Toenail fungus is called onychomycosis. Initially, the infectious process affects the thumb, but as it develops, it spreads to others. The disease goes through several stages. The earlier treatment is started, the easier it is to resolve the problem. This is especially true in relation to the big toe of the lower limb - it has a large surface area and large size, so the degree of injury is large.
![Fungal nail infection of the big toe](/images/articles/98/Fungal%20nail%20infection%20of%20the%20big%20toe.jpg)
Stages of onychomycosis
Nail fungus goes through several stages of development, each of which is characterized by certain symptoms. The following stages of development of the disease are distinguished:
- Original.At this stage, no visible pathological deviations are observed: the changes are still external. The nail plates of the toenails of the lower extremities lose their shine. White spots or stripes appear on the surface. In general, the nail appears healthy, the person does not feel pain or discomfort. If you identify nail fungus at this stage, you can quickly get rid of it.
- Moderate or progressive.The structure of the nail is already undergoing pathological changes. The nail acquires a pronounced yellowish tint, peels off and disintegrates. There is also an unpleasant odor coming from the affected foot.
- Advanced or dystrophic stage.Deep nail damage occurs. In this case, the infectious process passes from the thumb to the rest. The entire surface of the nail plate is affected by the fungus, detaches from the bed and comes off. The patient is bothered by severe itching. When pressing on the affected areas, a painful, throbbing sensation appears. For this reason, the patient should not wear closed shoes.
![Dystrophic (advanced) stage of onychomycosis](/images/articles/98/Dystrophic%20(advanced)%20stage%20of%20onychomycosis.jpg)
At the third stage of development of the infectious process, infection of the skin of the foot is possible. In this case, the fungus can only be cured with the help of complex therapy, which involves the use of both local and systemic drugs (tablets for oral administration).
Reasons for the development of fungus on the big toe
The main reasons provoking the development of onychomycosis are:
- contact with a person carrying a fungal infection;
- neglect of hygiene rules;
- wearing someone else's shoes or narrow shoes that do not fit you;
- weakened immune system;
- visiting a public bath, sauna, swimming pool or beauty salon, where non-disinfected instruments can be used;
- trauma to the nail and surrounding skin;
- flat foot;
- long-term use of antibacterial drugs;
- hyperhidrosis (increased sweating of the feet);
- the presence of endocrine or immune lesions;
- disorders of the circulatory system, which is especially important for elderly patients;
- phlebeurism;
- diabetes.
![Flat feet are one of the causes of toenail fungus](/images/articles/98/Flat%20feet%20are%20one%20of%20the%20causes%20of%20toenail%20fungus.jpg)
Old age is an important factor that increases the risk of developing onychomycosis. Older people suffer from poor blood supply to the extremities, which also increases the risk of developing fungal infections.
The causative agent of the disease enters the nails or skin from infected objects or through contact with a carrier. The pathogen spreads quickly and invades new areas. The fungus enters the subungual space through damaged areas of the nail plate or surrounding skin.
The fungus spreads quickly to the nail bed. The rate of advancement exceeds the rate of plaque growth. Soon the pathogenic microorganism reaches its target and causes changes in the structure of the nail. It has been established that men suffer from fungus 3 times more often. Nail plates are affected by such types of fungi as dermatophytes, mold and yeast.
When should you consult a doctor?
You should see a doctor at the first signs of a fungal infection. You should not wait for obvious signs of the disease to appear - the formation of white spots and even slight itching on the feet should be a reason to contact a specialist - a mycologist or dermatologist.
![At the first signs of onychomycosis, you should contact a mycologist](/images/articles/98/At%20the%20first%20signs%20of%20onychomycosis,%20you%20should%20contact%20a%20mycologist.jpg)
Diagnostic
Diagnostic measures to identify the disease and its stage include:
- visual inspection of nail plates;
- take a tissue sample from the affected nail;
- cultural examination - inoculation of the material received by the patient onto a nutrient medium to identify the type of microorganisms that affected the nails.
In some cases, a specialist makes a differential diagnosis and separates onychomycosis from diseases such as lichen planus, psoriasis and keratoderma.
Treatment of fungal nail infection at an early stage of development
If the disease was detected at an early stage, it will be much easier to deal with it. In this case, it is generally sufficient to use local agents which act directly on the nail concerned.
At the first stage of mycosis, if no more than 50% of the nail plate is affected, the following drugs are prescribed:
- Varnish to apply to the surface of affected nails. This should be done twice a day, the total course of treatment will be one month. The product has contraindications, so it can only be used as prescribed by a doctor.
- Product made in cream form. The main active ingredient kills almost all types of fungi. The cream is applied 3 times a day, the duration of treatment lasts about a month.
- A product that is gypsum impregnated with a special composition. The adhesive strips are left in place for 3 days then removed. Special substances covering the surface of the plaster help soften the nail plate, so that it can be easily removed with manicure tools or scissors.
- Medicine containing a substance that destroys the fungus and stops its proliferation. It is recommended to smear the affected areas 1-2 times a day. The duration of treatment depends on the condition of the nail plate and can be from two to four weeks.
Any medication intended to treat even mild forms of nail fungus should be prescribed by a doctor.
Advanced therapy for onychomycosis
In severe cases of the fungus, as well as in cases of ongoing infectious processes, complex treatment is indicated. Systemic antifungals should be prescribed if there are no contraindications. The patient is prescribed the following medications:
- Systemic antibiotic from the triazole group in tablet form. The active substance of the drug reaches the location of pathogenic microorganisms and has a fungicidal effect.
- A drug from the imidazole group that inhibits the development of pathogenic microorganisms and destroys them. The course of treatment and dosage are determined by the attending physician. The product causes unwanted effects.
- A drug from the allylamine group that has a fungicidal effect. The active substance gradually accumulates in the layers of the nail plate, which allows you to destroy even quite deeply located fungi.
Additionally, in cases of advanced nail fungus, the procedures are effective in removing infected plaque. This can be done in the following ways:
- Surgical excision.This method involves lifting the plaque with a sharp surgical instrument and removing it from the bed. After the operation, a bandage is applied. The surgical method is traumatic and rarely used. Instead, minimally invasive methods are practiced.
- Removing plaque using chemicals, promoting rapid exfoliation of the affected nail. In this case, the problem area is treated with a special solution, wait for the medicine to take effect, and then use products that help to quickly separate the plate from the nail bed.
- Laser treatment.This is a modern and painless method that will quickly eliminate nail fungus. The laser acts on the plate, bringing it to high temperature as quickly as possible. The beam penetrates deeply and neutralizes pathogens. The method is bloodless and absolutely safe, as it does not cause burns.
![Laser treatment for big toe nail fungus](/images/articles/98/Laser%20treatment%20for%20big%20toe%20nail%20fungus.jpg)
In advanced stages of onychomycosis, it is necessary to strictly follow the doctor's recommendations, since the lack of adequate treatment increases the risk of widespread damage to the body from fungal infection.
Traditional methods
Toenail fungus can also be cured using traditional medicine. Such methods are complementary in nature and cannot constitute the basis of therapy. The most popular folk remedies include:
- Onion pulp.It is necessary to grate several onions and apply the resulting mass to the affected nails. Secure the top with a bandage. Leave on for 15 to 20 minutes, rinse.
- Hydrogen peroxide.First, soak the affected feet in a water bath to soften the nails as much as possible. Then remove the top layer of the plate. Dip a piece of gauze in hydrogen peroxide and wrap the phalanx of the finger with the affected nail, thereby capturing the immediate lesion. Leave to act for 40 to 50 minutes. You can repeat the procedure up to twice a day.
- Apple vinegar.It is important to use a natural product. Take 2 tablespoons of vinegar and add the same amount of vodka and a tablespoon of glycerin. Dip a cotton swab in the resulting mixture and apply to your nails for 15 minutes. Repeat 4 times a day.
Traditional recipes help to alleviate the severity of the symptoms of the disease and eliminate discomfort, but they are not able to destroy the causative agents of the disease.
The course of the disease and features of the treatment of nail fungus in children
Onychomycosis is rare in children. The main cause of the disease is weak immunity due to incomplete training. Symptoms of onychomycosis in children are:
- the plaque loses its natural pink color, gray or white spots appear on the surface;
- irregularity and tuberosity of the nail plates;
- crumbly and brittle nails;
- redness and swelling of the skin around the child's infected nail.
To treat nail fungus in children, only topical preparations, such as sprays, varnishes or creams, are usually used. If necessary, systemic agents are also prescribed. Antifungal medications for oral administration should only be prescribed by a doctor.
Features of treatment in pregnant and lactating women
During pregnancy, there is a high risk of developing onychomycosis if the woman has previously suffered from the disease and has not completely cured it. This is due to the weakened immune system that occurs during pregnancy.
It is important to treat the fungus in time, because in severe cases it creates a risk of bacterial infection that threatens the health of the mother and fetus. Systemic medications should not be used during pregnancy, as they have a high level of toxicity.
During pregnancy and breastfeeding, topical medications should be used, but only those that are safe for the expectant mother and her baby. These include sulfur-salicylic ointment.
Treatment of the elderly
In older people, decreased immunity is a natural age-related phenomenon that creates additional risks of developing onychomycosis. In this case, the specialist also exercises caution when choosing a remedy for treating nail fungus.
Systemic medications are prescribed if the disease lasts a year or more, as well as in cases of extensive lesions and degenerative changes in the nails.
Most often, elderly patients are prescribed systemic antifungal agents from the allylamine and triazole group.
Preventive measures
If you have signs of fungus on your little finger or thumb, see your doctor immediately. But steps can be taken to prevent the development of this disease. The following recommendations must be respected:
- wash your feet at least once a day;
- wash socks daily and wear clean socks;
- if you sweat excessively, use special foot deodorants;
- Wear shoes of the right size, they should not be too tight and they should be washed daily;
- use only personal hygiene products, as well as manicure and pedicure tools;
- when visiting the swimming pool, beach, sauna, use personal rubber shoes;
- After visiting the pool, sauna, wash your feet with soap and water, if necessary, use pharmaceutical preparations for prevention.
Toenail fungus is a disease that is quite difficult to cure in its advanced stages. At the first symptoms, you should consult a doctor. Treatment depends on the stage of development of onychomycosis: at the initial stage, local medications are sufficient; when initiated, systemic antifungals are required.