Onychomycosis - damage to nails with a fungal infection. The disease occurs in 5-10% of the population and among other nail lesions is about 30%.
The causes of onychomycosis
The infection of the nail plates of the feet occurs mainly in public baths, saunas, swimming pools. Scales with pathogenic mushrooms, which fall into patients with onychomycosis, fall on the floors, benches, bars, paths, carpets and litter. In conditions of high humidity, mushrooms can not only persist for a long time, but also multiply, especially on unpainted wooden benches and gratings, which makes them an intense source of infection.
Often, onychomycosis is transmitted inside the family when using general shoes, towels, washcloths, insufficient processing of the bath after washing, as well as due to rugs and gratings in the bathroom. Damage to the nails of the hands usually occurs when combing the foci on the skin.
The occurrence of onychomycosis is facilitated by trauma of nails, especially multiple (in athletes), impaired blood supply to the limbs, severe concomitant diseases (diabetes mellitus, immunodeficiency states, blood disease).
Onychomycosis is often found in persons who have long received antibacterial, corticosteroid and immunosuppressive therapy. The lesion of the nail plates occurs secondly: at first, the mushrooms affect the interdigital folds or sole, and then the nails.
Three types of onychomycosis are distinguished all over the world:
- Normotorophical,
- hypertrophic
- Atrophic.
With a smooth scar type of onychomycosis, only the color of the nails changes: in their extreme departments, spots and stripes appear, the color of which varies from white to guard. Gradually, the entire nail changes the color, maintaining, however, shine and normal thickness.
With a hypertrophic type, the color changes, the nail loses its shine, becomes dull, thickens and deforms, partially destroyed, especially from the sides. Often patients experience pain when walking. A typical nail fungus is characterized by a dull brownish-gray coloring of the affected part of the nail, its thinning and rejection from the box; The naked area is covered with loose layers.
We treat the fungus
Local antifungal agents are ineffective with damage to the nail plates. Processing with antifungal ointments, creams, solutions, varnishes must be preceded by removal of the affected area of the nail mechanically or using keratolytic plasters.
Mechanical removal consists in cutting or cutting with bites of affected fragments of the nail plate.
The use of keratolytic plasters in the treatment of onychomycosis allows you to soften the nail, as a result of which it easily and painlessly removes from the surface of the nail bed with a dull scalpel or scissors.
As a keratolytic agent, a drug is used, which includes an ointment containing 1% antifungal agent and 40% urea. The ointment is applied to the surface of the nail and covered with the attached adhesive and bandage. After a day, the areas affected by onychomycosis are cleaned. The procedures are performed daily until the affected nails are completely removed. In the future, as the affected nail is removed, local ones are used: antifungal varnishes.
- In the first month of treatment, a drug is prescribed for 6-8 tablets per day (750-1000 mg), in the second-in the same dose every other day, and then, up to the growing of healthy nail plates, 2 times a week. It is taken in 3 doses with a teaspoon of vegetable oil. The duration of treatment for brushes mycosis is 4-6 months, with a mycosis of the feet-9-12, and even 18 months.
- Treatment with the preparation against the fungus ensures a cure only in 40% of patients. A combination with nail removal increases the percentage of cure. However, a large number of side effects, as well as a high percentage of relapse of the disease, limit its use.
For successful and safe treatment of onychomycosis, it is advisable to adhere to certain rules with systemic antifungal drugs.
First of all, the diagnosis should be reliable. The drug should not be prescribed if there is no laboratory confirmation.
After the diagnosis is made, it is necessary to carefully collect an allergic history. If at the same time, drugs or foods that cause allergic reactions or any other manifestations of intolerance are detected, then their intake should be excluded.
For the period of treatment with systemic antimycots, it is advisable to limit the use of other drugs, with the exception of vital.
Prevention and treatment
In order to prevent gastrointestinal disorders, it is recommended to exclude products that cause flatulence from food during treatment: black bread, legumes, milk, cabbage.
Of no small importance is the selection of comfortable shoes both during treatment and after its completion. Often, an improvement in the condition of the affected nail clearly correlates with the wearing of non -traumatic shoes, since the pollination of tissues caused by shoes can cause exacerbation or distal to nail onychomycosis. Before starting treatment, it is advisable to conduct a study of indicators of general and biochemical blood tests.
Control examinations must be carried out the first time after 2 weeks, then 1 time per month. Control microscopy - 6 months after the end of treatment. The identification of the mycelium of pathogenic fungi serves as an indication for a second course of treatment with preliminary surgical removal of the affected nails.
Prognosis for the treatment of onychomycosis
Despite the high percentage of cure for patients with onychomycosis when using therapeutic agents, therapy with these drugs does not exclude the use of local antifungal drugs. The combination with conservative and surgical removal of nail plates reduces the time for taking systemic anti -bactericidal agents and increases the effectiveness of treatment.