Treatment of onychomycosis of toenails - effective regimens for taking medications and folk remedies. Tablets for the treatment of nail fungus Cure for onychomycosis of the nails

Etiotropic treatment of onychomycosis is local, when an antifungal drug is applied to the affected nail, and systemic, when the drug is administered orally. Local and systemic exposure has its advantages and disadvantages and its own list of indications and limitations.

Local therapy

Allows you to create very high concentrations of an antifungal drug on the surface of the nail. When applied topically, the drug is not absorbed into the systemic circulation, so this treatment is safe (there are no side and toxic effects observed with the use of systemic drugs). The disadvantage of local therapy is that the drug does not always quickly reach the pathogen - the fungus, and therefore it is necessary to use auxiliary agents - keratolytics, removal of the nail plate, cleaning the bed. And if the matrix is ​​affected, then treatment with local remedies is obviously ineffective. In addition, local therapy is more laborious. With the defeat of many or all nails, it is advisable to prescribe systemic drugs.

Systemic therapy

Ensures the penetration of drugs into the nails through the blood. The onset of the effect is somewhat delayed due to the fact that the drugs accumulate in the nail matrix, but they are able to remain there for a long time after the end of treatment. A limitation of systemic therapy is the risk of side effects and sometimes toxic effects associated with many months of taking drugs. Pregnant and lactating mothers, persons with liver disease or drug allergies, systemic therapy is not indicated.

Combination Therapy

This is a combination of local treatment with systemic. The goals of combination therapy may be different. Most often, local treatment is combined with systemic to reduce doses and reduce the time of administration of a systemic drug, thereby reducing the likelihood of side effects. In addition, topical preparations can be used to prevent recurrence after treatment with a systemic drug.

The approach to treatment should be comprehensive and includes etiotropic treatment with the use of active antimycotics (targeted effect on the causative agent of onychomycosis), as well as correction of background conditions (treatment of varicose veins; correction of a secondary immunodeficiency state; compensation of carbohydrate metabolism disorders, etc.) . The choice of specific drugs and methods of their use should be carried out taking into account the severity of onychomycosis, depending on the clinical form, the severity of subungual hyperkeratosis, the degree of involvement in the process of the nail, its growth rate, age, gender and concomitant visceral pathology of the patient. During treatment, patients should carefully monitor the condition of the skin and nails, and after the end of treatment, it is necessary to strictly observe measures to prevent re-infection.

SYSTEMIC THERAPY

The selection of the drug must be carried out taking into account:

1. The type of fungus isolated in culture
2. The clinical form of onychomycosis, the severity and localization of the lesion.
3. Safety of treatment, risk of side and toxic effects.

The duration of treatment for onychomycosis depends on the growth rate of the nail and averages 4-6 months. (with damage to the hands), 12-18 months. (for leg injury).

Prescribing regimens for systemic drugs

Standard scheme

provides for a daily intake of the usual dose of the drug during the entire period of treatment. The duration of treatment corresponds to the time of regrowth of the nail plate. According to this scheme, you can prescribe any systemic drug.

short circuit

in which the duration of treatment is shorter than the time of nail regrowth. Treatment is carried out with usual or increased doses. According to this scheme, itraconazole and terbinafine can be used, which can linger in the nails for a long time after stopping treatment.

Intermittent or discontinuous circuit

involves the appointment of a normal or increased dose of the drug in several short courses. The intervals between these courses are equal to the duration of the courses themselves, for example, a weekly course with a weekly interval. The discontinuous scheme has not yet received wide acceptance.

Scheme of pulse therapy

According to this scheme, an increased dose of the drug is prescribed in short courses at intervals exceeding the duration of the courses themselves.

The advantage of short, intermittent therapy and pulse therapy regimens is their safety in terms of side and toxic effects and convenience for the patient while maintaining high efficiency. However, the standard treatment regimen with any drug gives statistically better cure rates. No systemic drug should be prescribed during pregnancy and lactation, and in the presence of liver disease, drugs should be prescribed with caution. If persistent clinical or laboratory signs of liver dysfunction appear during treatment, treatment is stopped. During treatment, liver function tests should be measured regularly. With impaired renal function, a decrease in glomerular filtration rate, dose adjustment may be required.

Infection with a fungal infection can occur at any time when you do not expect it at all. Such a disease requires long-term therapy, and is difficult to treat in advanced stages. Many are interested in whether it is possible to carry out home treatment for onychomycosis of the nails? There are enough traditional medicine recipes, but they are best used only after consulting a doctor.

The specifics of the disease and the main symptoms

Onychomycosis of the nails affects the skin and the nail plate, both on the legs and on the hands. There are many ways of infection, so not everyone manages to protect themselves from a dangerous pathology. Its causative agents are mold fungi and yeast bacteria that love humid habitats and lie in wait for a person in pools, saunas, in a shower or bath.

Common symptoms of onychomycosis

• a change in the nail plate - the appearance of white spots, darkening of the nail, acquiring a yellow or gray tint;
• peeling of the skin around the nail, itching, the skin becomes dry, there is redness and inflammation of the affected area;
• the nail gradually begins to thicken, its keratinization develops, which eventually provokes the destruction of the nail by crumbling or detaching from the nail bed;
• raising the nail at the edge, the appearance of ulcers and wounds on the affected skin.

If you briefly examine the skin damaged by a fungal infection, it can be assumed that a person has psoriasis or eczema. That is why it is necessary not to self-diagnose, but to contact a specialist in order to accurately identify the causative agent of the disease and determine the correct treatment.

Important! Several types of fungus (dermatophytes and yeast) that affect the nail plate at the same time can cause additional symptoms of the disease: the fingers themselves thicken, and not just the nail, the phalanges become rounded at the ends and thicker than in a healthy form.

It is worth noting that with an advanced disease, the deformation of the nails and skin is so severe that a sick person may experience significant discomfort in the form of pain when walking or wearing shoes.

In order not to start nail fungus, you need to know how to identify it in the early stages. To do this, pay attention to the appearance of atypical signs, such as:

• itching around the nail and between the fingers, which manifests itself for several days;
• dry skin and its slight peeling, while moisturizing creams do not help.

These are the very first signs of nail fungus, which, unfortunately, many people can confuse with other diseases (avitaminosis, dry skin due to pH imbalance, dehydration). If you do not consult a doctor in time, who will accurately diagnose, the disease will gain more strength and the symptoms will worsen.

Effective drugs in the treatment of onychomycosis

Fungal infection is difficult to treat, especially when it comes to severe forms of pathology. This is due to the fact that bacteria quickly take root and spread in the body, especially with a weakened immune system, when there is no strength to fight microbes.

Among the drugs that are used to treat nail fungus, terbinafine and fluconazole can be distinguished. These drugs are not expensive, but effective. They fight well with a fungal infection and eliminate it almost completely after complex therapy.

Terbinafine

Terbinafine is available for both internal and external use. Prices for tablets vary from 160 to 500 rubles. depending on the number of capsules in the package and their dosage. The average cost of a cream is from 60 to 140 rubles. (depending on the volume - 15 and 30 g, respectively).

The nature of the action of terbinafine is that it adversely affects the development and structure of the fungus, and ultimately provokes its death. The drug is especially effective in the early stages of the disease, when the infection has not yet had time to adapt to the conditions of the new habitat.

Note! Terbinafine, getting into the blood, does not affect the internal organs, it is absorbed by the liver and excreted from the body with urine.

Fluconazole

Another drug that is not expensive and effective is fluconazole (price from 35 rubles per package - 1 tab. 150 mg). The tool is able to destroy the cellular structure of the fungus, thereby worsen its vital activity and lead to the death of the infection.

Fluconazole is available in tablet form (1 ton 150 mg). It is used in this dosage once a week. Such treatment can last from 6 months to several years. Everything depends on the result. You can not interrupt therapy at the first sign of improvement in the condition of the nail plate and skin. Treatment should be carried out until the fungus is completely eliminated and a new healthy nail appears.

Note! Treatment with fluconazole will be much more effective and faster if, in combination with it, external ointments and creams are used, as well as traditional medicine.

Key Benefits of Treating Toenail Fungus with Fluconazole

1. The drug does not cause severe complications and negative side effects.
2. Minor contraindications.
3. Ease of use, the ability to adjust the intake and doses, taking into account all patient parameters (weight, age, concomitant diseases).
4. Availability and effectiveness of the drug, low cost of treatment.

Important! Fluconazole helps to fight not only with onychomycosis, but is also an effective tool in the fight against mycosis of the feet and hands.

As for its contraindications, they are insignificant and mainly concern nursing mothers, pregnant women, as well as people with individual intolerance to the drug itself or its individual components.

Treatment with folk remedies

Fighting nail fungus at home is possible if an accurate diagnosis has been made and appropriate drug therapy has been prescribed. In this case, the main treatment can be supported by traditional medicine, which will help enhance the effect of drugs.

In folk medicine, there are many recipes that are aimed at eliminating nail fungus. It is known that vinegar treatment is effective, in addition to it, peroxide, herbal bath decoctions and much more can be used.

Vinegar compresses against nail fungus

Dilute 50 g of 9% vinegar in water (temperature not less than 30 degrees), move carefully. Moisten gauze or cloth in the finished liquid, wrap the areas affected by the fungal infection, secure with polyethylene and leave overnight.

Such treatment should be carried out on a daily basis for about 2 weeks, after which a break should be taken using other methods of treatment.

Vinegar and eggs in the fight against foot fungus

You will need 1 egg (chicken) and 25 ml of table vinegar. Beat the egg, add vinegar, mix well, pour in a little vegetable oil (15 ml). Store prepared liquid in a cool place. Treatment is carried out by lubricating the damaged nails and skin with the prepared liquid overnight, while wrapping them in polyethylene. Such therapy is used until a new nail begins to grow, and the symptoms of the fungus gradually go away.

Herbal decoction compresses

Celandine (15 g), lilac (30 g inflorescences), marigold flowers (30 g) and oak bark (45 g). Dry all ingredients, grind and mix thoroughly. Pour boiling water over the prepared mixture (0.75 l), boil for several minutes and let it brew. Apply compresses from the decoction before going to bed every day. The treatment lasts until the fungus is completely gone.

Soda and celandine

Dilute 50 g of soda in 2.5 liters of water. In a hot bath with such a solution, steam the legs, and after drying, lubricate well with celandine oil. Such procedures are recommended to be done before going to bed, and during the day to use a solution (20%) of propolis. They need to lubricate the affected areas.

During pregnancy

If we talk about the treatment of fungus during pregnancy, then everything is a little more complicated. Hot foot baths can provoke premature birth, increase the tone of the uterus. Drug therapy is also not an option, since ointments and tablets are not recommended for use during childbearing.

Therefore, during pregnancy, doctors advise onychomycosis to be treated by rubbing peppermint (decoction), tangerine juice into the affected areas. The use of birch tar helps well. It should be applied to nails and skin at least once a day.

Note! Folk methods of dealing with nail fungus cannot fully cope with the infection. They are an auxiliary tool in the complex therapy of the main drug treatment. The use of traditional medicine recipes can help enhance the effect of conservative therapy drugs.

Onychomycosis of the nails is an infectious disease that can await a person at every turn. Pathology is dangerous because it quickly infects the nails and skin of the hands and feet, but is slowly treated. Therefore, you need to be extremely attentive to your health. At the first uncharacteristic symptoms, it is important to immediately seek the advice of a specialist. Nail fungus in the early stages can be cured in a short time, but neglected forms threaten severe complications on the internal organs that arise due to poisoning of the body with the waste products of the fungus.

Content

Fungal diseases at home can be defeated only by starting therapy in a timely manner and correctly identifying the pathogen, especially if you need to treat onychomycosis of the toenails. Several types of dermatophytes, yeast-like fungi, and even representatives of the genus Candida are capable of provoking this ailment. What are the means to deal with them?

What is onychomycosis

Fungal infections of the nails and adjacent skin are called "mycoses", and if the disease affects only the nail plate, this is onychomycosis. Infection occurs due to non-compliance with the rules of personal hygiene: the use of shared towels, rugs, slippers. The causative agents of onychomycosis can be transmitted through the bottom of the shower cabin, sauna. The risk of catching onychomycosis is especially high in patients with diabetes mellitus, people with skin injuries, circulatory problems in the lower extremities, and weakened immunity. Recognizing the disease is easy:

• discoloration of the nail, the appearance of yellow spots or stripes (but the natural shine is preserved) - normotrophic onychomycosis;
• loss of gloss and start of the process of thickening of the nail plates, deformation - hypertrophic onychomycosis;
• atrophy of the affected part and self-destruction from the nail bed - onycholytic mycosis.

General therapy

How you have to deal with nail mycosis is determined by the size of the affected area, the severity of the disease. However, before starting the treatment of onychomycosis of the toenails, it is necessary to make sure that the problem is not in the deformation of the plate due to mechanical damage. To do this, you need to pay a visit to a dermatologist and undergo diagnostics, which involves laboratory tests of scrapings. If the diagnosis is confirmed, the treatment of mycosis of the toenails will be:

• taking immunomodulators;
• topical use of antifungal creams or ointments;
• the use of keratolytics;
• physiotherapy.

The use of local antimycotics

External treatment of onychomycosis of the toenails is the main method of combating this disease, since drugs taken orally do not give the same pronounced effect. Most of the local preparations are harmful to all pathogens of onychomycosis, so it is not necessary to clarify their nature, excluding the Candida fungus - it requires a separate approach. Most doctors prescribe:

• varnishes that protect nails from the further spread of the fungus (Batrafen, Lotseril);
• ointments or gels that have bacteriostatic, anti-inflammatory, antipruritic qualities (Lamisil, Ketoconazole);
• solutions / drops for the destruction of the fungus from the plate and nail folds (Clotrimazole, Exoderil - in the form of an ointment it is less effective).

Medicines

Tablets, unlike local remedies used to treat onychomycosis of toenails, give a prolonged effect, as they accumulate in the body as they are taken. However, this same nuance is the reason for a large number of contraindications and precautions for taking them. Often, systemic treatment is prescribed in the absence of a clear result from the local one, and drugs are used for this:

• terbinafine (Terbinafine-Teva, Terbizil);
• itraconazole (Irunin, Miconihol, Teknazol);
• fluconazole (Fluconazole, Mikosist).

Removal of the nail plate

If onychomycosis not only caused the appearance of white or yellow spots, but led to keratinization of the nails, their deformation or detachment, doctors consider it appropriate to start treatment by removing the affected plate, because such a nail can no longer be saved. Firstly, it will not allow the pathogen to actively multiply. Secondly, drugs will be able to fully work on a healthy surface and inside. The procedure can be done at home or in the hospital:

• Self-removal of the affected nail is carried out with the help of keratolic patches, which are glued to the plate (preliminary application of a special ointment is possible) and stay on it until the morning. Their tissue part is impregnated with a special composition that softens dead cells.
• If the doctor insists on the complete removal of the plate affected by onychomycosis, this will be an operation that involves local anesthesia and a long recovery.

Physiotherapy

An auxiliary method of treating toenail onychomycosis is physiotherapy - they are needed to improve blood circulation in the lower extremities. Such therapy is not capable of acting on the fungus, so it is useless alone. Often, doctors prescribe to the main treatment regimen:

• UHF and amplipulse impact on the lumbosacral and cervical sections for a week.
• Diathermy on the lumbosacral zone.
• Laser therapy (blood irradiation) on peripheral vessels.

Medicines

Local treatment of the fungus requires systematic: you need to use the drugs prescribed by the doctor every day, often combining them - apply something in the morning, something at night. Before using these products, it is necessary to steam the nails, remove the free edge, and, if necessary, remove the affected area. Often, at the initial stage of treatment, only varnishes are used, and later the question arises of the advisability of purchasing ointments / gels and solutions, especially if onychomycosis is already characterized by detachment of the nail or its destruction.

varnish

The advantage of such a remedy for the treatment of onychomycosis of toenails is the format: the liquid substance quickly hardens, so it does not stain things and surfaces. However, the varnish acts only on the nail plate, so it does not affect the tissues affected nearby. The film created by him prevents the reproduction of fungal spores, and after a couple of days the pathogen dies. Doctors allocate such funds:

• Loceryl - on amorolfine, destroys fungal cells, can be used to prevent onychomycosis. Used after steaming the legs. Lacquer Loceryl in the set has a nail file, tampons and a spatula. The downside is the high price: from 1400 r.

• Batrafen - among other varnishes it is considered the most effective, it works on ciclopyrox. Affects 58 varieties of fungi, killing them, helps relieve inflammation. It must be applied exactly according to the instructions. Price - from 2000 rubles.

• Mycosan - works on plant components, therefore it has a small number of contraindications, helps to strengthen nails. The drug prevents the growth of the fungus and provokes its death. Used within a month after cleaning the plate. The price of varnish is from 500 rubles.

Creams, gels and ointments

Among all the means for local long-term therapy of a fungal disease of the nail plate, ointments and creams are especially widespread. They are inconvenient by the need to wait for absorption, but their spectrum of action is wider than that of varnishes. They not only have a destructive effect on the fungus, but also relieve inflammation, remove unpleasant symptoms. Apply only after steaming the feet for maximum effect. Doctors advise:

• Lamisil cream - based on terbinafine, which breaks the cell membrane of the fungus. The drug is highly effective, but it needs to be used for several months, up to 2 times a day.

• Exoderil cream is a popular antimycotic agent based on naphthyfine, which destroys all fungi and stops inflammation. It is used up to 8 weeks, once a day according to the schedule (at the same time).

• Candide cream - differs from the rest in the ability to influence the causative agent of candidiasis, is well tolerated, it is used for 4 weeks up to 2 times a day.

Local medicines for mycosis often do not cause adverse reactions, among the contraindications they have only an increased sensitivity to the active ingredient. If they are based on allylamines (naftifine, terbinafine), they can accumulate, so they have a prolonged effect. The picture of prices for the most effective can be tracked in the table:

Antimycotic sprays and solutions

This type of preparations for mycosis is used up to 2 times a day and is effective only as a complementary element to the main treatment regimen. Most of the solutions and sprays work on azoles / allylamines, they are applied not only to the plate (it is important to get into the root zone), but also to the nail roller. Most doctors recommend:

• Terbix;
• Mycospor;
• Thermicon.

Tablets

Systemic treatment is used when the disease begins to progress - up to this point, local therapy is mostly dispensed with. With onycholytic mycosis, an antibiotic (Griseofulvin) combined with an external keratolytic is prescribed inside. Griseofulvin is taken from 1 tsp. vegetable oil 250 mg up to 3 times a day, and at the same time they use varnishes Batrafen, Loceryl, etc. In other situations, preparations of azoles and allylamines are prescribed, the price picture for which looks like this:

Azoles

The most extensive group of drugs for the treatment of onychomycosis are azole-based drugs: they give a fungicidal and fungistatic effect. Firstly, they inhibit the synthesis of the cell membrane of the fungus, and secondly, when accumulated, they lead to the death of all pathogenic microorganisms. Assign them mainly against yeast-like fungi, dermatomycetes. Azoles are used up to 3 times a day, the course lasts 4 weeks. The most effective:

• ketoconazole (Mycozoral, Ketoconazole) - drink 1 tablet per day;
• itraconazole (Miconichol, Irunin) - drink 2 capsules a day, treatment can last six months.

Allylamines

The ability to block the growth of the fungus in allylamines is combined with the ability to break the cell membrane, which destroys the microorganism. Some of them affect all types of fungi, while naftifine is used primarily against an additional bacterial infection, but it is only available for external use. Allylamines penetrate into the thickness of the nail plate, give a prolonged effect. The duration of treatment is up to 3 months. There is only 1 remedy here - Terbinafine (Lamisil, Terbinafine):

• efficiency is 94%;
• course of treatment up to 3 months;
• reception - 250 mg after meals once a day;
• when breastfeeding, the drug is not used, a high load on the liver is not excluded.

Preparations for improving blood circulation in small vessels of the extremities

In order to increase the effectiveness of the main therapy, you can also drink a course of drugs that affect blood circulation in the fingers and toes: they help transport the substances contained in antifungal drugs in their original concentration. Additionally, there is a reduction in the duration of treatment, since a healthy nail plate grows faster. They make sense:

• Trental;
• Agapurin;
• Doxium;
• A nicotinic acid.

Laser removal

An alternative to conservative type surgery is laser removal of the affected area. The procedure, according to doctors, is fast and safe, with a minimum degree of discomfort, lasts up to half an hour, and is devoid of side effects. It is carried out like this:

• The doctor chooses a laser according to the type of fungus and the severity of the disease.
• The thickened section of the nail plate is sawn off and treated with an antiseptic.
• The affected area is irradiated for several minutes to kill the fungus.

Folk methods

The use of alternative medicine recipes implies a long-term fight against onychomycosis and, according to experts, it is desirable to combine such treatment with medication, especially in the case of subungual hyperkeratosis, advanced mycosis and Candida fungus. All the procedures listed below are preferably performed daily for 3-4 weeks.

Apple vinegar

The classic method of treating onychomycosis is foot baths with apple cider vinegar: it is poured into warm (!) Water, the proportion is chosen by eye. Doctors advise taking 3-5 tbsp. l. for 3 liters of water. The legs are kept in a basin for 15 minutes, after which they must be wiped dry, paying attention to the interdigital spaces. This procedure is the starting point for subsequent treatment measures: applying creams, applying compresses, etc.

Garlic compress

A strong antibacterial quality is observed in garlic, which, in order to eliminate nail mycosis, must be passed through a press and placed between layers of gauze. For a more pronounced effect, it can be mixed with grated onions, and some experts advise adding a drop of vodka here. The compress is applied at night, be sure to wrap the fingers with a film.

Doctors call the budgetary method of treating onychomycosis the application of compresses, which are a piece of gauze folded several times and soaked in tea tree oil. It is fixed with a plaster, applied in the evening, and removed in the morning. Tea tree has a strong antibacterial property and acts as a mild keratolic, so after several procedures, the affected area of ​​the nail can be removed.

Baths with celandine

In summer, the treatment of fungal diseases can be carried out with the help of celandine: for this purpose, flowers are taken, which are poured with boiling water. Proportion - 100 g per 1 liter. When the liquid boils, count 10 minutes and remove the broth from the stove. After cooling and filtering, it is drained into a basin, diluted with a liter of pure boiling water. If it is very hot, it is allowed to cool a little more, and the feet are placed in this bath for 15 minutes.

Peppermint with sea salt

Mint, which is used exclusively fresh, has proven itself well in the treatment of fungus. To do this, the leaves must be washed well, chopped with a knife or passed through a garlic press. Later, it is mixed in half with coarse sea salt and allowed to stand for half an hour. The resulting mixture can be applied to the affected nail with or without gauze, but always for 8-10 hours. It is advisable to start the procedure when the plate thickens, but does not deform yet.

chaga mushroom

The mass of antiseptic substances contained in this product has led to its active use against infectious diseases. Treatment of onychomycosis of toenails with kombucha involves simple lotions with a piece of this product, which is fixed with a plaster or bandage. The procedure should be carried out in the morning and in the evening, keep the lotion for 6-8 hours.

Prevention

If you consider yourself to be at risk, be sure to strengthen your immune system and carefully monitor your personal hygiene, especially if you tend to visit a bath, sauna, swimming pool. Treat slippers with alcohol, do not take other people's personal belongings - then you will not have to think about how to treat nail fungus. It would be useful to make weak solutions of iodine (3 drops per 2 liters of water) and rinse washed feet with them every day after visiting public places.

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Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Treatment of onychomycosis of toenails - effective regimens for taking medications and folk remedies

The question of what “onychomycosis” is is likely to be answered correctly only by specialists. Meanwhile, this fungal infection that affects the nails on the legs and hands - one of the most common, if not in the world (where there has not yet been a full-scale study of the problem), then in Europe for sure.

In the early 2000s, a study conducted in 16 countries in this part of the world revealed a disappointing trend - onychomycosis accounts for 27% of cases of fungal diseases of the feet. In such a situation, it is very important that inexpensive effective drugs for the treatment of onychomycosis of the nails on the hands and feet are available to all patients. This will help not only cure those who have already suffered from a dangerous fungus, but also stop the further spread of the infection.

Onychomycosis - what is it?

The causative agents of this fungal disease:

• dermatophytes (in the vast majority of cases),
• microsporia,
• trichophytosis.

Candidal onychomycosis is caused by the fungus Candida spp. Having penetrated into the deep layers of the nail plate, pathogens destroy its cells in order to make their constituent substances available “for consumption”. Having received the necessary nutrition, the fungus leaves behind waste products that, once in the lymph and blood of a person, are harmful not only to the nail, but to the body as a whole, and can negatively affect the nervous system.

The disease is diagnosed in children and adults, but fungal infection is especially common in people over 65 years of age. As a rule, it is a component of a whole complex of problems of an elderly person - the presence of diabetes mellitus, heart and vascular diseases, obesity, osteoarthropathy of the feet and other diseases.

Here are the eloquent figures: 1/3 of diabetics are concerned about fungal nail diseases, and among patients with psoriasis, onychomycosis affects 56% of people.

ICD-10 code

Causes and risk factors

Onychomycosis is a contagious disease, the main cause of the disease is transmission of infection from a sick person to a healthy person. Scales exfoliated from the infected nail plate can end up on the floor, carpet, tile in the pool, sand on the beach, on which a healthy person will walk barefoot.

The fungus can get inside the nail plate if it is injured as a result of:

• wearing tight and non-breathable shoes;
• various injuries (domestic, industrial, sports);
• an unsuccessful pedicure, in which the nail is cut too much.

Risk factors are:

• ignoring personal hygiene standards (using other people's towels, shoes);
• weakened body defenses and the use of drugs that reduce immunity;
• circulatory problems (varicose veins);
• chronic diseases (AIDS, diabetes, stomach diseases).

The risk group includes:

• athletes using common equipment, visiting swimming pools, gyms, baths;
• visitors to nail salons (not every one of them processes the tools used with high quality);
• representatives of professions who often have to use shared showers (military personnel, miners, medical workers).

By the way, when the nail softens from hot water in the shower or bath, the infection is much easier to get inside and start its destructive activity.

Classification: types and stages

According to the classification, experts divide cases of onychomycosis into 3 types:

Based on the localization of the affected area, it is customary to distinguish onychomycosis:

• proximal (the fungus captures the base of the nail);
• distal (the disease manifests itself on the free part of the plate, resembling a splinter that has fallen under the nail);
• lateral (the fungus affects the edges of the plate, sometimes with this disease there is a problem of an ingrown nail);
• total (the nail plate is completely affected by the infection).

Usually onychomycosis goes through 3 stages, each of which has its own characteristics:

1. During the 1st stage of the disease, the color of the nail becomes dark, the surface is uneven.
2. There is a deformation of the nail plate - it thickens, exfoliates. During the 2nd stage, the tissues surrounding the nail may become inflamed.
3. At the final stage of onychomycosis, the nail crumbles, and sometimes it falls apart completely.

Characteristic symptoms and signs

Almost all types of diseases are characterized by the following symptoms:

• inflammation in the area of ​​the periungual roller;
• the presence in the structure of the nail of stripes and spots that differ in color from the color of a healthy nail;
• changes in the nail tissue of a dystrophic nature;
• separation of the nail from the bed.

Infection usually manifests itself on the big toes., then comes the turn of the nails on the other fingers - first the legs, and then the hands. Tissue adjacent to the nail also suffer from onychomycosis. When they become inflamed, the person experiences pain and itching.

Not so common white superficial onychomycosis differs from other types of the disease in that the first signs of infection appear not only on the big toes, but also on the little fingers of the hands.

The surface of the nail plate is covered with white dots, which turn yellow over time. Sometimes it can be one large spot of white. The collapsing part of the nail plate in this form of the disease resembles chalk powder.

Photo of onychomycosis of nails at the initial stage

Diagnostic methods

It is very difficult to make a diagnosis on your own: the symptoms of onychomycosis (especially in the initial stages) often resemble signs of diseases such as psoriasis, lichen planus, keratoderma. Even a specialist dermatologist will not rely solely on visual examination in his conclusions. The patient will undergo a laboratory bacteriological culture analysis, a scraping of the nail tissue will be examined (laser microscopy).

When onychomycosis is suspected, it is usually used luminescent diagnostics(examination of a diseased nail with a Wood's lamp).

Treatment of nail disease on the hands and feet

The treatment regimen is determined by the doctor, taking into account the severity of the disease. If onychomycosis is diagnosed in its initial stage, external means - ointments, varnishes, creams - can help to cope with it. Advanced cases sometimes require surgery.

The most effective inexpensive drugs

The treatment of onychomycosis is a lengthy process, so it is very important that doctors have budgetary, but quite effective means at their disposal. A patient with any income can afford the treatment of foot nails for 9-18 months, fingernails - from 4 to 6 months. such antifungal medicines in the form of tablets, how:

• Ketoconazole
• fluconazole,
• Itraconazole
• Griseofulvin.

One drug is usually used for 3-6 months. If the treatment is repeated, it is changed to another drug, since the fungus may develop resistance to the first drug.

Depending on the localization of the disease, its stage, the individual characteristics of the patient's body, the existing contraindications, the doctor may recommend one or another dosage form:

• cream (Nizoral, Bifosin);
• varnish (Batrafen, Lotseril);
• spray (Termikon, Lamisil);
• ointment (Mycozoral);
• antifungal liquids (Fukortsin, Creolin);
• patch (keratolytic, trichloroacetic).

The effectiveness of each remedy depends on how accurately the patient will follow the instructions for use attached to the drug.

For example, before using Loceryl medical varnish, feet should be washed in hot water and wiped dry. Clean the diseased nail with a nail file (usually this tool is attached to the preparation), cut it. Treat the skin around the nail plate with alcohol. After waiting for it to dry, apply varnish on the nail.

If you ignore at least one of the listed preparatory stages, the effectiveness of treatment can be minimized.

Help folk remedies at home

It is impossible to rely only on folk methods of treating this disease, but they are certainly useful as part of complex therapy. Here is a list of resources that can be used:

1. Iodine . This drug has a detrimental effect not only on the fungus, but also on various microbes, which, multiplying, complicate the treatment of onychomycosis. The drug is applied to the entire nail plate every day or every other day, using a cotton swab for this. For prevention, it is desirable to lubricate not only sick, but also healthy nails.
2. Essential oils . It is good if it is an assorted olive, lavender and tea tree oil. As in the case of iodine, you need to process the entire nail plate. After that put on socks. In order for the oils to have time to absorb, the procedure is done before going to bed. We have an article on the effect of tea tree oil on nail fungus.
3. Garlic . It must be turned into gruel by passing through the press. Garlic is applied to the nails at night, wrapping them with cling film.
4. Apple vinegar . Before using this remedy, the legs are steamed out, and then tampons soaked in vinegar are bandaged to the damaged nails for 2 hours. The procedure is done regularly, each time cutting off the overgrown part of the nail.
5. Celandine. This plant helps to treat many diseases, in this case, warm baths with a healing decoction will be useful. The procedure is carried out every day for 1 hour. A positive result can be achieved in 3-4 weeks.

Laser

Dermatologists consider laser treatment to be a safe modern method. Rays, acting on infected areas, kill all spores of a dangerous fungus. It is not always possible to reach them with the help of traditional external means - the mycelium is located at a depth of up to 7 mm.

Other benefits of laser treatment:

• painless procedure,
• fast effect and lasting result,
• disinfectant action,
• the ability to individually adjust the duration of the session,
• no need for hospitalization of the patient,
• safety for the soft tissues surrounding the nail.

Experts consider it necessary to act with a laser on all 10 nail plates at once (in terms of a preventive measure), although, for example, only 1-2 are infected.

UFO

With onychomycosis, the doctor may prescribe physiotherapy. Ultraviolet rays have a detrimental effect on infectious agents without harming healthy tissues.

If the patient had to remove the nail plates destroyed by the fungus, then for the speedy growth of new ones, the doctor may prescribe (as part of complex treatment) UHF procedures and amplipulse therapy.

Surgery

Sometimes you have to resort to surgery to completely or partially remove the diseased nail. If it is possible to get by with the removal of only dead areas, this is done by sawing or cutting off pieces of the nail plate.

Before these procedures, the nail tissue is softened with a keratolytic patch. Surgical treatment is carried out only by specialists.

Possible Complications

Pessimists who do not believe that onychomycosis is curable should bear in mind that they are fortunately wrong. However, if the disease is ignored or self-medicated without being sure of the correct diagnosis, problems can arise.

Possible complications include:

• the occurrence of mycotic eczema with a large area affected by the fungus;
• burns caused by improper use of the keratolytic patch;
• violations of the liver, gastrointestinal organs, provoked by the accumulation of toxins in the body;
• the development of an allergic reaction, also occurring due to the fact that the body is “overloaded” with substances harmful to it;
• psychological problems caused by the fact that a person cannot live a normal life - for example, do not hesitate to visit a bathhouse, go to the beach.

With information about the manifestations and treatment, with the classification and can be found in this material.

Causes and signs, methods of treatment and photos of carbuncles - all this in the article.

Prevention

In order not to get infected with onychomycosis, you must adhere to the following rules:

• take rubber shoes with you to pools and baths;
• do not use other people's towels;
• do not wear other people's slippers, slippers, sneakers (especially those worn on bare feet);
• after any water procedures, wipe your feet dry;
• use special means for sweating feet;
• in case of injuries of fingers and nails, treat wounds with antimicrobial agents;
• if you suspect any skin disease, consult a doctor.

You should also take care of strengthening your immunity, since a strong body is always more resistant to various kinds of infections, including fungal ones.

Treatment of the advanced form of onychomycosis consists in the use of combination therapy with systemic drugs, as well as topical agents. In case of a disease caused only by dermatophyte fungi, Terbinafine is prescribed, if the disease is provoked by Candida fungi, Fluconazole is used. For the treatment of onychomycosis caused by mold fungi, Intraconazole is suitable. If the causative agent of the disease is unknown or several fungi are found, a broad-spectrum drug (for example, Intraconazole) is used.

The most effective is pulse therapy. In this case, an increased dose of the drug is taken in short courses at intervals that should exceed the duration of the courses of administration. For example, "Intraconazole" is prescribed 400 mg per day for 7 days, then a 3-week break is taken. "Fluconazole" according to this scheme is taken 150 mg 1 time per week. The preparations are used until the nail plates are completely grown. This is considered effective, safe in terms of side effects and convenient for the patient.

External therapy for advanced onychomycosis

Treatment of advanced onychomycosis using antimycotic drugs should be carried out in combination with external therapy, consisting of 2 stages. At the 1st stage, the affected nail or part of it is removed mechanically or with the help of keratolytic patches. During mechanical removal, the affected nail plates are sawn off or cut off with nippers. Keratolytic patches help to soften the nail, as a result, it can be painlessly removed with ordinary scissors.

At the 2nd stage, the treatment of the nail bed and the growing nail plate is carried out. For this purpose, you can use the Mycospor cream for 4-6 weeks. The drug is intended for the simultaneous removal of the nail and for the destruction of pathogenic fungi. Effective means of local therapy for onychomycosis are the drugs "Loceril" and "Batrafen", which are available in the form of nail polishes. These products can be applied to the nail plates without removing them. Effective concentrations persist for 7 days, so the drugs can be used 1-2 times a day. in Week. During the period of treatment and after it, it is necessary to repeatedly treat shoes with disinfectants, which include: powder-powder "Borosin", spray-powder "Daktarin", 10% solution of "Formalin", 0.5% solution of "Chlorhexidine" and etc.