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Nail fungus

yellow nails due to fungus

Toenail 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 grouped into these three large groups.In addition, in up to 90% of cases, nail plaque disease is caused by fungi belonging to the dermatomycetes group, of which there are up to 20 different species.Yeast-like fungi of the genus Candida do not cause nail diseases so often, in about 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 resembles 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 among the population is influenced by many factors: the climatic conditions in which the population lives, the social conditions of a particular person, their age, gender and profession.In addition, dermatologists are seeing a steady increase in the number of cases in both adults and children.The likelihood of developing toenail fungus increases with age (the disease is more common in people over 65 years old).

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 children the nail phalanges are affected much less often than in older people.

Symptoms vary depending on the form of the fungus:

  1. Symptoms of normotrophic nail fungus.The color of the affected plate changes, but the thickness and shine remain the same.First of all, stripes and spots appear on the nail - their shape and size vary, the location corresponds to the side 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 surface of the plaque.The nail completely changes color, remaining normal thickness.Onycholysis is another symptom of normotrophic nail fungus.This consists of the inability of the plaque 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 plaque thickening, the dimensions of which exceed 2 mm or more.This increase is due to increased growth of skin scales under the nail.There is a loss of shine, the affected plates become dull and begin to crumble.As a result, the nail becomes significantly deformed.The more advanced the stage of the disease, the greater the degree of deformity.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 set of symptoms that accompany 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, patients notice a change in the color of the plaque;it becomes brownish gray.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, outcome and prevention) Above the surface of the bed, the patient discovers layers of loose consistency, consisting of skin scales.Atrophy of the plate occurs in stages, starting from the outer end towards the growth zone and the nail fold.The growth area 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 certain parts of the nail plate.The affected part of the plaque loses its normal color and becomes dull.Transverse grooves run along it, which have a yellowish color.When toenail fungus occurs due to infection by mold and mycotic organisms, the nail plates may turn from 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 plate to distort.The nail bed remains partially exposed.The final stage of the disease is characterized by the complete destruction of the nail and the opening of a bed with scales of skin at the top.If the clinical picture of distal nail fungus is supplemented by lateral onchomycosis, the ridges surrounding the nail swell, turn red and thicken.A man is suffering.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 lesion of the nail plate mainly affects the area located on the side 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 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 completely destroys it.
  6. Symptoms of total nail fungus.If the lateral, distal, or proximal form of the disease is left untreated, total onychomycosis occurs.The nail loses its color, begins to crumble, break and is completely destroyed.
  7. Symptoms of white superficial nail fungus.Opal white spots appear in the back pad area which, as the fungus multiplies, completely covers the entire nail.The spots tend to coalesce and may visually resemble a fine, scattered powder.

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

  • Crumbling nails;
  • Change the color of the plate;
  • Nail phalanx dissection;
  • Painful sensations that arise as the pathological process progresses;
  • Itchy skin may occur in the area surrounding the nail.

Causes of toenail fungus

Nail fungus always appears following infection by mycotic organisms.These are most often dermatomycetes.Increased keratophilia is a distinctive feature of 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, then spread to the nail plates.

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

  1. Under the distal (free, lateral) edge of the nail.In this case, the pathological process will be localized under the plaque - 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 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 take place 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, thereby 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, this inflammatory process most often affects the nails.

For the fungus to enter the nail area, it must first be damaged and destroyed.

This occurs 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 objects made of synthetic materials, wear narrow and uncomfortable shoes.As a result, a favorable humid and warm environment is created in which mushrooms multiply rapidly.
  • A sympathetic type of autonomic regulation, in which a person suffers from increased sweating.This factor concerns the individual characteristics of the body.
  • Flat feet or narrow spaces between the toes, anatomical features of foot development.Such deformations lead to a significant deterioration of the ventilation of the foot.
  • Nail growth rate.
  • Failure to comply with personal hygiene rules.
  • Disorders of the functioning of the immune system.In addition, nail fungus is not the only disease characterized by a decrease in protective forces.Other organs are also susceptible to mycotic damage.
  • Varicose veins.
  • Climatic characteristics of the area in which a person lives.Most often, fungal infections affect people living in regions with temperate or cold climates.The fact is that you often have to wear warm clothes, thick and tight shoes, thereby creating favorable conditions for the fungus to function.Residents of subtropical countries are also at risk, since the development of the fungus is facilitated by high humidity and ambient temperature in general.
  • Age-related changes in the human body.Most often, toenail fungus is diagnosed in older and increasingly older people.However, dermatologists and mycologists note an increasing trend in incidence among adolescents and children.So, statistics indicate that every 10 years of life increases the risk of infection by 2.5 times.While in childhood the probability of mycotic infection is 3%, in older people this figure reaches 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 more often than women.However, it is men who seek qualified help less often.
  • Costs of the profession.Fungus on the feet is more common among miners serving workers at nuclear power plants and among 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 regard, visits to specialists regarding fungal infections by workers of saunas, baths and laundries are becoming more and more frequent.Frequent visitors of mycologists are massage therapists, orthopedists, employees of nursing homes and other representatives of service personnel.
  • Associated pathologies.The greatest danger in this regard is diabetes mellitus, foot deformities, excess 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.(also read: Causes, symptoms, diagnosis and prevention of HIV)
  • Take antibacterial drugs, corticosteroids and cytostatic drugs.

As for direct routes of infection, they most often occur in the following cases:

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

It is worth knowing that the greatest danger in this regard lies in parquet floors, benches and other wooden objects 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 are foot fungus dangerous?

It is wrong to consider toenail fungus as a purely cosmetic 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 fungal infections of the skin and its appendages in cases of immunodeficiency.
  • Development of diabetic foot in the context of diabetes mellitus.
  • Development of erysipelas of the lower limbs.
  • Development of elephantism.
  • Development of lymphostasis.
  • Development of invasive mycoses in patients undergoing immunopressor or cytostatic treatment.
  • Impaired nail growth and rotation in the surrounding tissues, 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. infection by mold), which is difficult to treat therapeutically.Most often, aspergillosis develops against the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

Fungus on the feet never affects the nail all at once.

The disease often progresses slowly, going 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 traces left by the fungus are visible.They look like scratches and areas of damaged plates.The fragility of the phalanx increases and its color changes.Sometimes serous contents can come out from under the nail.
  3. Hypertrophic lesion stage.First of all, 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 lesions on the skin of the feet.An itching sensation appears in the interdigital folds, cracks, blisters and maceration may appear.As it penetrates deeper into the nail, the fungus begins to affect one or both of its edges.Much 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, since there are no obvious clinical signs.Scratches and stains on nails are virtually indistinguishable to the naked eye.Detection of the disease is possible in the laboratory.

Advanced Toenail Fungus

Advanced foot fungus is characterized by total damage to the nail phalanx.In case of prolonged absence of treatment, the likelihood of not only complete destruction of the nail, but also damage to the skin, as well as the spread of the disease to the nails of the hands, increases.

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 total stage of the disease is possible only against the background of existing systemic diseases, which most often occur in older people.The final stage is the destruction of the nail plate or its serious deformation, as well as the development of serious complications that fungus on the feet can cause.

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 drugs to cope with the problem.There are both local and general means of action.

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

The therapeutic tactics are based on four points:

  • Accounting for the affected area;
  • Time since onset of illness;
  • The nature of the pathological changes caused by the disease;
  • Presence of a 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 eliminate the problem.What is important is an integrated treatment approach, a combination of local treatment and oral medications.This raises the question: how to choose a medication and get rid of toenail fungus?Below we will consider all types of modern drugs.

Antifungal nail polish

When the 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.

Additionally, 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 polish.

To achieve the maximum effect from treating nail fungus with varnish, you must adhere to certain rules:

  • You should not complete the treatment yourself until you receive laboratory data indicating the absence of fungus in the nail;
  • The application of the varnish must be regular and without jumps;
  • The treatment can last for a year and it is a necessary measure to get rid of the mycotic organism.

Toenails have the capacity to accumulate medication to a greater extent than fingernails.You should not combine varnishes, as their therapeutic effect will be less.

There are also certain contraindications to treatment with antifungal varnishes:

  1. Lactation period;
  2. Carrying 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 antimycotic varnishes:

  • Using a nail file, you should remove as much of the affected nail as possible;
  • Degrease the surface of the nail using a solution of water and alcohol, or use a soap and soda bath to spray the nail;
  • Apply the remedy;
  • Once a week it should be removed using ordinary solvent.

Remedies to remove nails affected by fungus

Before applying nail polish remover, you need to spray your feet in water containing one teaspoon of liquid soap and soda per 1000 ml.Then the feet are dried and the skin around the affected nail should be fixed using a 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 a tape.

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

Antifungal tablets

Systemic antibacterial agents are needed 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 of them are incompatible with hormonal contraceptives, some cannot be taken in childhood, and some are prohibited if you have liver problems.

Local treatment with cream, spray, ointment

If the treatment has been correctly selected and the symptoms of the fungal infection have been completely eliminated and the program has been completed, the affected nail tissue will eventually be replaced with healthy tissue.

However, full recovery can only be verified by carrying out tests that patients undergo 14 and 30 days after the end of treatment.If during treatment the skin on the legs begins to peel and turn red, this is a manifestation of an allergy that occurs in response to the use of the drug.It is therefore important to stop treatment in time.

Other ways

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 must soak your feet in the resulting solution for about a quarter of an hour.It is an excellent complement to the main antimycotic treatment.

Laser treatment

Treatment of the disease with a laser beam is a method of physiotherapeutic treatment.It can only be used in combination with antifungal drugs to achieve an effect.Laser therapy alone will not completely eliminate nail fungus.This procedure is aimed at improving nail nutrition and increasing blood circulation.As a result, the antimycotic drug penetrates the damaged plaque better.However, the laser itself 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.

Nail fungus prevention

If a person's immune system is working properly, toenail fungus will not harm them even after infection, because 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 rather laborious process, so the following preventive measures can help prevent infection:

  • You should avoid walking barefoot on the beach;
  • Closed rubber slippers are optimal shoes for saunas and baths;
  • Socks to be worn every day should be made of cotton;
  • It is forbidden to put on other people's shoes;
  • You should keep your feet dry.