Nail fungus (onychomycosis)

Onychomycosis is a disease of the hands, feet and nails caused by the fungal flora, which gradually leads to the destruction of the nail plate, and its structure, color, and shape change.

The pathogens of onychomycosis include three fungi:

• Skin fungus. Dermatomycetes are parasitic fungi, and their main representatives are Trichophyton, Microsporum, and Epiderm. In 80-85% of cases, dermatophytes become the source of nail fungus.
• Candida fungus (similar to yeast). Candida is present in any human flora, but due to its nature, it can start to multiply rapidly, causing nail fungus. In 8-10% of cases, Candida infects the nail surface.
• Moldy. Mold is the most likely cause of nail fungus. They are only infected in 5-6% of cases.

Causes of nail fungus

In 100% of cases, gray mold disease occurs due to skin damage caused by fungal pathogens. The contact of the skin of the foot with the infected surface causes the fungus to penetrate through the upper layer of the epithelium into the nail and thus cause further deformation of the nail plate. Depending on the location of the lesion, the following types of onychomycosis may occur:

• The fungus enters the nail bed through the edge surface of the nail. Since there are almost no symptoms in the first few days of infection, it is difficult for patients to notice any changes. But as the fungus grows on the roots of the nails, hyperkeratosis begins to develop. Hyperkeratosis is caused by the color of the nail changing from light pink to light yellow, and the connection between the nail surface and the nail bed is also weakened, resulting in delamination and peeling.
• Fungi can enter the nail through the free surface of the nail plate. This happens when the spore has a high keratin-solubilizing capacity (rapidly destroying keratin). In this case, compared with the first option, the nail infection occurs faster.
• Go through the nail crease (the area of the skin near the nail plate). However, this method of infection is less common, and the inflammatory process of the nail matrix (root area) can begin.

Risk factors that may cause fungal nail infection

• Flat feet or other characteristic structures, developed feet;
• Varicose veins in the legs;
• Reduced immunity due to previous diseases;
• HIV infection;
• Increased sweating;
• Wearing shoes and clothes made of synthetic materials;
• Low foot aeration. Occurring again due to uncomfortable and tight shoes;
• Mechanical injury of the foot;
• Scratches, abrasions, open wounds;
• Remove nails that have grown;
• Often use antibiotics;
• Candidiasis (mainly in women);
• Complications. Diabetes, thyroid disease, skin disease, stomach disease, pancreatic disease, overweight, etc. may also increase the risk of onychomycosis by 6-8 times;

Well, in addition to these factors, there are other methods that can make you directly infected with nail fungus.

• Use general personal hygiene products (pumice, towels, slippers, flip-flops)
• Visit public saunas, baths, swimming pools, changing rooms, no shoes.
• Wear someone else’s shoes
• Does not meet the sterilization standards of beauty salons (especially for pedicures).

Symptoms, the form of onychomycosis

The symptoms of the disease depend on many factors: age, form of onychomycosis, degree of infection, condition of the entire body. The symptoms of nail fungal infection are accompanied by itching, burning, and skin irritation.

Currently, dermatologists divide nail fungal damage into five main forms:

• Hypertrophy. Its characteristic is that the nail plate thickens sharply. The thickness of the nail may exceed 3-4 mm-this is due to the increase of small skin scales that grow on the surface of the infected nail. The side part of the nail plate suffered the most damage. On the contrary, the middle (central) part becomes thicker. At the edges, the nails begin to collapse strongly. Due to hypertrophic injury, the nail becomes curved, narrow and very thick. In addition, the color of nails will change drastically, accompanied by peeling.
• Being nutritious. This is the simplest form, because the nail affected by the fungus does not thicken, but stays the same. Only the color of the nail plate will change. The fungus starts with the appearance of small yellow spots and then increases rapidly in size. If you do not consult a specialist and do not start treatment, the size of the stain will increase over time, gradually capturing the entire area of the nail plate. Since a person can quickly detect color changes, onychomycosis can be diagnosed quite early in the disease.
• Atrophic (osteolytic). The atrophic form of onychomycosis is accompanied by a sharp change in nail color from pink to gray, which subsequently destroys the structure of the nail. It is characterized by rapid development, which eventually leads to the nail plate being completely separated from the nail bed. In other words, the patient may accidentally hook or pry the infected nail and “remove” it completely. The final stage of atrophic fungus is the necrosis of nail tissue.
• Side and distal. Usually combined with the distal type of the fungus to diagnose the lateral morphology. The symbiosis of these variants can cause discoloration of the nail plate, first with longitudinal yellowish grooves, and then an increase in nail lesions. Within 4-5 weeks, without proper treatment, nail cells will begin to die, and the nail itself will collapse severely. The final stage of fungal-induced lateral nail lesions is the complete exposure of the nail bed, which is very dangerous and there is a risk of mucosal infection.
• The general form of onychomycosis. For any of the above types of onychomycosis, the total fungus is lack of treatment. Please note that the nail will quickly change color, fall off, collapse, and then completely drain from the nail bed. In this case, it is not only necessary to consult a dermatologist, but also a surgeon.

The staging of onychomycosis

To prevent yourself from being infected by toenail fungus, it is important to remember that the infection and subsequent nail deformation will never happen overnight. In medical terms, this is the primary focus of the disease, the positive trophic stage and the hypertrophic stage.

In the initial stage, the nails are only affected at the edges. At the same time, the size of the affected area does not exceed 2-3 mm. In rare cases, the free edge of the nail may be affected. Before the nails are directly damaged, the skin of the feet will be infected. The patient feels itching, rubbing and corn, and painful calluses may appear. Over time, the fungus spreads from the feet to the nails. If you find a change at this time and consult an expert, you have the opportunity to completely save and restore the nail plate in a short time.

The positive nutrition stage is the next stage of the disease. The intermediate process of nail plate thickening has not yet started, but the affected area of the nail is already obvious. The affected area can be small (2-4 mm) or larger (greater than 5 mm). In most cases, they are expressed in the form of thin vertical stripes with a yellowish tint. The first manifestation of toenail fungus is a change in color: it can be noticed quickly and treatment can be started on time.

The final stage of onychomycosis is the hypertrophy stage of the disease. It starts from small spots under the nails and then grows rapidly. It may be accompanied by an inflammatory process that parallels the formation of suppurative sacs. The nail plate thickened, chipped, peeled, and then became thin sharply, and finally, the nail cells died and peeled off completely.

Important note: The danger of hypertrophic nail damage is also the possibility of damage to nearby skin and transition to a chronic plane. However, the development of such an event is only possible without timely medical intervention and follow-up treatment of nail fungus.

Nail Fungus Treatment

The most widely used are various antifungal drugs. The mechanism of action of this drug not only reduces the destruction of direct spores, but also reduces the accumulation of active substances in the nail plate itself. This can avoid recurrence and protect the legs from future injuries.

Before choosing one or the other medicine, you must definitely identify the type of nail fungus through microbiology, make a comprehensive diagnosis and consult a dermatologist.

In the most modern dermatology clinics, the following methods can be used to diagnose onychomycosis:

• KOH microscope
• High-precision PCR diagnosis

Before prescribing specific drugs, a dermatologist must consider the nature of the fungal infection, the type of onychomycosis, the time elapsed since the infection, etc.

The most commonly used treatment methods: medicine, laser and traditional medicine.

Drugs

Among medicinal antifungal drugs, the most widely used are varnishes, ointments and tablets.

In the initial stage of fungus, it is recommended to use topical preparations, in which antifungal varnishes occupy an important position.

Important note: If the doctor prescribes an anti-fungal varnish, do not skip any steps, otherwise the desired effect will not be produced.

In addition to varnish, there are some special ointments and gels with the same antifungal effect. Ointment is also a topical medication. Most commonly, experts prescribe ointments. The ointment should be applied to the affected areas of the nails and feet within a period of time. The exact treatment time is prescribed by experts.

There are also antifungal drugs. Unlike ointments and varnishes, tablets are general medicines that are taken orally. The most commonly used antifungal drugs are: tablets are usually not prescribed at the initial stage of infection, but only after the fungus has entered the positive nutritional stage.

Laser fungal treatment

Currently, some clinics use lasers for hardware treatment of nail fungus. The laser beam penetrates the submandibular surface and heats it to the growth zone, which not only kills the fungus, but also stimulates the growth of new nails. Scientists’ studies have shown that as the nail plate system is heated to 60-70 degrees, fungal microorganisms will die. Since the length of the laser beam only reacts to cells affected by mold infection, only laser radiation can achieve a similar thermal effect without damaging the surrounding tissues. Although the use of laser to irradiate the lesion is expected to completely eliminate nail fungus, dermatologists usually recommend several such treatments. Compared with drug therapy, this method is much more expensive, so it is not suitable for everyone.

For those who are too lazy to see a doctor, there are some remedies in the traditional medicine arsenal

Experts recommend only combining folk methods with ongoing systematic traditional treatments. These funds can be used as preventive measures to eliminate the possibility of fungi reappearing in the future.

Here are some recipes that may be effective in treating nail fungus, but they are not necessary at all. However, in the absence of other opportunities to fight onychomycosis, the use of these simple suggestions is not forbidden.

1. Treat the affected area of the nail plate with 5% iodine solution twice a day. When using iodine, you may feel a slight tingling and burning sensation. If the discomfort worsens, this type of treatment should be stopped and other treatments should be switched to.
2. Use propolis to make a 20% tincture, and then apply it to the skin and nail areas affected by the fungus. The role of propolis is to promote the rapid regeneration of damaged cells and the recovery of nails. After just a few applications, the effect of propolis will become apparent.
3. One of the most famous ways to fight fungus alone is to use Kombucha. To prepare the compress, you need to cut off a small piece of mature kombucha, tie the mushrooms to the affected area with a bandage or gauze bandage, and leave it overnight. In the morning, untie the bandage and remove dead nails. After that, it is necessary to treat the affected area and the surrounding skin with an iodine solution or any other disinfectant. It is recommended to continue to treat nails with Kombucha for 3-4 weeks.

Prevent nail fungus infection

• Any disease, including onychomycosis, is easier to prevent than prevention. To protect yourself from nail fungus and minimize the risk of infection, you should take simple precautions to help you stay healthy.
• First of all, this is to observe personal hygiene habits, especially in public places. This also applies to your own apartment and even to public places such as saunas and bathrooms. You should always wear separate slippers and use your own loofah and pumice stone to care for your heels.
• If you notice excessive sweating on your feet, you should change your shoes or use a special sandal insole. These insoles have a porous structure, thus normalizing air circulation.
• Check your feet regularly for small cracks, scratches and cuts. If scratches are found, the area needs to be treated with preservatives (iodine and other alcohol solutions).

Like many other diseases, toenail fungus may not appear immediately, so it is very important to monitor the condition of the nails and the skin of the feet. It is best to carefully follow all prescribed precautions-these simple measures will save treatment time and money in the future.