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 earlier treatment is started, the easier it is to cope with 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 injury is significant.
![Fungal infection of big toe nails](/images/articles/98/Fungal%20infection%20of%20big%20toe%20nails.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 deviations are observed: the changes are still external. The nail plates on the toes of the lower extremities lose their shine. White spots or stripes appear on the surface. In general, the nail looks healthy, the person does not experience pain or discomfort. If you identify nail fungus at this stage, you can quickly get rid of it.
- Moderate or progressive.The structure of the nail is already undergoing pathological changes. The nail acquires a pronounced yellowish tint, peels off and disintegrates. 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 rest. The entire surface of the nail plate is affected by the fungus and peels off from the bed and becomes loose. The patient is bothered by severe itching. When pressing on the affected areas, a painful and throbbing sensation occurs. 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)
At the third stage of development of the infectious process, infection of the skin of the foot 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 causing the development of onychomycosis are:
- contact with a person who is a carrier of a fungal infection;
- neglect of hygiene rules;
- wearing someone else's or narrow shoes that do not fit;
- weakened immune system;
- visiting a bathhouse, sauna, swimming pool or beauty salon, where undisinfected instruments may 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 immune lesions;
- disturbances in the circulatory system, which is especially important for elderly patients;
- phlebeurism;
- diabetes.
![Flat feet is one of the causes of toenail fungus](/images/articles/98/Flat%20feet%20is%20one%20of%20the%20causes%20of%20toenail%20fungus.jpg)
An important factor that increases the risk of developing onychomycosis is old age. Older people suffer from poor blood supply to the extremities, which also increases the risk of developing fungal infections.
The causative agent of the disease gets onto the nails or skin from infected objects or through contact with a carrier. The pathogen spreads quickly, invading new areas. The fungus enters the subungual space through damaged areas of the nail plate or surrounding skin.
The fungus quickly spreads to the nail bed. The rate of advancement exceeds the rate of plate growth. Soon the pathogenic microorganism reaches its target and causes changes in the structure of the nail. It has been established that men suffer from fungus 3 times more often. The nail plates are affected by types of fungi such as dermatophytes, mold and yeast.
When should you see a doctor?
You should consult a doctor at the first sign of a fungal infection. You should not wait for obvious signs of the disease to appear - the formation of white spots and even mild itching in the area of the feet should be a reason to contact 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)
Diagnostics
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 received by 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 fungal nail infection at an early stage of development
If the disease was detected at an early stage, it will be much easier to cope with it. In this case, it is usually sufficient to use local agents that directly affect the affected nail.
At the first stage of mycosis, if no more than 50% of the nail plate is affected, the following drugs are prescribed:
- Varnish that should be applied to the surface of affected nails. This should be done twice a day, the total course of treatment will be one month. The product has contraindications, so it can 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 3 times a day, the course of treatment lasts about a month.
- A product that is gypsum impregnated with a special composition. The adhesive strips are left on for 3 days and then removed. Special substances covering the surface of the plaster help 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 proliferation. It is recommended to smear 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.
Any medications 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 in the case of an ongoing infectious process, complex treatment is indicated. Systemic antifungal agents must be prescribed if there are no contraindications. The patient is prescribed the following medications:
- Systemic antibiotic from the triazole group in tablet form. 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 that has a fungicidal effect. The active substance gradually accumulates in the layers of the nail plate, which makes it possible to destroy even those fungi that are located quite deep.
Also, with advanced nail fungus, procedures are effective to get rid of the infected plate. 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. After the operation, a bandage is applied. The surgical method is traumatic and is rarely used. Instead, minimally invasive methods are practiced.
- Removing plaque using chemicals, promoting rapid exfoliation of the affected nail. In this case, the problem area is treated with a special solution, wait until the drug takes effect, and then use products that help quickly separate the plaque from the nail bed.
- Laser treatment.This is a modern, painless method that will quickly get rid of nail fungus. The laser acts on the plate, bringing it to high temperatures as quickly as possible. The beam penetrates deeply and neutralizes pathogens. The method is bloodless and absolutely 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 generalized damage to the body by a fungal infection.
Traditional methods
Toenail fungus can also be cured using 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, rinse off.
- 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. Dip a piece of gauze in hydrogen peroxide and wrap the phalanx of the finger with the affected nail, capturing the immediate lesion. Leave for 40-50 minutes. You can repeat the procedure up to two times a day.
- Apple 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 into the resulting mixture and apply to your nails for 15 minutes. Repeat 4 times a day.
Traditional recipes help alleviate the severity of the symptoms of the disease and eliminate discomfort, but they are not able to destroy the causative agents of the disease.
The course of the disease and features of treatment of nail fungus in children
Onychomycosis is rare in children. The main cause of the disease is weak immunity due to incomplete formation. Symptoms of onychomycosis in children are:
- 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 spray, varnish or cream, 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 has not completely cured it. 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, since in severe cases it creates a risk of bacterial infection that threatens the health of both mother and fetus. Systemic drugs should not be used during pregnancy, as they have a high level of toxicity.
During pregnancy and lactation, topical medications should be used, but only those that are safe for the expectant mother and her baby. These include sulfur-salicylic ointment.
Treatment of the elderly
In older people, decreased immunity is a natural age-related phenomenon that creates additional risks for the development of onychomycosis. In this case, the specialist also exercises caution when choosing a remedy for treating 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.
Most often, elderly patients are prescribed systemic antifungal agents from the group of allylamines and triazoles.
Preventive measures
If you have signs of fungus on your pinky or thumb, see your doctor immediately. But 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 ones;
- if you sweat excessively, use special foot deodorants;
- Wear shoes that are the right size, they should not be too tight, and they should be washed daily;
- use only personal hygiene products, as well as manicure and pedicure tools;
- when visiting the pool, beach, sauna, use personal rubber shoes;
- 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 cure in the advanced stage. At the first symptoms you should consult a doctor. Treatment depends on the stage of development of onychomycosis: at the initial stage, local drugs are sufficient; when initiated, systemic antifungal agents are required.