Onychomycosis: course, treatment in adults and children

Onychomycosis, known to professionals as onychomycosis, is a very common pathology. About 40% of people will be affected by this condition at least once in their lives. In this case, fungus is more common on the feet than on the hands.The disease begins with the appearance of white or yellow-brown spots under the tip of the nail. As the fungal infection penetrates deeper into the skin, the nail plate begins to discolor, thicken, and crumble at the edges. If treatment is not started early, onychomycosis can begin to affect the area between the toes and may even reach the skin of the feet. This neglected fungus is called epidermophytosis. Be sure to consult your local doctor!

How do you get onychomycosis?

Because the disease is contagious, it can only be contracted through contact. There are hundreds of different types of pathogens in the environment. But perfectly healthy people with strong immune systems are less susceptible to onychomycosis. Onychomycosis requires a combination of factors to develop: poor health (for example, after a recent acute respiratory viral infection), and small cracks in the nail and surrounding skin. In addition, after pathogenic bacteria invade, it is necessary to create a moist and warm environment conducive to reproduction.Other risk factors that increase your risk of developing nail fungus include:

• Microtrauma to the nail plate;
• diabetes;
• taking immunosuppressants;
• Congenital nail plate thickening;
• Venous insufficiency (poor blood circulation in the legs);
• peripheral arterial disease;
• advanced age;
• Fungal skin infection.

People who frequently notice lesions on their nails should take certain steps to prevent recurrence. At the very least, you need to keep your feet dry and warm. You should not walk barefoot in public places, especially in swimming pools, saunas and spas. Professional athletes and people who engage in strenuous physical labor for most of the day should also pay attention to choosing appropriate footwear. Feet should not be sweaty and nails should not be squeezed.

Who should I contact if I have onychomycosis?

There are many effective over-the-counter medications available for treatment without a doctor's prescription. But if a new growth appears on the nail for the first time, it is necessary to consult a dermatologist or podiatrist. In fact, fungus isn't the only possible cause of nail problems. Many other pathologies may mimic the presentation of fungal infections. For example, some forms of psoriasis can mimic the symptoms of nail fungus. Therefore, diagnosis and treatment selection must be made by a medical expert. In the future, if the condition relapses, patients will be able to reuse medications that have been prescribed.

Symptoms, Diagnosis

Before prescribing fungal treatment, a good doctor should have the patient undergo laboratory tests. Even experienced experts cannot determine the type of pathogen with the naked eye. Most commonly, patients are asked to send clippings of the affected nails to a lab for examination under a microscope.If the chosen treatment does not help, then you need to consult your doctor again. Symptoms that indicate onychomycosis is progressing:

• Microbleeds around the nail bed;
• Swelling and pain in the affected area;
• The deck was completely deformed;
• Characteristic pulsation when walking;

Only by identifying the true cause of infection can truly effective treatment be possible.

Treatment programs

There is no best or optimal treatment. Medical prescription depends directly on the severity of the condition and the type of microorganism causing the disease. In most cases, your doctor will prescribe a medication that needs to be applied directly to the nail or taken orally. Let's take a closer look at each option.

Oral antifungals.

They are the first choice and most common treatment for recurrent fungus. These tablets help new nails grow cleanly and have the correct structure. You need to be prepared that results won't come quickly; the entire treatment process takes 6-12 weeks. Oral treatment should be discontinued only when the nails have completely grown back to be clean and healthy.As for the downsides, this therapy isn't suitable for people over 65, as well as people with liver problems or diagnosed congestive heart failure. Additionally, oral antifungal medications may cause side effects such as rash and nausea. It is strictly forbidden to start taking such medications without preliminary testing. In addition, approximately 2 weeks after starting treatment, it is recommended to perform gua sha again to check how the body is responding to the prescribed medication.

Healing varnish.

If the nails are affected for the first time (the onset of the disease is diagnosed) or if the fungus is detected in the "spot stage", then the doctor may prescribe the use of a special antifungal varnish containing the main active ingredient. For best results, it is recommended to treat the affected nail plate and surrounding skin at least once a day. After 7 days, it is necessary to remove the accumulated varnish layer with medical alcohol, evaluate the results and repeat the process if necessary. This product can quickly remove small patches of fungus, but if the lesions are deep enough, the risk of recurrence is high.

Antifungal cream.

If the lesions have spread under the nail and into the surrounding skin, then it is recommended to use a cream rather than a varnish. Before each use, feet must be thoroughly washed and dried, and the affected nail layer filed away. Then you need to apply a thin layer of frost. If the infection has spread to surrounding skin and the skin has also thickened, it is recommended to apply additional urea cream to soften the skin before starting treatment. Antifungal nail creams are very effective and rarely cause complications.If this disease occurs against the background of diabetes, then not only podiatrists, but also endocrinologists are involved in formulating the treatment plan. Experts will ensure that prescribed medications do not conflict with each other. In fact, even a small problem in a diabetic foot can turn into full-blown gangrene.Don’t assume that completely completing the treatment means your nails will look great. Unfortunately, fungal damage does not mean that the nail plate will return to its natural color and shape. A complete update may take up to 18 months.

When is surgery needed?

If the fungus keeps coming back and stops responding to the medications you are taking, your best option is to seek help from a surgeon. Experts will recommend complete removal of the affected nail so that the antifungal medication can be applied directly to the skin. The only but important disadvantage of this method is that sometimes the new boards will grow back very thin and already deformed. If the nail is so deformed and damaged that foot hygiene cannot help correct the condition, surgical removal may also be performed. The procedure is also suitable for patients who are unable to take medications or use topical medications due to personal intolerance.

prevention methods

Following all of your doctor's recommendations is key to a successful treatment outcome. But sometimes, due to low immunity or non-compliance with hygiene rules, the fungus returns. Simple preventive measures to help avoid relapse:

• Keep your feet clean and dry;
• Wear flip flops in public swimming pools, showers and changing rooms;
• Perform general cleaning and disinfection of all surfaces in your own bathroom;
• Change socks every day;
• For people who wear barefoot shoes, it is recommended to clean the insoles at least once a week and install new shoes or use insoles after the fungus intensifies;
• Remove shoes and socks that are too tight from your closet;
• Cut your nails short and file the edges to a strict right angle;
• Wash your feet often, several times a day in summer;
• Wear shoes that allow your feet to breathe;

Once the fungus has worsened, any shoes that cannot be washed or disinfected at 90 degrees must be thrown away. It is also recommended to boil socks and household textiles.Carpets should be thrown away or treated with disinfectants and antifungal laundry detergent. Tools for handling nails (scissors, files, tweezers) must be disinfected after each use. During an exacerbation of the condition, it is forbidden to use decorative varnishes, perform extensions or install artificial tips.

Characteristics and treatment methods of fungal diseases in children

Onychomycosis does look unsightly, but it rarely poses a serious threat to life and health. This is why adults sometimes neglect treatment. However, mycosis in children has its own characteristics. Changing the appearance of your nails can have a profound impact on your child's self-esteem. Children may feel ugly and worry about their health. The rapid progression of the disease can cause significant stress for the baby, even causing problems with perception of his own body and diminishing self-esteem.The task of parents is to check up on their children regularly. After all, children often hide fungal growth because they believe they are responsible for the disease, don't want to upset their elders, or are simply afraid of treatment. After parents discover foot lesions, they should not show disapproval, disgust, or even scold their children. It is forbidden to use expressions such as "you didn't wash your feet" or "because you rarely change your socks". It is necessary to calmly talk about what onychomycosis is, dispel possible fears, reassure and generally describe the treatment.It is important to explain to the child that the disease is not his fault. But at the same time, it must be conveyed that fungal infections like dark and moist spaces, so it is necessary to change socks regularly, keep shoes clean and not forget about daily hygiene procedures.Treatment of fungus in children is usually with oral medications. The fact is that children's nails are very thin and grow very quickly, which means there is a higher risk of complications after using creams and gels.Fungal infections are common. But with high-quality daily hygiene procedures and a strong immune system, the risk of infection can be minimized.