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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 dermatophytes, 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 all combine into these three large groups.In addition, in up to 90% of cases, the cause of onychoplaka disease is fungi belonging to the group of dermatomycetes, of which there are up to 20 different species.Yeast-like fungi of the genus Candida cause nail diseases not so often, in about 10% of cases.The remaining small percentage of morbidity occurs due to infection of the nail by fungal fungal organisms.Nail fungus in medical terminology sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite high.Toenail fungus affects up to 20% of the entire world's population.The prevalence of the disease in the population is affected by many factors: the climatic conditions in which the population lives, the social conditions of a particular person, his age, sex and occupation.In addition, dermatologists note a continuous 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 older people over 65).

Symptoms of toenail fungus

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 age of the patient can affect the speed of recovery.It is known that in childhood the phalanges of the nails are affected much less often than in the elderly.

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, stripes and spots appear on the nail - their shape and size vary, the 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, gradually covering the entire plaque area.The nail completely changes color, remaining normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in the inability of the plaque to grow to the nail bed.As a result, the patient can easily remove it - accidentally or on purpose.
  2. Symptoms of hypertrophic nail fungus.In addition to discoloration, this form of the disease is characterized by plaque thickening 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 luster, 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 deformity.Onychomycosis - the acquisition of a shape by the nail similar to a bird's nail, 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 while 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 brown-gray.The 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 and its complete necrosis.(also read: 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.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 peripheral 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 dull.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, becomes rough on the sides.Over time, the affected parts die, causing the plaque to deform.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 flakes on top.If the clinical picture of distal nail fungus is complemented by lateral oncomycosis, then the ridges surrounding the nail swell, turn red, and become thicker.A man is in pain.When the pathology is aggravated by a bacterial infection, pus may come out from under the nail if you press it lightly.
  5. Proximal nail fungus symptoms.This rare lesion of the nail plate mainly affects the area at the side of the skin fold.The main cause of proximal toenail fungus is the removal of the cuticle (cuticle).The nail plate begins to turn white in the area adjacent to the growth zone.The fungus locates its spores and mycelium precisely in the nail tunnels located in this zone.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, then total onychomycosis occurs.The nail loses its color, begins to crumble, break and is completely destroyed.
  7. Symptoms of white superficial nail fungus.In the area of the back pad, white opal spots appear, which, as the fungus multiplies, completely covers the entire nail.The spots tend to coalesce and visually may look like scattered fine dust.

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

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

Causes of toenail fungus

Toenail fungus always occurs as a result of infection by fungal organisms.Most often they are dermatophytes.Increased keratinophilicity is a characteristic feature of fungi included in this group.They are helped to penetrate the skin and nails by a wide range of proteolytic enzymes they possess.Initially, the dermatomycetes infect the skin of the feet and then spread to the nail plates.

There are three possible ways in which they 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 multiplies, subfungal hyperkeratosis develops.This leads to deterioration of the connections between the bed and the plate, followed by their separation.From the bed, fungi enter the nail and slowly destroy it.
  2. Through the dorsal part of the nail, fungi penetrate into its depths much less often.This distribution method is available only in dermatomycetes with strong keratolytic abilities.In this case, the process of nail destruction itself will proceed much faster.
  3. The rarest route of spread is via the proximal ridge.From the terminal part of the matrix, the fungus penetrates under the nail plate and into the bed, or settles in the matrix, destroying from there the collagen structures of the nail phalanx.If the damage to the nail is caused by fungi of the genus Candida, then the proximal ridge with its swelling and thickening will be involved first in the pathological process.However, more often such an inflammatory process affects the nails.

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

This happens under the influence of the following causative factors:

  • Mechanical injuries.
  • Exposure to chemical agents, such as: regular contact with detergents containing synthetic ingredients, continuous contact with water, application of degreasers, etc.
  • Wearing things made of synthetic materials, wearing uncomfortable tight 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 the fact that the ventilation of the foot deteriorates significantly.
  • Nail growth rate.
  • Non-observance of personal hygiene rules.
  • Disorders 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 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, thereby creating favorable conditions for the fungus to work.Residents of subtropical countries are also at risk, as the growth of the fungus is facilitated by high humidity and generally ambient temperature.
  • Age-related changes in the human body.Most often, toenail fungus is diagnosed in the elderly and older adults.However, dermatologists and mycologists note an increasing trend in incidence among adolescents and children.Thus, statistics show that every 10 years of life increases the risk of infection by 2.5 times.While in childhood the chance of a fungal infection is 3%, in the elderly this percentage increases to 50%.Experts attribute such indicators to the fact that as we age, the rate of plaque growth slows down, bed nutrition worsens, and angiopathy develops.
  • Genus.It has been found that men get sick almost three times more often than women.However, it is men who seek specialist help less often.
  • The cost of the profession.Fungus on the feet is most often found in miners serving nuclear power plant workers and workers in metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas pollution, the greater the risk of contamination.In this regard, visits to specialists regarding fungal infections by workers in saunas, baths and laundries are becoming more and more frequent.Frequent visitors of mycologists are massage therapists, orthopedists, employees of rest homes and other representatives of the service staff.
  • Related pathologies.The greatest risk in this regard is diabetes mellitus, leg deformities, excess body weight, gastrointestinal diseases, metabolic disorders, thyroid pathologies, any peripheral vascular disease, for example, with lymphostasis or venous insufficiency.HIV infection increases the risk of developing nail fungus by 5 times.(also read: HIV Causes, Symptoms, Diagnosis and Prevention)
  • Taking antibacterial drugs, corticosteroids and cytostatic drugs.

As for direct routes of infection, this happens most often 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 (even within the family) household items, such as towels, slippers, pumice stones, carpets.
  3. Carrying out cosmetic procedures, especially pedicures, in beauty salons where hygiene rules are not respected.

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

Why is foot fungus dangerous?

It is a mistake to perceive toenail fungus as a purely cosmetic problem.This is a serious disease that requires special treatment.After all, onychomycosis is one of the most common chronic diseases.Untreated foot fungus is dangerous because of the following complications:

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

Stages of toenail fungus

Foot fungus never affects the nail at the same time.

The disease often develops slowly, passing through several stages of development:

  1. The early or initial stage is a borderline lesion.In this case, any pathological changes are practically invisible.The manifestation of the process is expressed by the appearance of narrow gray stripes located in the area of the free edge of the nail.
  2. Stage of normotrophic damage of the nail plate.When thickening has not yet appeared and there is no subfungal hyperkeratosis, but the traces created by the fungus are visible.They look like strips and sectors of damaged plates.The fragility of the phalanx increases and its color changes.Sometimes serous contents can come out from under the nail.
  3. Stage of hypertrophic damage.First, onyxia is formed - a sublingual lesion, the nail thickens and hypertrophy increases.The plaque changes color and, depending on the type of pathogen, crumbles, exfoliates, becomes thinner, stops growing or is 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.A feeling of itching appears in the interdigital folds, cracks, blisters and wetting 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 route of infection, described above.

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

Advanced toenail fungus

Advanced athlete's foot is characterized by total damage to the nail phalanx.With a prolonged absence of treatment, the possibility 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 nail collapse, separation and deformation.Thinning of the nail body and changing its color occurs gradually over many years.A rapid transition to the overall stage of the disease is possible only in the context of existing systemic diseases, which most often appear 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 the fungus can cause on the feet.

How to get rid of nail fungus

The modern pharmaceutical industry offers people diagnosed with toenail fungus a wide variety of effective drugs to treat the problem.There are means of local and general action.

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

Treatment tactics are based on four points:

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

Modern drugs not only destroy fungal organisms and stop their growth, but also tend to accumulate in the thickness of the nail plate, remaining 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 get rid of the problem completely.What is important is an integrated approach to treatment, a combination of topical treatment with oral medications.This begs the question, how to choose a remedy and get rid of toenail fungus?Below we will consider all modern types of drugs.

Antifungal nail polish

When the toenail fungus has not reached an advanced stage, only topical treatment can be used.For this purpose, specialized varnishes or solutions containing antifungal ingredients can be used.

In addition, to achieve a therapeutic effect, you can use patches that have an exfoliating effect.To make your nails look more attractive, you can apply nail polish over the medicated polish.

To achieve the maximum effect from the treatment of 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 omissions.
  • The treatment can last a year and this is a necessary measure to get rid of the fungal organism.

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

There are also some contraindications for treatment with antifungal varnishes:

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

Redness of the skin areas around the nail is sometimes possible.

Rules for using antifungal varnishes:

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

Treatments to remove nail fungus

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

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 get rid of fungus, but some of them are incompatible with hormonal contraceptives, some cannot be taken in childhood, and others are prohibited for use if you have liver problems.

Topical care with cream, spray, ointment

If the treatment was chosen correctly and the symptoms of the fungal infection were completely eliminated and the regimen was completed, then the affected nail tissue will eventually be replaced by a healthy one.

However, complete recovery can only be verified by conducting examinations to which patients are subjected 14 and 30 days after the completion of treatment.If during treatment the skin on the legs begins to peel and redden, this is a manifestation of an allergy that occurs in response to the use of the drug.Therefore, it is important to stop the treatment in time.

Other means

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 need to immerse your feet in the resulting solution for about a quarter of an hour.This is a great addition to the main antifungal treatment.

Laser treatment

Treatment of the disease with a laser beam is a method of physiotherapy treatment.It can only be used in combination with antifungal drugs to achieve an effect.Laser treatment 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 better into the damaged plaque.However, the laser itself cannot kill the fungus.

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

Prevention of toenail fungus

If a person's immune system is working properly, then toenail fungus will not harm them even after infection, since the immune system will neutralize it on its own.If a fungal infection spreads along the nail plate, then it is necessary to choose the best methods to fight it.

This is a fairly intensive process, so the following preventive measures can help prevent infection:

  • You should avoid walking barefoot on the beach.
  • Closed rubber slippers are the optimal shoes for saunas and baths.
  • Socks for daily use should be made of cotton fabric.
  • It is forbidden to wear another person's shoes.
  • You should keep your feet dry.