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Toenail fungus

yellow toenails due to fungus

Toenail fungus is a disease that is contagious 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 in these three large groups.In addition, the cause of nail plate disease in up to 90% of cases are fungi belonging to the group of dermatomycetes, of which there are up to 20 different species.Yeast-like fungi of the genus Candida do not cause nail diseases very often, in about 10% of cases.The remaining small percentage of morbidity occurs due to infection of the nail with mycotic mold organisms.Nail fungus in medical terminology sounds like onychomycosis.

According to statistics, the prevalence of the disease is quite wide.Athlete's foot affects up to 20% of the entire world's population.The spread 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).

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 rate of recovery.It is known that in childhood the nail phalanges are affected much less often than in the elderly.

The symptoms vary depending on the shape 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 and gradually cover the entire area of the plate.The nail completely changes color, remains normal thickness.Onycholysis is another symptom of normotrophic nail fungus.It consists in the plate's inability 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 thickening of the plate in dimensions that exceed 2 mm or more.This increase occurs due to increased growth of cuticles 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 of the nail that resembles 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 type of nail fungus leads to a person starting to experience pain while walking.The nail color becomes dark yellow or grey.
  3. Symptoms of atrophic nail fungus.First of all, patients notice a change in the color of the plate;it turns brownish grey.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 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.Common to these two types of mycotic lesions 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 molds and mycotic organisms, the nail plates may turn blue-green to black in color.The nail itself begins to crumble and becomes rough on the sides.Over time, the affected parts die off, causing the plate's shape 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 of skin flakes at the top.If the clinical picture of distal nail fungus is supplemented by lateral onchomycosis, then the ridges around the nail swell, become red and thicken.A man suffers 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 removal of the eponychium (cuticle).The nail plate starts to turn white in the area 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 destroys it completely.
  6. Symptoms of total nail fungus.If the lateral, distal or proximal form of the disease is not treated, 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 dorsal pad, which, as the fungus multiplies, completely covers the entire nail.The spots tend to coalesce and visually may look like scattered fine powder.

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

  • Nail crumbles;
  • Change plate color;
  • Dissection of nail phalanx;
  • Painful sensations that occur when the pathological process progresses;
  • There may be itchy skin in the area around the nail.

Causes of toenail fungus

Toenail fungus always occurs as a result of infection with fungal organisms.Most often they are dermatomycetes.Increased keratophilicity is a characteristic feature of the fungi included in this group.They are helped to penetrate the skin and nails by a large number 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 below 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 multiplies, subungual hyperkeratosis develops.This leads to a deterioration of 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 much less often into its depths.This method of distribution is available only for dermatomycetes with pronounced keratolytic abilities.In this case, the actual process of nail destruction will proceed much faster.
  3. The rarest route of spread is through the proximal ridge.From the last part of the matrix, the fungus penetrates under the nail plate and into the bed or settles in the matrix and from there destroys the collagen structures in 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, such an inflammatory process more often 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 provocative factors:

  • Mechanical damage.
  • Exposure to chemical factors, such as: regular contact with cleaning agents 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 rapidly.
  • A sympathetic form 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 foot development.Such deformations lead to the fact that the aeration of the foot deteriorates significantly.
  • Nail growth rate.
  • Non-compliance with rules for personal hygiene.
  • Disturbances in the function of the immune system.Moreover, nail fungus is not the only disease with a decrease in protective powers.Other organs are also susceptible to fungal damage.
  • Varicose veins.
  • Climatic features in the area where a person lives.More often, fungal infections affect people who live in areas with temperate or cold climates.The fact is that you often have to wear warm clothes, thick and tight shoes and thereby create favorable conditions for the function of the fungus.Residents of subtropical countries are also at risk, as 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 notice an increasing trend in the incidence among young people and children.Statistics thus indicate that every 10 years of life increases the risk of infection by 2.5 times.While the probability of fungal infection in childhood is 3%, this number increases to 50% in the elderly.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.
  • Sex.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 who serve nuclear power plant workers and in workers in metallurgical enterprises.The higher the dust content, air temperature, humidity, ionizing radiation and gas pollution, the higher the risk of infection.In this connection, visits to specialists regarding fungal infections from 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.(also read: Causes, symptoms, diagnosis and prevention of HIV)
  • Taking antibacterial drugs, corticosteroids and cytostatics.

As far as the direct routes of infection are concerned, this most often happens in the following cases:

  1. Visit saunas and baths, swimming pools and public showers - all public places where people go barefoot for some time;
  2. The use of common (even within the family) household items, such as washcloths, slippers, pumice stones, carpets;
  3. Performing cosmetic procedures, especially pedicures, in beauty salons where hygiene standards are not observed.

It is worth knowing that the biggest 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 out the fungal mycelium from it.

Why is athlete's foot dangerous?

It is wrong 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 athlete's foot is dangerous due to the following complications:

  • Spread of mycosis of the skin and its appendages in the presence of immunodeficiency states.
  • Development of diabetic foot on the basis of diabetes mellitus.
  • Development of erysipelas in the lower extremities.
  • Development of elephantism.
  • Development of lymphostasis.
  • Development of invasive mycosis in patients undergoing immunosuppressive or cytostatic therapy.
  • Decreased nail growth and its rotation into surrounding tissue, which is accompanied by severe pain and an inflammatory reaction.
  • Development of eczema.
  • Addition of a bacterial infection and development of inflammation.
  • Loss of the nail plate, exposure of the nail bed.
  • The development of aspergillosis (that is, infection with molds), which is difficult to treat therapeutically.Most often, aspergillosis develops on the background of untreated dermatophytic onychomycosis.

Stages of toenail fungus

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

The disease often develops 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 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 can 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 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 occur.As it penetrates deeper into the nail, the fungus begins to affect one or other of its edges.This largely depends on the type of pathogen and the route of infection, which was 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 impossible to distinguish with the naked eye.Detection of the disease is possible under laboratory conditions.

Advanced toenail fungus

Advanced athlete's foot 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 crumbling nails, separation and deformation.Thinning of the nail body and change in its color occurs gradually over many years.A rapid transition to the overall stage of the disease is only possible against the background of existing systemic diseases, which most often occur 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 range of effective drugs to cope with the problem.There are funds for both local and general 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 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 disease;
  • The nature of 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 get rid of the problem.The important thing is an integrated approach to therapy, a combination of local treatment with oral medication.This raises the question, how to choose a drug and get rid of toenail fungus?Below we will consider all modern types of medicine.

Antifungal nail polish

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

To achieve a therapeutic effect, you can also use plasters that have a peeling effect.To make your nails look more attractive, you can apply manicure varnish over the medicated varnish.

To achieve the maximum effect of treatment of nail fungus with varnish, you must comply with certain rules:

  • You should not complete the treatment on your own until you receive laboratory data indicating the absence of fungus in the nail;
  • Application of varnish must be regular and without skipping;
  • The 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 substance 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 with antifungal varnishes:

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

Sometimes reddening of the skin areas located around the nail is possible.

Rules for using antifungal varnishes:

  • Using a nail file, 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 with a common solvent.

Means for removing nails affected by fungus

Before applying the nail remover, steam your feet in water with one teaspoon of liquid soap and soda per1000 ml.Then the feet are dried, the skin around the affected nail must be 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 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 forbidden to use if you have liver problems.

Local treatment with cream, spray, ointment

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

However, complete healing can only be verified by performing tests that patients undergo 14 and 30 days after the end of treatment.If the skin on the legs during treatment 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 the treatment in time.

Other means

Oils: tea tree and lavender.As for lavender oil, it can remove irritation and tea tree oil helps fight bacteria.However, it is important that the oil is natural;only in this case they can have the desired effect.

Apple cider vinegar, mouthwash, lemon juice.After mixing these three products, soak your feet in the resulting solution for about fifteen minutes.This is an excellent addition to the main antifungal 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 the nutrition of the nail and increasing blood circulation.As a result, the antifungal 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 recurrence.Laser therapy is a safe and painless way to fight nail fungus infections.

Prevention of toenail fungus

If a person's immune system is working properly, toenail fungus will not harm him even after infection, as the immune system will neutralize it by itself.If a fungal infection spreads along the nail plate, it is necessary to choose the best methods to fight it.

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

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