Nail fungus is diagnosed in 20-30% of people. The pathology is much more difficult to treat than fungal skin infections. To achieve a good treatment effect, it is recommended to use systemic and local antifungal drugs for 18 months or more. In some cases, repeated treatment is necessary.
Nail fungus treatment
Causes of fungal infections of nail plates, classification, pathogenesis
Onychomycosis is an infectious pathology manifested by damage to the nail plate due to the penetration of fungal flora. This can occur on both fingernails and toenails.
Damage to nail plates is caused by the following pathogens:
- foot damage - dermatomycetes, candida albiges, non-dermatomycetes molds;
- nail fungus - dermatomycetes, C. parapsilosis, fungal agents of mold.
The nail complex can be affected by one fungal agent or by 2-3 types of pathogens at the same time.
Factors provoking pathology:
- age over 50;
- long-term work in hazardous jobs that worsen immune status;
- regular sweating of the feet due to poor choice of shoes;
- traumatic damage to the nail complex, which stimulates the inflammatory process and the proliferation of pathogenic microbes;
- immunodeficiencies that cause tumor processes, autoimmune diseases, diabetes mellitus and other conditions;
- dystrophy of 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 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 a 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 a 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 (nail abrasion areas) are noted.
- Normotrophic variety - the nail plate has scratches or damaged sectors, but at the same time retains its original thickness and shape; the nail becomes brittle and acquires a yellow-gray tint; the plaque becomes thinner and grows more slowly.
- Hypertrophic appearance - observed in patients who have not treated onychomycosis; the nail plate thickens either at the level of the free part of the nail, or in the place of the nail folds; They also highlight complete damage to the plaque, when it uniformly changes color, transparency and thickness.
- White superficial variety - occurs more often after prolonged treatment with systemic antifungal drugs; appears as whitish or yellowish opacities on the surface of the nail.
- Proximal deforming appearance - the nail plate takes on a wavy shape (similar to a washboard), color and transparency remain the same.
- Onycholytic variety - the plaque becomes fragile, brittle, thin; occurs against the background of 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 treatment.
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 plaque with its normal thickness and shape. The nails of young patients become streaked, dull and have a whitish-yellow tint. The plaque begins to peel off at the base.
- Mycotic leukonychia - looks like pinpoint spots that coalesce 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 deformity) 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 suffers from chronic diseases (diabetes mellitus, thyroid pathologies). A generalized course is caused by prolonged absence of treatment.
Nail deformation is often accompanied by its growth into the lateral fold of the nail bed. This condition requires surgical intervention, as it causes intense pain and swelling.
Which doctor should I consult in case of nail fungus?
If symptoms of onychomycosis appear, it is recommended to consult a doctor. The doctor will carry out 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 deformation of the nail plate. A pronounced change in the shape of the nail requires surgical treatment.
If you suspect 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 tissue is taken from the patient from the free part of the nail, the plate itself and the subungual area. If a pathogen is identified, the material is resampled for testing. If fungi are detected again, treatment is started.
In some cases, sowing is indicated. It is performed more often after treatment. Culture shows the ability of fungi to cause relapses.
In addition to culture and microscopy, before antifungal treatment, the patient may be prescribed:
- general blood test, urine analysis,
- liver enzymes,
- alkaline phosphatase,
- bilirubin,
- TSH.
These studies will make it possible to identify chronic diseases and prevent possible complications linked to taking medications.
How does a podiatrist or dermatologist treat toenail fungus?
Treatment of nail fungus should be carried out in a timely manner. Treatment 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 drugs that treat nail fungus, as well as local drugs that help relieve symptoms more quickly.
Systemic therapy consists of antifungal drugs used in the form of tablets and capsules. They enter the bloodstream and kill fungal agents from within. Systemic treatment, taken correctly, prevents relapses because it stops the source of the infection.
Local preparations are applied directly to the nail plate. They improve the appearance of the nail, kill fungal spores locally and promote its rapid renewal.
In addition to local and systemic treatment, surgical or cosmetic correction is indicated in advanced cases. Surgical treatment is prescribed more often in cases of 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.
The best effective remedies for fungus
Local therapy is less effective and is therefore often combined with systemic medications. Topical remedies for nail fungus include:
- ointments,
- creams,
- varnish.
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 (removal of material with diamond cutters and other methods).
After removing the affected nail, local treatment begins. If the nail plate is preserved after softening or mechanical cleaning, apply varnish. The most common of this group of external agents are drugs containing the following substances:
- Amorolfine, indicated for application twice a week; The duration of treatment is six months (hands), one year (feet).
- The active ingredient is ciclopirox; applied every other day during the first month, then during 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 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 prompt treatment is favorable. Correctly prescribed treatment can completely eliminate the symptoms of the disease. If the pathology is not treated, serious deformation of the nail plate and spread of infection to the skin are possible.
How to prevent the appearance of pathology
The appearance 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 room with antiseptic solutions and change clothes (especially socks and tights). Products containing chlorine are recommended for treating damp rooms.
It is advisable to avoid visiting public baths and saunas, or take personal shoes with you, which will reduce the risk of infection. As a preventive measure, it is allowed to use antifungal sprays after a visit.
The pathogen can be contracted on the beach. Therefore, after a beach vacation, you need to 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 should 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 based on the weather. Feet should not sweat. The size of boots or shoes must be adapted so that the foot is not pinched. Excessive pressure and trauma cause the proliferation of fungal agents. If a family member has been diagnosed with the fungus, the whole 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 very successfully. Pharmacies have a large arsenal of antifungal drugs, both systemic and local. Treatment should be prescribed by a doctor to prevent complications and subsequent relapses of 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 treatment is indicated with 250 mg tablets once daily for 12 weeks. Along with the tablets, you need to apply the cream to the affected areas twice a day. The duration of local treatment can be up to 2 weeks or more. It is best to apply the cream until the nail is completely renewed.