Toenail fungus (med. onychomycosis) is an infectious, fungal disease that affects the nail plate. Unfortunately, it is easily contagious and spreads quickly from one nail to the other, which not only detracts from the aesthetic appearance of the nail but can also lead to health problems. The main causative agents of nail fungus are dermatophytes, mycelia and mould fungi.
Not all cases of fungal infections affect the appearance of the nail, but it is estimated that about 60% of all nail lesions are due to nail fungus (onychomycosis).
Certain risk factors have been identified that increase the likelihood of contracting and developing nail fungus:
- Older age
- Foot fungus
- Diabetes mellitus, vascular disease
- Immune system disorders
- Family member with nail fungus
- Going to swimming pools, saunas, sports club
- Constant traumatisation of nails
- Moist, warm environment, e.g. closed shoes, rubber gloves
- Increased sweating
There are several main forms of hand and toenail fungus:
The most common form of nail fungus is distal onychomycosis. In this case, the free edge of the nail plate is damaged. In 85% of cases the causative agent is the dermatophyte Trichophyton rubrum. Initially, one corner of the nail becomes discoloured – white, yellow or brown. The nail fungus gradually spreads to cover the entire nail plate. Ponlaginous masses appear and the nail plate may detach from the nail bed (i.e. onycholysis may occur). This type of infection is particularly characteristic of toenail fungus.
White superficial onychomycosis is usually caused by the dermatophyte Trichophyton mentagrophytes. This type of infection is characterised by pale white spots on the nail surface. If left untreated, the nail fungus spreads and can cover the entire nail plate. The white areas are soft and can be easily sampled for laboratory examination.
Proximal pontine onychomycosis is less common – parts of the nail near the nail roller are affected and the infection spreads further towards the free edge of the nail. The main causative agents are the dermatophyte T. rubrum, the mycelia C. albicans and fungi of the genus Aspergillus. This variant of onychomycosis has been observed to be more common in people with immunodeficiencies (e.g. immunosuppressive drugs or immunodeficiency).
Total dystrophic onychomycosis is a form of nail fungus in which the entire nail plate is affected. This lesion is usually a progression of other forms of nail fungus. Total dystrophic onychomycosis is characterised by a thickened, uneven, brittle nail plate and hyperkeratotic masses under the nail. However, it is not possible to determine whether the nail fungus is the causative agent of the nail lesions by looking at the nail lesions alone, as these may be associated with other nail diseases such as psoriasis. In this case, it is necessary to consult a specialist doctor.
Mixed onychomycosis is a combination of two or more of the above types. A combination of white superficial onychomycosis and distal onychomycosis is the most commonly observed.
It is common knowledge that treating toenail fungus on the hands and feet is a complex and lengthy process that requires close cooperation and patience between doctor and patient. This is because nail fungus is very resistant to treatment. The standard treatment for toenail fungus is oral medication, ointments, surgical removal of the nail plate or a combination of these methods. If left untreated, the disease can become complicated:
- Pain, especially when clipping the nails, walking, running
- Bacterial infection, e.g. rose, cellulitis, osteomyelitis
- Fungal infections in other areas of the body, e.g. feet, body or scalp hair.
In addition, if nail fungus is not treated, there is a risk of infecting other family members.
The Laser Dermatology Centre was the first in Lithuania to offer its patients laser treatment for nail fungus on the hands and feet.
The procedure is simple, painless and lasts from 20 minutes to 1 hour, depending on the number of nails affected.
According to scientific studies, laser treatment of nail fungus outperforms other treatment methods in terms of effectiveness. Laser nail fungus treatment is also an excellent alternative when traditional treatment is contraindicated or has proven ineffective.
Signs of fungus
Both skin and nail fungus are extremely unpleasant and often underestimated diseases. Many people who suffer from this disease infect their relatives, friends or acquaintances without recognising it or even knowing anything about the disease and its proper treatment.
Fungus on the hands, feet or skin can be contracted in many places and at any time, as the fungal spores lurk:
- swimming pools;
- bed linen;
- shoes and other places.
The main signs and symptoms of nail fungus are:
- A chipped nail plate;
- uneven and deformed nails;
- Redness of the nail roller;
- yellow nails or greyish nails;
- pus under the nail roller;
- thickened nail plate;
- swelling of the nail roller;
- flattened nail plate;
- white or yellowish lines on the nails (longitudinal, diagonal).
Main signs and symptoms of skin fungus:
- scaly, round, scaly, reddened skin foci on the hairy part of the scalp, with visible scaly hair in the foci.
- On the skin of the body, with the legs and arms being the most affected areas, there are scaly foci of various shapes, tightly circumscribed and bordered by fine papules (fungal foci can be 5 cm or more in size). The edges of the affected area are also raised and the pigmentation of the central part of the foci is reduced.
- Scaly foci, where the rashes spread laterally, are most common in the groin area. The boundaries of the foci are strict.
- Dandruff, redness, urination, pustules, scabs and nodules are observed in the perioral area.
If you have even the slightest suspicion of a possible infection, do not wait to check whether a fungal infection of the nails or skin has developed, as the earlier the fungal treatment is started, the better the results. Do not delay and seek professional advice.
How to prevent nail fungus
Discolouration of your nails? Have your nails turned yellow, thickened and developed yellowish lines on your nails? Or maybe your nails have started to crumble and become deformed? If you’ve noticed any of these symptoms, you most likely have nail fungus. We advise you to be alarmed, see a doctor and follow a strict treatment plan.
If you are faced with this problem, the question often arises: How can you protect yourself from nail fungus and what are the most effective measures? Nail fungus is a contagious chronic disease caused by dermatophytes, moulds and yeasts. At the beginning of the disease, only one nail may be affected, but later it can spread to other nails. As soon as the first signs appear, all possible and effective treatment measures are necessary.
If your nails show symptoms similar to those of nail fungus, the first step is to consult a specialist for tests and appropriate treatment. Only after the microscopic and culture results are available can the specialist prescribe:
- medical treatment;
- laser treatment;
- combined medical and laser treatment;
- provide information on specific care, as hygiene is particularly important in nail fungus.
There is now a wealth of information on the internet on how to prevent nail fungus, but we recommend that you do not rush to rely on all the advice offered. Various folk remedies and home treatments can only further damage your damaged nails.
The first thing you can do to prevent nail fungus is to practice good hygiene:
- disinfect your shoes with a special solution;
- moisten dry feet and soles and rub them well with a disinfectant solution;
- spray clean and dry socks with disinfectant solution and allow to dry;
- boil socks and bed linen for 15 minutes in a solution of 1 % baking soda or washing powder. 10 grams of baking soda or washing powder per 1 litre of water;
- Disinfect and disinfect personal hygiene items that can give you the fungus, such as scissors, and do not share them with anyone;
- wash the bath, shower, sink and floors as often as possible with hot water and disinfectant.
All these disinfectants help to prevent the spread of fungi. It is important to remember that certain symptoms may only be similar to those of nail fungus, so you need to be tested so that we can prescribe the most appropriate and effective treatment for you.