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 treat. The absence of obvious symptoms of infection at the initial stage of the disease is the reason for late diagnosis of onychomycosis and, consequently, 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.
According to 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, gray-yellow, 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 bumpy, swells and causes pain when walking, as it grows into soft tissues.
- The atrophic form is manifested by thinning of the nail, which acquires a cloudy color (sometimes with gray-yellow spots, stripes or "air bubbles"). It is important to remember that only a specialist can identify nail fungus. Eliminating advanced nail fungus without surgery will be very difficult.
If you find signs of fungus on the nails, hands or other formations, you need to urgently consult a dermatologist.
Symptoms
Manifestations of onychomycosis can be divided into three groups, which differ depending on the severity of 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 shine. The cuticle and the skin around the nail may appear excessively dry and keratinize quickly. At the same stage, scaly spots in the interdigital spaces and itching of varying severity can be observed - from mild and episodic to severe and permanent.
- Stage II (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 is obvious that it "crumbles", and uneven edges remain at the cut site. White, yellow, gray or brown spots or stripes appear on the nail, and the surface of the nail acquires an uneven relief. Thickening of the nail can develop to the extent that any manipulation of it (manicure, pedicure) causes pain in a person. 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 hygienic 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 soft tissues under the nail. This stage is most often characterized by the death of the nail and its loss.
Causes of fungus
There is only one reason for onychomycosis - infection with pathogenic fungi, as well as their growth and reproduction in the tissues of the nails.
But the fungus, present almost everywhere, affects only certain people. The reason is simple: infection requires not only a pathogen, but also conditions conducive to infection.
These include:
- Decreased local immunity. Skin and nails have their own resources to prevent infection. But when wearing tight and uncomfortable shoes, frequent or regular skin damage, excessively thorough and deep pedicure/manicure, contact with aggressive substances, the protective functions of the skin and nails weaken, whichfacilitates the penetration of the fungus and its reproduction.
- Occupational or daily activities that involve prolonged exposure of hands/feet to humid environments. It doesn't have to be direct contact with water or other liquids - wearing rubber shoes and gloves creates warm, moist conditions favorable to pathogenic fungi.
- Non-compliance with the rules of personal hygiene causes subungual fungus. Wearing someone else's shoes, lack of individual shoes when visiting swimming pools and public saunas, untimely change 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 nail infections, an artificial reduction in the thickness of the nail is often used using special nail files. This frees the surface of the nail plate from the denser outer layer, which increases the ability of active substances of drugs to be absorbed deeply.
In case of deep damage 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 depending 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 antimycotics. 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 effective agents when applied topically (ointments, creams, solutions)can be prescribed.