Toenail fungus is called onychomycosis. The infectious process initially affects the thumb, but as it progresses it spreads to others. The disease goes through several stages. The earlier treatment is started, the easier it is to deal with the problem. This is especially true of the big toe of the lower extremity - it has a large area and size, so the degree of injury 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 point, no visible pathological deviations can be 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 any pain or discomfort. If you detect nail fungus at this stage, you can get rid of it quickly.
- Moderate or progressive.The structure of the nail is already undergoing pathological changes. The nail takes on a distinct yellowish color, flakes off and falls apart. There is also an unpleasant smell from the affected foot.
- Advanced or dystrophic stage.Deep damage occurs to the nails. In this case, the infectious process passes from the thumb to the rest. The entire surface of the nail plate is affected by the fungus, detaches from the nail bed and becomes loose. The patient suffers from severe itching. When you press on the affected areas, there is a painful and throbbing feeling. 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 development of the infectious process, infection of the skin of the feet is possible. In this case, the fungus can be cured 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 for the development of onychomycosis are:
- contact with a person who is a carrier of a fungal infection;
- neglect of hygiene regulations;
- wearing strange or narrow shoes that don't fit;
- weakened immune system;
- Visiting a bathhouse, sauna, swimming pool or beauty salon where non-disinfected instruments are allowed to be used;
- trauma to the nail and surrounding skin;
- Flat feet;
- long-term use of antibacterial drugs;
- Hyperhidrosis (increased sweating in the feet);
- the presence of endocrine or immunological lesions;
- Disturbances in the circulatory system, which is particularly important for older patients;
- phlebeurism;
- Diabetes mellitus.
![Flat feet are one of the causes of toenail fungus](/images/articles/98/Flat%20feet%20are%20one%20of%20the%20causes%20of%20toenail%20fungus.jpg)
An important factor that increases the risk of onychomycosis is age. Older people suffer from poor blood circulation in the extremities, which also increases the risk of fungal infections.
The causative agent of the disease gets onto the nails or skin through infected objects or through contact with a carrier. The pathogen spreads quickly and invades new areas. The fungus invades the subungual space through damaged areas of the nail plate or surrounding skin.
The fungus spreads quickly to the nail bed. The feed rate exceeds the plate growth rate. Soon the pathogenic microorganism reaches its target and causes changes in the structure of the nail. It has been found that men are three times more likely to suffer from fungus. The nail plates are attacked by fungal species such as dermatophytes, mold and yeast.
When should you see a doctor?
At the first signs of a fungal infection, you should see a doctor. You should not wait for the appearance of obvious signs of the disease - the formation of white spots and even slight itching in the area of the feet should be a reason to visit a specialist - a mycologist or 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)
diagnosis
Diagnostic measures to identify the disease and its stage include:
- visual inspection of the nail plates;
- Taking a tissue sample from the affected nail;
- Cultural examination – inoculation of the material obtained from the patient on a nutrient medium to identify 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 a fungal nail infection at an early stage of development
If the disease was detected at an early stage, it is much easier to deal with it. In this case, it is usually sufficient to use local remedies that act directly on the affected nail.
If in the first stage of mycosis no more than 50% of the nail plate is affected, the following drugs are prescribed:
- Varnish that should be applied to the surface of the affected nails. This should be done twice a day, the total duration of treatment is a month. The product has contraindications and may therefore only be used as prescribed by a doctor.
- Product produced in the form of a cream. The main active ingredient kills almost all types of fungi. The cream is applied three times a day and the duration of treatment is about a month.
- A product impregnated with plaster with a special composition. The adhesive strips are left on for 3 days and then removed. Special substances that cover the surface of the patch help soften the nail plate so that it can be easily removed with a manicure tool or scissors.
- A drug that contains a substance that destroys the fungus and stops it from multiplying. It is recommended to lubricate the affected areas 1-2 times a day. The duration of treatment depends on the condition of the nail plate and can range from two to four weeks.
All medications that are intended to treat even mild forms of nail fungus must be prescribed by a doctor.
Advanced therapy for onychomycosis
In severe cases of the fungus, as well as with an ongoing infectious process, complex treatment is indicated. Unless there are contraindications, systemic antifungals must be prescribed. The patient is prescribed the following medications:
- Systemic antibiotic from the triazole group in tablet form. The active ingredient of the drug gets to the site of pathogenic microorganisms and has a fungicidal effect.
- A drug from the imidazole group that inhibits the development of pathogenic microorganisms and destroys them. The course of treatment and dosage are determined by the attending physician. The product causes side effects.
- A drug from the group of allylamines, which has a fungicidal effect. The active ingredient gradually accumulates in the layers of the nail plate, which can also kill deep-seated fungi.
Even 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 using a sharp surgical instrument and removing it from the bed. After the operation, a bandage is applied. The surgical method is traumatic and rarely used. Instead, minimally invasive methods are practiced.
- Remove plaque with chemicals, which promotes rapid flaking of the affected nail. In this case, the problem area is treated with a special solution, waiting for the drug to take effect, and then using products that will help quickly remove plaque from the nail bed.
- Laser treatment.This is a modern, painless method that quickly eliminates nail fungus. The laser acts on the plate and brings it to high temperatures 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 for nail fungus on the big toe](/images/articles/98/Laser%20treatment%20for%20nail%20fungus%20on%20the%20big%20toe.jpg)
In advanced stages of onychomycosis, it is necessary to strictly follow the doctor's recommendations, since the lack of adequate treatment increases the risk of general damage to the body from a fungal infection.
Traditional methods
Toenail fungus can also be cured with traditional medicine. Such methods are additional in nature 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. Secure the top with a bandage. Leave on for 15-20 minutes, then rinse.
- Hydrogen peroxide.First soak the affected feet in a water bath to make the nails as soft as possible. Then remove the top layer from the plate. Dip a piece of gauze in hydrogen peroxide and wrap the finger phalanx with the affected nail to capture the immediate lesion. Leave on for 40-50 minutes. You can repeat the process 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 a tablespoon of glycerin. Dip a cotton swab in the resulting mixture and apply to your nails for 15 minutes. Repeat 4 times daily.
Traditional recipes help to reduce the severity of the symptoms of the disease and eliminate discomfort, but are not able to 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 incomplete education. Symptoms of onychomycosis in children include:
- the plate loses its natural pink color, gray or white spots appear on the surface;
- unevenness and tuberosity of the nail plates;
- crumbling 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, systemic agents are also prescribed. Antifungal drugs for oral administration should only be prescribed by a doctor.
Features of treatment in pregnant and lactating women
During pregnancy, there is a high risk of developing onychomycosis if the woman has already suffered from the disease and it has not completely healed. This is due to the weakening of the immune system that occurs during pregnancy.
It is important to treat the fungus in a timely manner because in severe cases it poses a risk of bacterial infection, endangering the health of the mother and fetus. Systemic drugs should not be used during pregnancy because they have high toxicity.
During pregnancy and breastfeeding, topical medications should be used, but only those that are safe for the expectant mother and her baby. This includes sulfur-salicylic ointment.
Treatment of older people
In older people, reduced immunity is a natural age-related phenomenon that poses additional risks for the development of onychomycosis. In this case, too, the specialist is careful when choosing a remedy to treat nail fungus.
Systemic drugs are prescribed if the disease lasts a year or more, as well as for extensive lesions and degenerative changes in the nails.
Systemic antimycotics from the group of allylamines and triazoles are most often prescribed to older patients.
Precautions
If you notice signs of fungus on your pinky finger or thumb, see your doctor immediately. However, measures can be taken to prevent the development of this disease. The following recommendations should be observed:
- Wash your feet at least once a day;
- Wash socks every day and wear clean socks;
- If you sweat excessively, use special foot deodorants.
- Wear shoes of the right size, they should not be too tight and they should be washed daily;
- Use only personal hygiene products and manicure and pedicure tools.
- Wear personal rubber shoes when visiting the swimming pool, beach or sauna.
- After visiting the swimming pool or sauna, wash your feet with soap and water and, if necessary, use pharmaceutical preparations for prevention.
Toenail fungus is a disease that is difficult to cure in advanced stages. At the first symptoms you should consult a doctor. Treatment depends on the stage of development of onychomycosis: in the initial stage, local drugs are sufficient, at the beginning systemic antifungal drugs are required.