the normal lesion stage of nutrition.When thickening has not occurred and there is no subungual hyperkeratosis, but the traces left by the fungus are visible.They look like streaks and scallops of damaged plates.The phalanges have increased fragility and change in color.Sometimes serous contents may drain from under the nail.
  3. Hypertrophic stage.First, onychomycosis is formed - subungual lesions, the nails become thicker and hypertrophy increases.The dish will change color and, depending on the type of pathogen, may chip, peel, thin, stop growing, or become deformed.As a result, the nail is completely lost.

The early stages of onychomycosis

In most cases, infection is preceded by skin lesions on the feet.Itching may occur in the interdigital folds, and cracks, blisters, and maceration may occur.As the fungus gets deeper into the nail, it begins to affect one edge of the nail or the other.This depends largely on the type of pathogen and route of infection, as discussed above.

Often, self-diagnosis is not possible in the initial stages because there are no obvious clinical symptoms.The streaks and spots on your nails are nearly indistinguishable to the naked eye.The disease can be detected under laboratory conditions.

Advanced onychomycosis

Advanced foot fungus is characterized by complete damage to the toe bones.If left untreated for a long time, not only will the nail be completely destroyed, but the skin will be damaged and the likelihood of the disease spreading to the fingernail will also increase.

The main indicators of the advanced stages of the disease are chipping, separation, and deformation of the nails.Over the years, the nail body gradually thins and changes color.A rapid transition to the general stage of the disease is possible only in the context of an existing systemic disease, which occurs most often in old age.The final stage is the destruction of the nail plate or its severe deformation, and the development of serious complications that can result from foot fungus.

How to Get Rid of Toenail Fungus

The modern pharmaceutical industry offers people diagnosed with onychomycosis a variety of effective medications to combat this problem.There are means of local action and general action.

The richness of available antifungal drugs makes independent selection of drugs difficult.After all, fungi can affect not only toenails, but also mucous membranes, any organs and tissues.Therefore, it is important to receive a thorough diagnosis and receive medical advice on treating onychomycosis.

The treatment strategy is based on four points:

  • Accounting for affected areas;
  • The amount of time that has elapsed since onset of illness;
  • the nature of the pathological changes caused by the disease;
  • Accompanying pathology is present.

Modern medications not only destroy fungal organisms and prevent their development, but they also tend to accumulate in the thickness of the nail plate and stay there for a long time.This allows you to significantly shorten the duration of treatment, up to 8 – 16 weeks.This time it was enough to completely solve the problem.What is important is a comprehensive treatment approach, that is, a combination of topical treatments and oral medications.This begs the question, how to choose a medication and get rid of onychomycosis?Below we will consider all modern drugs.

antifungal nail polish

When onychomycosis has not reached an advanced stage, only topical treatment can be used.For this purpose, special varnishes or solutions containing antifungal ingredients can be used.

In addition, in order to achieve therapeutic effects, you can use patches with exfoliating effects.To make your nails look more attractive, you can apply manicure nail polish over medicated nail polish.

In order to obtain the maximum effect of treating onychomycosis with varnish, you must adhere to certain rules:

  • You should not complete treatment on your own until you receive laboratory data showing that fungus is not present in the nails;
  • The application of varnish should be carried out regularly and no missed application is allowed;
  • Treatment can last up to one year and is necessary to eliminate the fungus.

Toenails are more likely to accumulate medication than fingernails.Varnishes should not be mixed as their therapeutic effectiveness will be reduced.

There are also certain contraindications to the use of antifungal varnish treatment:

  1. Lactation;
  2. pregnant with fetus;
  3. individual intolerance to drug ingredients;
  4. childhood.

Sometimes the area of skin around the nail may become red.

Rules for using anti-mildew varnish:

  • Using a nail file, you need to remove as much of the affected nail as possible;
  • Use a solution of water and alcohol to remove oil from the surface of your nails, or steam your nails with soap and soda;
  • take remedial measures;
  • It must be removed once a week using regular solvents.

Remedies for removing fungus affected nails

Before using nail remover, you need to steam your feet in water containing one teaspoon of liquid soap and soda per 1000 ml of water.The feet are then dried and the skin around the affected nail is secured with adhesive tape.Apply product generously to affected area, but do not rub.The top of the nail is also secured with adhesive tape.

After 4 days, remove the patch, steam your feet, and simply scrape off the fungus-affected nails using a manicure tool.

antifungal tablets

If toenail fungus has progressed to an advanced stage, systemic antimicrobials may be needed.Only a doctor can choose the best treatment option.There are many pills available to get rid of the fungus, but some of them are incompatible with hormonal contraceptives, some cannot be taken during childhood, and some are contraindicated if you have liver problems.

Topical treatments can include creams, sprays, ointments, etc.

If the treatment is chosen correctly, the symptoms of the fungal infection are completely eliminated, and the protocol is completed, the affected nail tissue will eventually be replaced by healthy nail tissue.

However, full recovery can only be verified through tests taken by patients 14 and 30 days after completion of treatment.If the skin on your legs begins to peel and turn red during treatment, this is a sign of an allergy from the medication.Therefore, it is important to stop treatment promptly.

other ways

Oils: Tea tree oil and lavender oil.While lavender oil eliminates irritation, tea tree oil helps fight bacteria.However, it is important that the oil is natural; only then can the desired results be achieved.

Apple cider vinegar, mouthwash, lemon juice.After mixing these three products, you need to soak your feet in the resulting solution for about a quarter of an hour.This is an excellent supplement to primary antifungal treatments.

laser treatment

Treating disease with laser beams is a form of physical therapy.It can only be effective if used in combination with antifungal drugs.Laser therapy alone cannot completely eliminate onychomycosis.The purpose of this surgery is to improve nail nutrition and increase blood circulation.Therefore, antifungal drugs can penetrate better into the damaged plates.However, the laser itself does not kill the fungus.

This method has no contraindications and reduces the risk of disease recurrence.Laser therapy is a safe and painless way to fight fungal nail infections.

Prevent onychomycosis

If a person's immune system is functioning properly, then onychomycosis will not harm him even after infection because the immune system will neutralize it on its own.If a fungal infection does spread along the nail plate, it is necessary to choose the best way to combat it.

This is a fairly labor-intensive process, so the following precautions can help prevent infection:

  • Walking barefoot on the beach should be avoided;
  • Closed rubber slippers are the best footwear for saunas and baths;
  • Socks for daily wear should be made of cotton;
  • It is forbidden to wear other people’s shoes;
  • You should keep your feet dry.