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Nail fungus

yellow nails due to fungus

Nail fungus is an infectious disease caused by mycotic organisms, such as dermatomycetes, molds and yeast-like fungi of the genus Candida.In fact, there are up to 50 species of fungi that can lead to the development of a pathological condition of the nail, but they are all combined into these three large groups.Furthermore, in up to 90% of cases, the cause of nail plate disease are fungi belonging to the group of dermatomycetes, of which there are up to 20 different species.Yeast-like fungi of the genus Candida do not cause nail disease as often, in about 10% of cases.The remaining small percentage of morbidity occurs due to nail infection with mycotic fungi.Nail fungus in medical terminology sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite wide.Foot fungus affects up to 20% of the world's population.The prevalence of the disease in the population is influenced by several factors: the climatic conditions in which the population lives, the social conditions of a given person, their age, sex and profession.Additionally, dermatologists see a steady increase in the number of cases among adults and children.The likelihood of developing nail fungus increases with age (the disease is more common among elderly people over 65).

Nail fungus symptoms

The symptoms of nail fungus will depend on the type of pathogen causing the infection, as well as the extent of the damage to the nail plate.The patient's age can affect the speed of recovery.It is known that in childhood the nail phalanges are affected much less frequently than in the elderly.

Symptoms vary depending on the form of the fungus:

  1. Normotrophic nail fungus symptoms.The color of the affected plaque changes, but the thickness and shine remain the same.First, stripes and spots appear on the nail - their shape and size vary, the location is the lateral parts of the nail.The color of these spots is ocher-yellow or white;If the disease is not treated, the spots increase in size, gradually covering the entire plaque area.The nail completely changes color while maintaining normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists of the inability of the plate to grow to the nail bed.As a result, the patient can easily remove it - accidentally or intentionally.
  2. Symptoms of hypertrophic nail fungus.In addition to discoloration, this form of the disease is characterized by thickening of the plaque to dimensions exceeding 2 mm or more.This increase occurs due to the increased growth of skin scales under the nail.There is a loss of shine, the affected plates become opaque and begin to crumble.As a result, the nail becomes severely deformed.The more advanced the stage of the disease, the greater the degree of deformation.Onychomycosis - the nail acquiring a shape similar to that of a bird's claw, is a common symptom of the hypertrophic type of the disease.The lateral parts of the nail are the most damaged.The complex of symptoms that accompany this form of nail fungus causes the person to begin to feel pain when walking.The color of the nails becomes dark yellow or gray.
  3. Symptoms of atrophic nail fungus.First, patients notice a change in the color of the plaque;becomes brownish gray.Normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the plaque is destroyed.The final stage of the atrophic form of the fungus is the exposure of the nail bed and its complete necrosis.(read also: Causes and symptoms of necrosis, outcome and prevention) Above the surface of the bed, the patient discovers layers of loose consistency, made up of skin scales.Plate atrophy occurs in stages, starting from the outer edge towards the growth zone and the nail fold.The growth zone remains intact longer than other parts of the nail.
  4. Symptoms of lateral and distal nail fungus.What these two types of mycotic lesions have in common is that they are often diagnosed in symbiosis and cause the same changes in parts of the nail plate.The affected part of the plaque loses its normal color and becomes opaque.Transverse grooves run along it, yellowish in color.When nail fungus occurs due to infection by fungi and mycotic organisms, the nail plates may turn blue-green to black in color.The nail itself begins to crumble, becoming rough on the sides.Over time, the affected parts die, causing the shape of the plaque to become deformed.The nail bed remains partially exposed.The final stage of the disease is characterized by complete destruction of the nail and opening of a bed with skin scales on top.If the clinical picture of distal nail fungus is complemented by lateral onychomycosis, the ridges surrounding the nail swell, turn red and become thicker.A man is suffering from pain.When the pathology is aggravated by a bacterial infection, pus may come out from under the nail if you press lightly on it.
  5. Symptoms of proximal nail fungus.This rare injury to the nail plate mainly affects the lateral area of the skin fold.The main cause of proximal nail fungus is removal of the eponychium (cuticle).The nail plate begins to turn white in the area located close to the growth zone.The fungus locates its spores and mycelium precisely in the nail tunnels located in this area.As the fungus multiplies, it envelops the entire nail and completely destroys it.
  6. Symptoms of Total Nail Fungus.If the lateral, distal or proximal form of the disease is not treated, total onychomycosis occurs.The nail loses its color, starts to crumble, break and is completely destroyed.
  7. Symptoms of White Superficial Nail Fungus.Opal-white spots appear in the region of the posterior pad, which, as the fungus multiplies, completely covers the entire nail.The stains tend to merge and visually may resemble scattered fine powder.

Despite the differences in clinical manifestations in different forms of fungal infection, several common symptoms can be identified, including:

  • Nail disintegration;
  • Change the color of the plate;
  • Dissection of the nail phalanx;
  • Painful sensations that occur as the pathological process progresses;
  • Itchy skin may occur in the area around the nail.

Causes of nail fungus

Nail fungus always appears as a result of infection with mycotic organisms.Most of the time they are dermatomycetes.Increased keratophilicity is a distinctive feature of the fungi included in this group.They are helped to penetrate the skin and nails by a wide range of proteolytic enzymes that they possess.First, dermatomycetes infect the skin of the feet and then spread to the nail plates.

There are three possible ways they penetrate deep into the nail:

  1. Underneath the distal (free, lateral) edge of the nail.In this case, the pathological process will be located under the plate - in the bed, and not in the nail itself.As the fungus proliferates, subungual hyperkeratosis develops.This leads to a deterioration in the bonds between the bed and the plate, followed by their separation.From the bed, the fungi penetrate the nail and slowly destroy it.
  2. Through the dorsal part of the nail, fungi penetrate its depths much less frequently.This delivery method is only available for dermatomycetes with pronounced keratolytic abilities.In this case, the process of nail destruction itself will be much faster.
  3. The rarest route of propagation is through the proximal ridge.From the final part of the matrix, the fungus penetrates under the nail plate and into the bed, or settles in the matrix, from there destroying the collagen structures of the nail phalanx.If the nail lesion is caused by fungi of the genus Candida, the proximal ridge with its swelling and thickening will first be involved in the pathological process.However, more often this inflammatory process affects the nails.

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

This happens under the influence of the following provoking factors:

  • Mechanical injuries.
  • Exposure to chemical factors, such as: regular contact with detergents containing synthetic components, constant contact with water, application of degreasers, etc.
  • Wear things made from synthetic materials, wear narrow, uncomfortable shoes.As a result, a favorable, moist and warm environment is created in which fungi multiply rapidly.
  • A sympathetic type of autonomic regulation, in which a person suffers from increased sweating.This factor is related to the individual characteristics of the body.
  • Flat feet or narrow spaces between the toes, as anatomical features of foot development.Such deformations lead to a significant deterioration in the aeration of the foot.
  • Nail growth rate.
  • Failure to comply with personal hygiene rules.
  • Disturbances in the functioning of the immune system.In addition, nail fungus is not the only disease with a decrease in protective forces.Other organs are also susceptible to mycotic damage.
  • Varicose veins.
  • Climatic characteristics of the area in which the person lives.More often, fungal infections affect people who live in areas with a temperate or cold climate.The fact is that it is often necessary to wear warm clothes, thick and tight shoes, creating favorable conditions for the fungus to function.Residents of subtropical countries are also at risk, as the development of the fungus is facilitated by high humidity and ambient temperatures in general.
  • Age-related changes in the human body.More often, toenail fungus is diagnosed in increasingly older adults.However, dermatologists and mycologists note an increasing trend in incidence among adolescents and children.Thus, statistics indicate that every 10 years of life lived increases the risk of infection by 2.5 times.While in childhood the probability of mycotic infection is 3%, in the elderly this number increases to 50%.Experts attribute these indicators to the fact that as we age, the rate of plaque growth slows down, bed nutrition deteriorates, and angiopathy develops.
  • Gender.It was found that men get sick almost three times more often than women.However, it is men who seek qualified help less.
  • Profession costs.Foot fungus is most often found in miners serving workers at nuclear power plants and in workers at metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gaseous pollution, the greater the risk of infection.In this sense, visits to specialists regarding fungal infections by workers in saunas, baths and laundries are becoming more and more frequent.Frequent visitors to mycologists are massage therapists, orthopedists, employees of nursing homes and other representatives of the service personnel.
  • Associated pathologies.The greatest danger in this regard is diabetes mellitus, foot deformities, excess body weight, gastrointestinal diseases, metabolic disorders, thyroid pathologies, any peripheral angiopathy, for example, with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus by 5 times.(read also: Causes, symptoms, diagnosis and prevention of HIV)
  • Taking antibacterial medications, corticosteroids and cytostatic medications.

As for direct routes of infection, this most often occurs in the following cases:

  1. Visiting saunas and baths, swimming pools and public showers - any public places where people go barefoot for some time;
  2. The use of common household items (even intra-family items), such as cloths, slippers, pumice stones, rugs;
  3. Carrying out cosmetic procedures, including pedicures, in beauty salons where hygiene standards are not observed.

It is worth knowing that the greatest danger in this regard are wooden floors, benches and other items made from this natural material.The fact is that wood has a porous structure and it is almost impossible to remove fungal mycelium from it.

Why is foot fungus dangerous?

It is wrong to consider nail fungus as a purely aesthetic problem.This is a serious illness that requires qualified treatment.After all, onychomycosis is one of the most common chronic diseases.Untreated foot fungus is dangerous due to the following complications:

  • Spread of mycosis of the skin and its appendages in the occurrence of immunodeficiency conditions.
  • Development of the diabetic foot in the context of diabetes mellitus.
  • Development of erysipelas of the lower extremities.
  • Development of elephantism.
  • Development of lymphostasis.
  • Development of invasive mycosis in patients undergoing immunopressive or cytostatic therapy.
  • Impaired growth of nails and their rotation into the surrounding tissues, which is accompanied by severe pain and an inflammatory reaction.
  • Development of eczema.
  • The addition of a bacterial infection and the development of inflammation.
  • Loss of the nail plate, exposure of the nail bed.
  • The development of aspergillosis (i.e., mold fungal infection), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of nail fungus

Foot fungus never affects the nail all at once.

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

  1. The initial or initial stage is a marginal lesion.In this case, any pathological changes are practically invisible.The manifestation of the process is expressed in the appearance of narrow gray stripes located in the region of the free edge of the nail.
  2. Stage of normotrophic damage to the nail plate.When thickening has not yet occurred and there is no subungual hyperkeratosis, but traces left by the fungus are visible.They look like stripes and sectors of damaged plates.The fragility of the phalanx increases and its color changes.Sometimes the serous contents can come out from under the nail.
  3. Hypertrophic injury stage.First, onychauxia forms - a subungual lesion, the nail becomes thicker and hypertrophy increases.The plaque changes color and, depending on the type of pathogen, crumbles, exfoliates, becomes thinner, stops growing or becomes deformed.As a result, the nail is completely lost.

The initial stage of nail fungus

Most often, the infection is preceded by damage to the skin of the feet.An itching sensation occurs in the interdigital folds, cracks, blisters and maceration may appear.As it penetrates deeper into the nail, the fungus begins to affect one or another of its edges.This largely depends on the type of pathogen and the route of infection described above.

As a rule, the initial stage is not available for self-diagnosis, as there are no obvious clinical signs.Stripes and stains on nails are practically indistinguishable with the naked eye.Detection of the disease is possible under laboratory conditions.

Advanced nail fungus

Advanced foot fungus is characterized by complete damage to the nail phalanx.With a prolonged absence of therapy, the likelihood of not only complete destruction of the nail increases, but also damage to the skin, as well as the spread of the disease to the nails on the hands.

The main indicators of the advanced stage of the disease are disintegration, separation and deformation of the nails.Thinning of the nail body and color change occurs gradually over many years.A quick transition to the full stage of the disease is possible only against the background of existing systemic diseases, which most often occur in old age.The final stage is the destruction of the nail plate or its severe deformation, as well as the development of serious complications that can cause foot fungus.

How to get rid of nail fungus

The modern pharmaceutical industry offers people who have been diagnosed with nail fungus a wide selection of effective medications to combat the problem.There are local and general means of action.

It is the abundance of available antimycotic drugs that makes it difficult to independently choose a medicine.After all, the fungus can affect not only toenails, but also mucous membranes, any organs and tissues.Therefore, it is very important to make a comprehensive diagnosis and receive medical recommendations regarding the treatment of nail fungus.

Therapeutic tactics are based on four points:

  • Accounting for the affected area;
  • Time elapsed since the onset of the disease;
  • The nature of the pathological changes caused by the disease;
  • Presence of concomitant pathology.

Modern medicines not only destroy fungal organisms and stop their development, but also tend to accumulate in the thickness of the nail plate, remaining there for a long time.This makes it possible to significantly reduce the duration of therapy, up to 8 to 16 weeks.This time will be enough to completely get rid of the problem.What is important is an integrated therapeutic approach, a combination of local treatment with oral medications.This raises the question: how to choose a medicine and get rid of nail fungus?Below we will consider all modern types of medicines.

Antifungal nail polish

When nail fungus has not reached an advanced stage, only local therapy can be used.For this purpose, specialized varnishes or solutions containing antimycotic components can be used.

Also, to achieve a therapeutic effect, you can use patches with a peeling effect.To make your nails more attractive, you can apply manicure polish over the medicated nail polish.

To get the maximum effect from treating nail fungus with varnish, you must follow some rules:

  • You should not complete treatment on your own until you receive laboratory data indicating the absence of fungus on the nail;
  • The application of the varnish must be regular and without skips;
  • Treatment can last a year and this is a necessary measure to get rid of the mycotic organism.

Toenails have the ability to accumulate the drug to a greater extent than fingernails.You should not combine varnishes, as their therapeutic effect will be lower.

There are also certain contraindications to antifungal varnish therapy:

  1. Lactation period;
  2. Carrying a fetus;
  3. Individual intolerance to the components of the drug;
  4. Infancy.

Sometimes redness is possible in areas of the skin located around the nail.

Rules for using antimycotic varnishes:

  • Using a nail file, you need to remove as much of the affected nail as possible;
  • Degrease the surface of the nail with a water and alcohol-based solution, or use a soap and soda bath to steam the nail;
  • Apply the medicine;
  • Once a week it must be removed with common solvent.

Remedies to remove nails affected by fungus

Before applying the nail remover, you need to steam your feet in water, where there is a teaspoon of liquid soap and soda per 1000 ml.Then the feet are dried, the skin around the affected nail must be fixed with an adhesive plaster.The product is applied to the affected area in a thick layer, but without rubbing.The top of the nail is also fixed with adhesive tape.

After 4 days, the sticker is removed, the feet are steamed and the nail affected by the fungus is simply scraped with manicure tools.

Antifungal tablets

Systemic antibacterial agents are necessary in cases where nail fungus has reached an advanced stage.Only a doctor can choose the optimal treatment regimen.There are many pills that can eliminate fungus, but some of them are incompatible with hormonal contraceptives, some cannot be taken in childhood, and some are prohibited for use if you have liver problems.

Local treatment with cream, spray, ointment

If the therapy was selected correctly and the symptoms of the fungal infection were completely eliminated, and the scheme was completed, the affected nail tissue will eventually be replaced with a healthy one.

However, complete recovery can only be verified by carrying out tests that patients undergo 14 and 30 days after the end of therapy.If during treatment the skin on your legs begins to peel and turn red, this is a manifestation of an allergy that occurs in response to taking the medication.Therefore, it is important to stop treatment in time.

Other means

Oils: tea tree and lavender.Lavender oil can eliminate irritation, and tea tree oil helps fight bacteria.However, it is important that the oil is natural;only in this case can they have the desired effect.

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 complement to the main antimycotic treatment.

laser treatment

Treatment of the disease with a laser beam is a physiotherapeutic treatment method.It can only be used in combination with antifungal medications to achieve effect.Laser therapy alone does not completely eliminate nail fungus.This procedure aims to improve nail nutrition and increase blood circulation.As a result, the antimycotic medicine penetrates the damaged plaque better.However, the laser alone cannot kill the fungus.

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

Nail fungus prevention

If a person's immune system works properly, nail fungus will not harm them even after infection, since the immune system will neutralize it on its own.If a fungal infection still spreads along the nail plate, it is necessary to select the best methods to combat it.

This is a rather laborious process, so the following preventive measures can help prevent infection:

  • You should avoid walking barefoot on the beach;
  • Closed rubber slippers are ideal footwear for saunas and baths;
  • Socks for daily use must be made of cotton fabric;
  • It is prohibited to wear other people's shoes;
  • You must keep your feet dry.