Toenail fungus is called onychomycosis. Initially, the infectious process affects the thumb, but as it develops, it spreads to others. The disease goes through several stages. The sooner the treatment starts, the easier it is to overcome the problem. This is especially true in relation to the big toe of the lower limb - it has a large area and size, so the degree of damage is significant.
![Fungal infection of the big toenails](/images/articles/98/Fungal%20infection%20of%20the%20big%20toenails.jpg)
Stages of onychomycosis
Nail fungus goes through several stages of development, each of which is characterized by certain symptoms. The following stages of disease development are distinguished:
- Original.At this stage, no visible pathological deviation is observed: the changes are still external. The nail plates on the toes of the lower extremities lose their shine. White spots or streaks appear on the surface. In general, the nail looks healthy, the person does not feel pain or discomfort. If you identify nail fungus at this stage, you can get rid of it quickly.
- Intermediate or advanced.The nail structure is already undergoing pathological changes. The nail acquires a light yellowish color, peels and splits. There is also an unpleasant odor coming from the affected foot.
- Advanced or dystrophic stage.Deep damage to the nails occurs. In this case, the infectious process passes from the thumb to the remaining part. The entire surface of the nail plate is affected by the fungus and is peeled off from the bed and becomes loose. The patient is disturbed by severe itching. A painful and throbbing sensation occurs when pressing on the affected areas. For this reason, the patient should not wear closed shoes.
![Dystrophic (advanced) stage of onychomycosis](/images/articles/98/Dystrophic%20(advanced)%20stage%20of%20onychomycosis.jpg)
In the third stage of the development of the infectious process, infection of the skin of the foot is possible. In this case, the fungus can be treated only with the help of complex therapy, which involves the use of both local and systemic drugs (tablets for oral administration).
Reasons for the development of fungus on the big toe
The main reasons that lead to the development of onychomycosis:
- contact with a person who is a carrier of a fungal infection;
- neglecting hygiene rules;
- wearing someone else's or ill-fitting narrow shoes;
- weakened immune system;
- visiting a bath, sauna, swimming pool or beauty salon where non-disinfected instruments may be used;
- trauma to the nail and surrounding skin;
- straight legs;
- long-term use of antibacterial drugs;
- hyperhidrosis (increased sweating of the feet);
- presence of endocrine or immune lesions;
- disorders in the circulatory system, which are especially important for elderly patients;
- phlebeurism;
- diabetes.
![Flat feet are one of the causes of nail fungus](/images/articles/98/Flat%20feet%20are%20one%20of%20the%20causes%20of%20nail%20fungus.jpg)
An important factor that increases the risk of developing onychomycosis is old age. Elderly people suffer from poor blood supply to the extremities, which increases the risk of developing fungal infections.
The causative agent of the disease comes from infected objects on the nails or skin or by contact with the carrier. The pathogen spreads quickly and invades new territories. The fungus enters the subungual space through damaged areas of the nail plate or the skin around it.
Fungus quickly spreads to the nail bed. The rate of advance exceeds the rate of plate growth. Soon, the pathogenic microorganism reaches its target and causes changes in the nail structure. It was found that men suffer from fungus 3 times more often. Nail plates are affected by fungal species such as dermatophytes, mold and yeast.
When should you see a doctor?
You should consult a doctor at the first signs of a fungal infection. You should not wait for the appearance of obvious signs of the disease - the appearance of white spots and even a slight itching in the area of the legs should be a reason to contact a specialist - a mycologist or a dermatologist.
![At the first signs of onychomycosis, you should contact a mycologist](/images/articles/98/At%20the%20first%20signs%20of%20onychomycosis,%20you%20should%20contact%20a%20mycologist.jpg)
Diagnostics
Diagnostic measures to determine the disease and its stage include:
- visual examination of nail plates;
- taking a tissue sample from the affected nail;
- cultural examination - injecting the material taken by the patient into a nutrient medium to determine the type of microorganisms that have affected the nails.
In some cases, a specialist makes a differential diagnosis and separates onychomycosis from diseases such as lichen planus, psoriasis and keratoderma.
Treatment of fungal nail infection in the early stages of development
If the disease is detected at an early stage, it will be easier to fight it. In this case, it is usually enough to use local agents that act directly on the affected nail.
In the first stage of mycosis, if more than 50% of the nail plate is not affected, the following drugs are prescribed:
- Varnish to be applied to the surface of the affected nails. It should be done twice a day, the total course of treatment will be one month. The product has contraindications, so it can be used only as prescribed by a doctor.
- The product is produced in the form of a cream. The main active ingredient kills almost all types of fungi. The cream is applied 3 times a day, the course of treatment lasts about a month.
- A product containing gypsum impregnated with a special composition. Adhesive strips are kept for 3 days and then removed. Special substances covering the plaster surface help to soften the nail plate, so it can be easily removed with manicure tools or scissors.
- A drug that contains a substance that destroys the fungus and stops its spread. It is recommended to rub the affected areas 1-2 times a day. The duration of treatment depends on the condition of the nail plate and can be from two to four weeks.
Any medication intended to treat even mild forms of nail fungus should be prescribed by a doctor.
Advanced therapy for onychomycosis
In severe cases of the fungus, as well as in the case of an ongoing infectious process, complex treatment is indicated. If there are no contraindications, systemic antifungal agents should be prescribed. The patient is prescribed the following drugs:
- Systemic antibiotic in the form of tablets from the triazole group. The active substance of the drug reaches the location of pathogenic microorganisms and has a fungicidal effect.
- A drug from the group of imidazoles that inhibits the development of pathogenic microorganisms and destroys them. The course of treatment and dosage is determined by the attending physician. The product causes adverse reactions.
- A drug from the allylamine group with a fungicidal effect. The active substance gradually accumulates in the layers of the nail plate, which allows to destroy the fungus that is deep enough.
Also, with advanced nail fungus, procedures to get rid of the infected plate are effective. This can be done in the following ways:
- Surgical excision.This method involves lifting the plate with a sharp surgical instrument and removing it from the bed. A bandage is applied after the operation. The surgical method is traumatic and rarely used. Instead, minimally invasive methods are used.
- Plaque removal using chemicals, promotes rapid wear of the affected nail. In this case, the problem area is treated with a special solution, wait until the drug shows its effect, and then use products that help to quickly separate the plate from the nail bed.
- Laser treatment.This is a modern, painless method that will quickly get rid of nail fungus. The laser moves over the plate and brings it to a high temperature as quickly as possible. The beam penetrates deeply and neutralizes pathogens. The method is bloodless and completely safe as it does not cause burns.
![Laser treatment of toenail fungus](/images/articles/98/Laser%20treatment%20of%20toenail%20fungus.jpg)
In the advanced stages of onychomycosis, it is necessary to strictly follow the doctor's recommendations, because the lack of adequate treatment increases the risk of general damage to the body by fungal infection.
Traditional methods
Nail fungus can also be treated using traditional medicine. Such methods are supplementary and cannot be the basis of therapy. The most popular folk remedies include:
- Onion pulp.It is necessary to grate several onions and apply the resulting mass to the affected nails. Close the top with a bandage. Keep for 15-20 minutes, wash.
- Hydrogen peroxide.First, soak the affected feet in a water bath to soften the nails as much as possible. Then remove the top layer from the plate. Soak a piece of gauze in hydrogen peroxide and wrap the phalanx of the finger with the affected nail, immediately hold the damaged area. Leave for 40-50 minutes. You can repeat the procedure up to twice a day.
- Apple cider vinegar.It is important to use a natural product. Take 2 tablespoons of vinegar and add the same amount of vodka and one spoon of glycerin. Dip a cotton swab in the resulting mixture and apply it on your nails for 15 minutes. Repeat 4 times a day.
Traditional prescriptions help to alleviate the severity of the symptoms of the disease and relieve anxiety, but they cannot destroy the causative agents of the disease.
The course of the disease and features of the treatment of nail fungus in children
Onychomycosis is rare in children. The main cause of the disease is weak immunity due to its incomplete formation. Symptoms of onychomycosis in children:
- the plate loses its natural pink color, gray or white spots appear on the surface;
- unevenness and roundness of the nail plates;
- broken and brittle nails;
- redness and swelling of the skin around the child's infected nail.
To treat nail fungus in children, only topical preparations such as sprays, varnishes or creams are usually used. If necessary, system agents are also assigned. Oral antifungal drugs should only be prescribed by a doctor.
Features of treatment in pregnant and lactating women
A woman's risk of developing onychomycosis during pregnancy is high if the woman has already suffered from the disease and has not completely treated it. This is due to the weakening of the immune system that occurs during pregnancy.
It is important to treat the fungus in time, because in severe cases it creates a risk of bacterial infection, which threatens the health of both the mother and the fetus. Systemic drugs should not be used during pregnancy because they have a high degree of toxicity.
Local drugs should be used during pregnancy and lactation, but only those that are safe for the expectant mother and her baby. These include sulfur-salicylic ointment.
Treatment of the elderly
Declining immunity in older people is a natural age-related phenomenon that creates additional risks for the development of onychomycosis. In this case, the specialist is also cautious when choosing a remedy for the treatment of nail fungus.
Systemic drugs are prescribed if the disease lasts for a year or more, as well as for extensive lesions and degenerative changes in the nails.
Elderly patients are often prescribed systemic antifungal agents from the group of allylamines and triazoles.
Preventive measures
If you have signs of a fungus on your pinky or thumb, see your doctor right away. However, measures can be taken to prevent the development of this disease. The following recommendations should be followed:
- wash your feet at least once a day;
- wash socks every day and wear clean ones;
- if you sweat excessively, use special foot deodorants;
- Wear shoes of the right size, they should not be too tight and should be washed daily;
- use only personal hygiene products, as well as manicure and pedicure tools;
- use personal rubber shoes when visiting the pool, beach, sauna;
- After visiting the pool, sauna, wash your feet with soap and water, if necessary, use pharmaceutical preparations for prevention.
Toenail fungus is a disease that is quite difficult to treat in its advanced stage. You should consult a doctor at the first symptoms. Treatment depends on the stage of development of onychomycosis: in the initial stage, local drugs are sufficient; systemic antifungal agents are required when initiated.