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toenail fungus

yellow toenails due to fungus

Toenail fungus is a disease of an infectious nature, caused by fungal 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 cause the development of a pathological nail condition, but they are all combined into these three large groups.Furthermore, in up to 90% of cases, the cause of nail plate disease is fungi belonging to the group of dermatomycetes, of which there are up to 20 different species.Yeast fungi of the genus Candida do not cause nail diseases so often, in approximately 10% of cases.The remaining small percentage of morbidity is due to infection of the nail by fungal mold organisms.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 entire world population.The prevalence of the disease among the population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of a particular person, his age, sex and profession.Additionally, dermatologists are seeing a steady increase in the number of cases among both adults and children.The likelihood of developing toenail fungus increases with age (the disease is more common among people over 65).

Symptoms of toenail fungus

The symptoms of toenail fungus will depend on the type of pathogen causing the infection, as well as the extent of 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. Symptoms of normotrophic nail fungus..The color of the affected plaque changes, but the thickness and gloss remain the same.First, streaks and spots appear on the nail;Its shape and size vary, its location is the lateral parts of the nail.The color of such spots is ocher yellow or white;If the disease is not treated, the spots increase in size and gradually cover the entire plaque area.The nail completely changes color, remaining its 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, whether 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 in dimensions greater than 2 mm or more.This increase occurs due to the increased growth of skin flakes under the nail.There is a loss of shine, the affected plates become dull and begin to crumble.As a result, the nail is severely deformed.The more advanced the stage of the disease, the greater the degree of deformation.Onychomycosis, the acquisition by the nail of a shape similar to 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 accompanying this form of nail fungus leads to the fact that a person begins to feel pain when walking.The color of the nails becomes dark yellow or gray.
  3. Symptoms of atrophic nail fungus..First of all, patients notice a change in the color of the plaque;turns brownish gray.The normal shine is lost, the nail surface 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, result and prevention) On the surface of the bed, the patient discovers layers of loose consistency, consisting 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 fungal 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, which have a yellowish color.When toenail fungus occurs due to infection with mold and fungal organisms, the nail plates may turn blue-green to black.The nail itself begins to crumble and becomes rough on the sides.Over time, the affected parts die, causing the shape of the plaque to become deformed.The nail bed is partially exposed.The final stage of the disease is characterized by the complete destruction of the nail and the opening of a bed with flakes of skin on top.If the clinical picture of distal nail fungus is complemented by lateral onchomycosis, the ridges surrounding the nail swell, redden and become thicker.A man suffers from pain.When the pathology is aggravated by a bacterial infection, pus may come out from under the nail if it is lightly pressed.
  5. Symptoms of proximal nail fungus..This rare nail plate lesion mainly affects the area on the side of the skin fold.The main cause of proximal nail fungus is the removal of the eponychium (cuticle).The nail plate begins to turn white in the area located next 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 surrounds the entire nail and destroys it completely.
  6. Symptoms of total nail fungus..If the lateral, distal, or proximal form of the disease is not treated, complete onychomycosis occurs.The nail loses its color, begins to crumble, break and is completely destroyed.
  7. Symptoms of superficial white nail fungus..Opal white spots appear in the back cushion area which, as the fungus multiplies, completely covers the entire nail.The spots tend to merge and visually may resemble scattered fine powder.

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

  • Nails crumble;
  • Change the color of the plate;
  • Dissection of the nail phalanx;
  • Painful sensations that arise as the pathological process progresses;
  • Itchy skin may occur in the area surrounding the nail.

Causes of toenail fungus

Toenail fungus always appears as a result of infection by fungal organisms.Most often they are dermatomycetes.Increased keratophilicity is a distinctive characteristic of the fungi included in this group.A wide range of proteolytic enzymes they possess help them penetrate the skin and nails.First, dermatomycetes infect the skin of the feet, and then spread to the nail plates.

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

  1. From below 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 of the connections between the bed and the slab, 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 into its depths much less frequently.This distribution method is available only for dermatomycetes with pronounced keratolytic abilities.In this case, the process of nail destruction will proceed much faster.
  3. The rarest route of spread 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, destroying the collagen structures of the nail phalanx from there.If the nail lesion is caused by fungi of the genus Candida, then the proximal ridge with its swelling and thickening will be the first to be involved in the pathological process.However, most 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.
  • Wearing things made of synthetic materials, wearing narrow and uncomfortable shoes.As a result, a favorable, humid and warm environment is created, in which fungi multiply rapidly.
  • A sympathetic type of autonomic regulation, in which a person experiences increased sweating.This factor is related to the individual characteristics of the body.
  • Flat feet or narrow spaces between the toes, as anatomical characteristics 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.
  • Alterations in the functioning of the immune system.In addition, nail fungus is not the only disease that causes a decrease in protective forces.Other organs are also susceptible to fungal damage.
  • Varicose veins.
  • Climatic characteristics of the area in which a person lives.Most often, fungal infections affect people who live in areas with temperate or cold climates.The fact is that there you often have to wear warm clothes, thick and tight shoes, thus creating favorable conditions for the functioning of the fungus.Residents of subtropical countries are also at risk, since the development of the fungus is facilitated by high humidity and general ambient temperature.
  • Age-related changes in the human body.Most often, toenail fungus is diagnosed in older and older adults.However, dermatologists and mycologists note a growing trend in incidence among adolescents and children.Thus, statistics indicate that every 10 years of life lived increases the risk of infection 2.5 times.While in childhood the probability of fungal infection is 3%, in the elderly this figure 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 has been found that men get sick almost three times as often as women.However, it is men who seek qualified help less frequently.
  • Profession costs.Foot fungus is most often found in miners caring for nuclear power plant workers and workers at metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas pollution, the higher the risk of infection.In this sense, visits to specialists for fungal infections by sauna, bath and laundromat workers are becoming more frequent.Frequent visitors to mycologists are masseuses, orthopedists, employees of nursing homes and other representatives of service personnel.
  • Associated pathologies.The greatest danger in this regard is diabetes mellitus, deformities of the feet, 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, corticosteroid and cytostatic medications.

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

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

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

Why are foot fungus dangerous?

It is a mistake to perceive toenail fungus as a purely aesthetic problem.This is a serious disease 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 mycoses of the skin and its appendages in case 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 immunosuppressive or cytostatic therapy.
  • Impaired nail growth 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. fungal infection), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Foot fungus never affects the nail all at once.

The disease usually progresses slowly and goes through several stages of development:

  1. The early 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 area of the free edge of the nail.
  2. Stage of normotrophic lesion of the nail plate.When thickening has not yet occurred and there is no subungual hyperkeratosis, but the traces made 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 serous content can come out from under the nail.
  3. Hypertrophic lesion stage.First, onychauxis is formed - a subungual lesion, the nail thickens and hypertrophy increases.The plaque changes color and, depending on the type of pathogen, crumbles, exfoliates, thins, stops growing, or becomes deformed.As a result, the nail is completely lost.

The initial stage of toenail fungus.

Most often, the infection is preceded by damage to the skin of the feet.An itchy 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 the other of its edges.This largely depends on the type of pathogen and the route of infection, which were described above.

As a rule, the initial stage is not available for self-diagnosis, since there are no obvious clinical signs.Streaks and spots on nails are practically indistinguishable to the naked eye.Detection of the disease is possible in laboratory conditions.

Advanced toenail fungus

Advanced foot fungus is characterized by complete damage to the nail phalanx.With a prolonged absence of therapy, the probability 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 of the hands.

The main indicators of the advanced stage of the disease are crumbling, separation and deformation of the nails.Thinning of the nail body and color change occurs gradually over many years.A rapid transition to the full stage of the disease is possible only against the background of existing systemic diseases, which occur more often 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 toenail fungus

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

It is the abundance of available antifungal drugs that makes independent choice of a drug difficult.After all, the fungus can affect not only toenails, but also mucous membranes, any organs and tissues.That is why it is so important to undergo a comprehensive diagnosis and receive medical recommendations on 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 drugs not only destroy fungal organisms and stop their development, but also tend to accumulate in the thickness of the nail plate and remain there for a long time.This allows you to significantly reduce the duration of treatment, up to 8 – 16 weeks.This time will be enough to completely solve the problem.What is important is an integrated therapeutic approach, a combination of local treatment with oral medications.This begs the question: how to choose a medication and get rid of toenail fungus?Below we will consider all modern types of medicines.

Antifungal nail polish

When toenail fungus has not reached an advanced stage, only local therapy can be used.To do this, specialized varnishes or solutions containing antifungal components can be used.

Additionally, to achieve a therapeutic effect, patches that have a peeling effect can be used.To make your nails look more attractive, you can apply manicure polish over the medicated polish.

To achieve the maximum effect when treating nail fungus with varnish, it is necessary to adhere to certain rules:

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

Toenails have the ability to accumulate the drug to a greater extent than fingernails.It is not advisable to combine varnishes, since their therapeutic effect will be less.

There are also certain contraindications to antifungal varnish therapy:

  1. Breastfeeding period;
  2. Have a fetus;
  3. Individual intolerance to the components of the drug;
  4. Childhood.

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

Rules for using antifungal varnishes:

  • Using a nail file, you should 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 vaporize the nail;
  • Apply the remedy;
  • Once a week it should be removed with a common solvent.

Remedies to eliminate nails affected by fungus

Before applying the nail remover, it is necessary to steam your feet in water, where there is a teaspoon of liquid soap and baking soda per 1000 ml.The feet are then dried and the skin around the affected nail is 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 an adhesive plaster.

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

Antifungal tablets

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

Local treatment with cream, spray, ointment.

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

However, complete recovery can only be verified by performing tests that patients undergo 14 and 30 days after completing therapy.If during treatment the skin on the legs begins to peel and turn red, this is a manifestation of an allergy that arises in response to the use of the drug.Therefore, it is important to stop treatment in time.

Other media

Oils: tea tree and lavender.As for lavender oil, it 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 should soak your feet in the resulting solution for about a quarter of an hour.This is an excellent addition to the main antifungal treatment.

laser treatment

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

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

Prevention of toenail fungus.

If a person's immune system is functioning properly, toenail fungus will not cause harm even after infection, as the immune system will neutralize it on its own.If a fungal infection spreads along the nail plate, then it is necessary to select the best methods to combat it.

This is a fairly laborious process, so the following preventive measures can help prevent infections:

  • You should avoid walking barefoot on the beach;
  • Closed rubber slippers are optimal shoes for saunas and baths;
  • Everyday socks should be made of cotton fabric;
  • It is prohibited to put on someone else's shoes;
  • You must keep your feet dry.