The share of foot mycoses is about 15-18% of the general population.Among nail pathologies, onychomycosis - fungal infections - accounts for 30%.The main cause of the disease is infection with various types of dermatophytes.
Depending on the type of fungal infection, onychomycosis of the feet has different symptoms and first signs.The causes of the disease are influenced by many factors.Treatment depends on the complexity of the course, the age of the patient, the general state of health and includes both medical and traditional methods.
Features of the disease
Toenail fungus, or as they are also called, onychomycosis, belongs to a group of fungal diseases.The causative agents are dermatophytes (accounting for about 80-95% of all cases), and sometimes molds and yeast-like fungi.
Toenail damage can be caused by:
- Trichophyton rubrum.
- T. interdigitale.
- Anthropophilic trichophytons.
- Mold fungi.
Mold affects the toenails of people aged 50-70.Onychomycosis is likely to occur as a result of a mixture of fungi.
There are several forms of onychomycosis:
- Normotrophic (keeping the normal configuration of the nails).
- Hypertrophic (subungual hyperkeratosis contributes to thickening of the nail plate over the entire surface).
- Atrophic (destruction of the nail plates occurs).
When affected by onycholysis, the plates separate from the nail bed.
According to the localization of the process, the fungus on the nails of the lower extremities is divided into distal (free edge of the nail), lateral (lateral sides), distal-lateral forms, proximal (the back cushion is affected), total (the entire nail is infected) and superficial.
Signs
Symptoms of onychomycosis depend on the type of pathogen.A healthy human nail has a smooth surface and a pink tint and looks shiny.In most cases, the fungus spreads to the nail plate from the infected skin of the corresponding finger.
The first signs of onychomycosis:
- change in the color and shape of the nail plate;
- surface darkening, roughness, delamination;
- plate thickening or thinning.
When the disease occurs, one nail is affected or the infection spreads to relatives.Possible manifestations: itching of the skin, peeling near the nail plate.
Symptoms of toenail fungus, depending on the pathogen, are given in the table:
| Stimulus | Manifestations | Peculiarities |
| T. rubrum | Yellow spots, longitudinal stripes on the lateral edges of the nail plates | In children, it is manifested by roughness of the surface |
| T. interdigitale | Spots, yellow stripes in the thickness of the central part.Deformation of the plate.Free edge thickening | The shape of the lesion is normotrophic |
| Anthropophilic trichophytons | Stripes and spots of gray color on the lateral parts and on the distal margin.Thickening of the plate, appearance of grooves, brittleness | In favus, the disease begins with the appearance of a yellow spot in the thickness of the nail plate, which gradually spreads over the entire plane.The toenails are affected during the long course of the disease |
| moulds | The lesion is superficial.Possible color of the nail plate: yellow, greenish, blue, brown shades, black |
Manifestations of onychomycosis, depending on the form of damage to the nail plate:
| Name | Symptoms | Coloring |
| Normotrophic | Shape and shine are preserved.Nail plates are thickened at the corners | Yellow distal margin, matte surface |
| Hypertrophic | Growth of subungual hyperkeratosis.Thickening over the entire plane, loss of luster.Cross stripes, deformed plates.There is surface loosening at the free edge.Some patients experience pain when walking | The initial stage is characterized by a yellowish color, passing to dirty gray |
| Atrophic | Significant deformation and destruction of plates;partial exposure of the nail bed;layering of loose, crumbling horn masses | Matte, color - dirty gray or yellowish |
| By type of onycholysis | Thinning of the plates, separation from the bed, loss of luster | Cloudy appearance, yellow, gray with a dirty tint.At the base of the nail, the color is preserved |
A patient can experience different forms of toenail fungus.
Reasons
The main source of infection is dermatophytes.
Infection with onychomycosis of the feet is likely:
- at home through household items (bath mat, towel, towel, slippers, socks);
- when wearing narrow shoes (especially made of synthetic materials) for a long time;
- in sauna, bath, pool, shower, gym.
Scales of pathogens from patients with athlete's foot fall on the floor, bars, benches and objects.High humidity promotes the development and spread of fungal infections.
The causes of nail fungus depend on its type and the way it penetrates the nail plate.Trichophyton rubrum infection occurs from the affected skin of the feet.Superficial white fungus Trichophyton mentagrophytes appears as a result of softening of the nail plate, which has been in a moist environment for a long time.Tissue damage starts from the top, the surface change is characterized by the formation of white lesions.
Other causes of the disease include:
- use of non-sterile tools when performing a pedicure;
- tendency to excessive sweating of the feet;
- reduced immunity;
- nail injuries;
- diabetes mellitus;
- impaired blood supply to the lower extremities.
Toenail fungus can be diagnosed in people taking corticosteroids, antibiotics or immunosuppressive therapy for a long time.
Treatment
When choosing a treatment method, the type of lesion, the degree of spread of the disease, the safety of the method, the general condition of the patient and the cost should be taken into account.
Treatment of toenail fungus is carried out with local therapy, folk remedies and systemic drugs.
Local therapy
Treatment is indicated for patients with distal, lateral and distal-lateral forms of onychomycosis.Condition: no more than 50% of plate area affected, die and not all toenails affected.
The most effective local drugs in the form of ointments, creams and solutions.
If single nails are affected, it is recommended to soften the plates at home with any preparation with a keralitic effect, remove the infected areas and then apply creams or solutions.Along with the treatment of the nail plates, a smooth skin therapy is also carried out.
Systemic treatment
It is used when local therapy is ineffective, multiple nail lesions.
Medications of choice include:
- Itraconazole
- fluconazole.
- Griseofulvin.
- Terbinafine.
The course of treatment will be more effective if the stratum corneum and the affected areas are removed first.The procedure will also reduce overall treatment time.
Traditional methods
When the disease is mild and in the initial stage, it makes sense to use folk remedies.
Use:
- baths (herbal, salt, soda, vinegar, potassium permanganate);
- lubrication of the nail plates with tincture of propolis, birch tar, iodine;
- compresses and pastes from a mixture of onion, soda and garlic.
Home remedies are available and treatment is inexpensive.
Features of therapy depending on age
Treatment of onychomycosis of the feet is different for adults and children.If one of the family members has a disease or fungal manifestations are found in children from school or kindergarten, a regular examination of the child's feet should be carried out.
Treatment in childhood requires the use of safe products as prescribed by the doctor.An important stage of the therapy is the observance of hygiene and the conduct of antifungal treatment of shoes.
In the treatment of adults, it is necessary to strictly follow the instructions for the use of the drugs, taking into account contraindications and possible side effects.