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Toenail fungus

yellow toenails due to fungus

Toenail fungus is a disease that is infectious in nature, 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.Moreover, 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-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 mold mycotic 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, gender, and profession.In addition, dermatologists note a constant 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 older people over 65 years of age).

Symptoms of toenail fungus

Symptoms of toenail 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. Symptoms of normotrophic nail fungus.The color of the affected plate changes, but the thickness and gloss 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 area of the plate.The nail completely changes color, remaining normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in 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 plate in dimensions exceeding 2 mm or more.This increase occurs 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 severely deformed.The more advanced the stage of the disease, the greater the degree of deformation.Onychomycosis - the acquisition of a shape by the nail 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 that accompany this form of nail fungus leads to the fact that a person begins to experience pain while walking.The nail color becomes dark yellow or gray.
  3. Symptoms of atrophic nail fungus.First of all, patients notice a change in the color of the plate; it becomes brownish-gray.Normal shine is lost, the surface of the nail becomes pale and dull.As the disease progresses, the plate is destroyed.The final stage of the atrophic form of the fungus is 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 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 plate 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 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 off, causing the shape of the plate to become deformed.The nail bed remains partially exposed.The final stage of the disease is characterized by complete destruction of the nail and the opening of a bed with skin flakes at the top.If the clinical picture of distal nail fungus is supplemented by lateral onchomycosis, then 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 lesion of the nail plate primarily 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 tunnels of the nail located in this zone.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 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.Opal-white spots appear in the area of the back cushion, which, as the fungus multiplies, completely covers the entire nail.The spots tend to merge and visually may resemble scattered fine powder.

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

  • Nail crumbling;
  • Change plate color;
  • Dissection of the nail phalanx;
  • Painful sensations that occur 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 mycotic organisms.Most often 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 in which they penetrate deep into the nail:

  1. From under the distal (free, lateral) edge of the nail.In this case, the pathological process will be localized 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 connections between the bed and the plate, followed by their separation.From the bed, 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 method of distribution is available only to dermatomycetes with pronounced keratolytic abilities.In this case, the process of nail destruction itself 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, from there destroying the collagen structures of the nail phalanx.If the nail lesion is caused by fungi of the genus Candida, then the proximal ridge with its swelling and thickening will first be involved in the pathological process.However, more often such an inflammatory process affects the fingernails.

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 uncomfortable narrow shoes.As a result, a favorable moist and warm environment is created in which fungi multiply quickly.
  • A sympathetic type of autonomic regulation, in which a person suffers from increased sweating.This factor relates to the individual characteristics of the body.
  • Flat feet or narrow spaces between the toes, as anatomical features of the development of the foot.Such deformations lead to the fact that the aeration of the foot deteriorates significantly.
  • Nail growth rate.
  • Failure to comply with personal hygiene rules.
  • Disturbances in the functioning of the immune system.Moreover, nail fungus is not the only disease with a decrease in protective forces.Other organs are also susceptible to mycotic damage.
  • Varicose veins.
  • Climatic features of the area in which a person lives.More often, fungal infections affect people living 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 functioning of the fungus.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.More often, toenail fungus is diagnosed in older and 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 figure increases to 50%.Experts attribute such indicators to the fact that as we age, the growth rate of the plate slows down, the nutrition of the bed 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 often found in miners serving nuclear power plant workers, and in workers of 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 in saunas, baths, and laundries are becoming more frequent.Frequent visitors of mycologists are massage therapists, orthopedists, employees of rest homes and other representatives of 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 drugs, corticosteroid and cytostatic drugs.

As for the 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 walk barefoot for some time;
  2. The use of common (even intra-family) household items, such as washcloths, slippers, pumice stones, rugs;
  3. Performing cosmetic procedures, in particular 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 wash out the fungal mycelium from there.

Why is foot fungus dangerous?

It is wrong to perceive toenail 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 diabetic foot against the background 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 nail growth and its rotation into 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 (that is, infection by mold fungi), 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 tracks 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 contents may come out from under the nail.
  3. Stage of hypertrophic lesion.First, onychauxis is formed - a subungual lesion, the nail thickens, and hypertrophy increases.The plate 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 toenail fungus

Most often, 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, which were 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 indistinguishable to the naked eye.Detection of the disease is possible in laboratory conditions.

Advanced toenail fungus

Advanced foot fungus is characterized by total damage to the nail phalanx.With prolonged absence of therapy, 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 nail crumbling, separation and deformation.Thinning of the nail body and change in its color 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 occurs 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 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 means of both local and general action.

It is the abundance of available antimycotic 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.Therefore, it is so important to undergo 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 that has passed since the onset of the illness;
  • The nature of pathological changes provoked 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, remaining there for a long time.This allows you to significantly reduce the duration of therapy, up to 8 – 16 weeks.This time will be enough to completely get rid of the problem.What is important is an integrated approach to therapy, a combination of local treatment with oral medications.This begs the question, how to choose a drug 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.For this purpose, specialized varnishes or solutions containing antimycotic components can be used.

In addition, to achieve a therapeutic effect, you can use patches that have a peeling effect.To make your nails look 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 treatment on your own until you receive laboratory data indicating the absence of fungus in the nail;
  • Application of varnish should be regular and without skipping;
  • 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 therapy using antifungal varnishes:

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

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

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 using a solution based on water and alcohol, or use a soap and soda bath to steam the nail;
  • Apply the remedy;
  • Once a week it must be removed using a regular solvent.

Remedies for removing 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 should be fixed using 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 using 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 get rid of 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 correctly selected and the symptoms of fungal infection were completely eliminated, and the scheme was completed, then the affected nail tissue will eventually be replaced by healthy one.

However, complete recovery can only be verified by performing tests that patients undergo 14 and 30 days after completion of therapy.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.Therefore, it is important to stop treatment on 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, mouth rinse, 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 addition 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 better into the damaged plate.However, the laser itself cannot kill the fungus.

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

Prevention of toenail fungus

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

This is a rather labor-intensive 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 for daily wear should be made of cotton fabric;
  • It is forbidden to put on another person's shoes;
  • You should keep your feet dry.