Nail fungus (onychomycosis)
Nail fungus (medical name onychomycosis) is a fairly common disease. According to medical estimates, more than 15% of the world’s population suffer from it, although this pathology is diagnosed much less often (in 2% of people). This discrepancy is explained simply: nail fungus does not threaten life, and if it worsens its quality, then in most cases it is very insignificant. Therefore, they do not always turn to a doctor about onychomycosis, trying to cope with the disease on their own or simply leaving it without treatment.
Nail fungus develops quite slowly. Therefore, the first signs of a fungal lesion usually escape the patient’s attention. When the nail changes caused by the fungus begin to catch the eye, it means that the process has already gone far enough, and it will not be easy to defeat the fungus.
Onychomycosis is often perceived as a cosmetological problem: nails affected by fungus look ugly. But it is necessary to fight the fungus not only in order to return the nails to the correct shape and shine. If the fungus is not treated, it will spread further. Usually the nail of the big toe is affected first. If the treatment is not started, the fungus passes to other toes, and since we inevitably touch our feet with our hands, then it is possible to get infected with nail fungus on our hands as well. The fungus also spreads to the skin surrounding the nail, causing it to become irritated and itchy.
Causes of onychomycosis
Onychomycosis can be caused by various types of fungi. First of all, these are dermatophytes. In second place are yeast fungi of the genus Candida, which are always present in small quantities on human skin (they often affect the nails of the hands). Infection with mold fungi is also possible (they usually accompany other pathogens. isolated lesion by mold fungi is typical not for our, but for a tropical climate).
The risk of fungal infection increases with age. In children, nail fungus is very rare, and, conversely, in older people it is detected relatively often. At the same time, men suffer from onychomycosis more often than women.
The age-specific nature of the fungus is explained by the fact that our local immunity decreases over the years, whereas the natural defense of a young organism, as a rule, suppresses the activity of fungi well, preventing them from colonizing the nail plate. There is a dependence not only on local immunity, but also on general immunity. Weakening of the general immunity is a favorable background for the development of any fungal infection.
For fungi of the genus Candida, it is enough that there are problems with immunity: they simply begin to multiply actively. Mushrooms of other species still need to somehow get into our body from the external environment. Some types of fungi can be carried by animals. Mold fungi are found everywhere; they are able to reproduce without having a carrier. However, in most cases, the fungal infection spreads from person to person.
Mushrooms love a humid environment. Therefore, infection with fungus often occurs in places where humidity is increased. These are swimming pools, saunas, changing rooms, gyms. Wearing socks and shoes on wet feet can also be a provoking factor.
If there are wounds and cracks, they allow the infection to get right inside the tissues, avoiding the need to storm the protective barrier that forms the surface of our skin.
The spread of fungi is facilitated by negligence in relation to personal hygiene: you can not use someone else’s slippers, soap, towel. It is due to the fact that not every family follows this rule, nail fungus often becomes a family disease.
Nail damage usually starts from the edge. Dermatophytes penetrate under the free edge of the nail plate (into the sub-elbow notch). In this case, the pathological process develops mainly in the nail bed. The second way of penetration of fungi is from the nail roller. Candida fungus usually affects the posterior nail roller first (paronychia occurs), and only then the nail itself suffers. One of the types of dermatophytes (i.e. mentagrophytes) can penetrate directly through the nail plate.
Symptoms of onychomycosis
The first sign of a fungal lesion is the loss of shine by the nail, clouding, discoloration. In cases where the infection affects the skin around the nail, itching is observed. If treatment is not started, the fungus begins to destroy the nail plate: the surface of the nail becomes rough, the nail can delaminate, peel off, break, crumble.
Specific manifestations depend on the pathogen, as well as on the localization, duration of the pathological process and its form. There are normotrophic, hypertrophic and atrophic forms of fungal lesions.
It is characterized by the fact that the thickness of the nail plate remains unchanged. The disease manifests itself in the form of white or yellowish spots that gradually increase in size. In the end, the color of the entire nail changes. The nail plate may peel off, as the fusion of the nail with the subcutaneous tissues is disrupted.
It is characterized by a significant increase in the thickness of the nail plate (due to the proliferation of the subarticular epithelium). The nail acquires a brownish-yellowish or gray color. The nail plate is usually actively crumbling. The nail is especially strongly destroyed from the sides, acquiring a claw-like shape as a result.
With this form of fungal infection, the nail is thinned and destroyed, starting from the outer edge. The destruction goes deep into the posterior nail roller; the nail bed is filled with a loose mass formed by decaying epithelial particles. Eventually, the nail may be completely lost.
Methods of diagnosis of onychomycosis
Discoloration and brittle nails should be a reason to consult a dermatologist. It is not necessary to replace the doctor and diagnose yourself yourself – you can make a mistake: nail changes may have a different reason.
The doctor makes a diagnosis based on a visual examination (a microscope can be used). Laboratory diagnostics is performed to confirm the diagnosis. It is also necessary in order to determine the type of pathogen (this will allow you to prescribe the most effective treatment).
At the reception, the doctor will make a scrape from the affected nail plate. If the pathological process has affected only the free edge of the nail, then a scraping of the subarticular epithelium is also taken.
Microscopy is performed in the laboratory. Cultural studies are also carried out (the material is placed in a favorable environment and they see if a colony of fungi will arise). Cultural studies allow us to determine which fungi caused the disease.
Methods of treatment of onychomycosis
Treatment of nail fungus involves removing the affected part of the nail. Further, treatment is carried out with the help of antifungal agents of local action (ointments, drops, sprays, varnishes). In case of significant lesions, the doctor may prescribe general antimycotic agents (tablets).
Since the activity of fungi increases against the background of problems with immunity, the proposed course of treatment may include measures aimed at improving overall immunity.
Local remedies (ointments, creams, drops) should preferably be applied to the open nail bed. Do not stop treating the lesion site before the expiration of the period prescribed by the doctor. Before removing the treatment, the doctor will most likely do another scraping so that a laboratory study confirms the absence of the fungus. Otherwise, the risk of recurrence of the disease is high.