The greatest prevalence of infection reached among the elderly over 65 years. The reasons for increasing the number of patients infected with onychomycosis, in this age group are explained simply. Aggravating factors that contribute to the progression of a fungus, in this case are those diseases and diseases such as diabetes, excess body weight, disturbances in the cardiovascular system, osteoarthropathy Stop.
What it is?
Onychomycosis - is a nail disease caused by a fungal infection. This pathology is very common, all of onychomycosis suffers from 10-20% of the world population. Infectious agents are the dermatophytes often, less often - Trichophyton, Microsporum and athlete.
Very often, the activity of dermatophytes complicated by concomitant development of yeast or moldy fungi that increase the negative effects of the disease and determine the resistance to therapy.
How do you get?
The causative agent of the disease, the population of spores of the fungus, great feeling of moisture. Therefore, most infections occur in these locations:
- public baths;
- sauna;
- swimming pools;
- dressing rooms in gyms, showers.
The scales fall off fungal diseases in patients with onychomycosis, settling mostly on carpets, floors, unpainted wooden benches subjects - there they multiply rapidly. nail infections often cause sharing shoes, towels and washcloths. Insufficient cleanliness of rooms is often the cause. Inflammation of the nail plate on the hands usually occurs at the expense of disentangling of microorganisms on the skin.
Onychomycosis is frequently infect humans again, even with the prior use of antifungal agents. If you do not completely destroy the pathogen, sooner or later the problem will return. In particular, it concerns the treatment methods associated with the removal of the nail - if the operation was carried out properly, the disease spreads to the neighboring fingers. In addition, there are likely to be infected by the novel microorganisms of unsanitary conditions.
Classification
But before you treat onychomycosis toe nail, it should determine the form of fungus.
So, the following types of onychomycosis:
- Hypertrophic. This form appears in the absence of long-term treatment ineffective or impact on the problem. In this type of nail plate thickening occurs and nail bed, which persist for a long time even after successful treatment of onychomycosis hypertrophic nails. Such damage is characteristic of advanced stages and requires more serious medical treatments - pills and antibiotics.
- Normotroficheskie. In this type there is no thickening of the nail and subungual region. There brittle nails, and the formation of stripes in skinny plates yellow-gray color. In this form of conservative and efficacious therapy traditional means of local character - ointments, paints, gels, etc.
- Proximal. Defeat, wherein initially touches the base of the nail growth.
- Distal. The most common form of fungal infection. Infection begins in the area of the free edge of the plate. Initially infection exposed nail bed. It is manifested in the form went down under the nail splinters or yellow spot. Wearing shoes in patients with this form causes discomfort.
- Atrophic. Nail dysplasia evident with subsequent detachment of the plate from the nail bed. Unfortunately, this form of therapy can not be conservative treatment and require surgical removal of the affected plates.
- Side. In this form of the fungus affects the lateral part of the nail plate and periungual rollers. Often accompanied by ingrown toenails.
- Total onychomycosis. Signs - affected the entire plate, it thickens, tarnishes, its color becomes yellow or even brown. As the disease nails deformed, acquiring the shape of the coracoid. Furrows appear dirty-gray color, free edge of the nail is loosened.
The symptoms of onychomycosis and photos
Each of the three types of onychomycosis their individual symptoms (see. photo), which also depend on the severity of the disease. The main symptoms of which are peculiar to each of the three types of onychomycosis include:
- presence of inflammation in the peri roller.
- presence of dystrophic changes of the nail plate.
- formation within the nail white, yellow spots, stripes.
- nail atrophy, with its separation from the bed.
The disease often begins with infection of the nail on the big toe. Then there is the spread of infection to the rest of the toes, and then the hands.
How to treat onychomycosis nail?
Modern effective treatment of onychomycosis includes the simultaneous application of these methods and medicaments:
- Receiving systemic antifungal drugs;
- Treatment of affected portions of the nail and surrounding skin topical antifungal agents, e.g., ointments, gels, paints, etc .;
- Removal of the nail plate surgical or conservative method for total lesion and its strong thickening;
- Administration of drugs that enhance blood circulation to the peripheral tissues of hands and feet;
- Physiotherapy courses aimed also at improving the blood flow in the feet and hands.
Systemic treatment of onychomycosis is ingestion antifungals for 6 - 12 months. Currently, the following antifungal drugs used for the treatment of onychomycosis:
- Griseofulvin, effectively suppresses protein synthesis in fungi, which leads to their rapid destruction. The daily dose is 500 mg, but especially in severe cases, can be doubled. Apply tool should be eating, and the dose can be divided into 2 doses. The course of treatment may be about half a year.
- Terbinafine for the treatment of onychomycosis of hands take nails for 1.5 months, and stop - 3 months. Healing occurs in 88 - 94% of patients.
- Fluconazole for the treatment of onychomycosis nail hands take for half a year, and stop - 8 - 12 months. Healing occurs in 83 - 92% of patients.
- Itraconazole is used for two possible schemes - continuous reception and pulse therapy. With continuous reception duration of treatment of onychomycosis of fingernails is 3 months, and stop - 6 months. Pulse therapy is an alternation of taking the drug for a week and breaks between them in three weeks. For the treatment of onychomycosis nail hands need two courses of pulse therapy, and foot - 3 - 4 courses. Complete recovery even without conservative removal of nails occurs in 80 - 85% of patients.
- Ketoconazole, blocking the development of fungi and contributes to their destruction. Means has a profound effect on the liver and can block the action of androgens. Against fungi is effective enough, but it is not recommended to take it for a long time, to avoid serious side effects. The daily dosage is 200 mg.
Topical treatment of onychomycosis should complement the systemic treatment, but in any case not replace it. Keep in mind that topical treatment of onychomycosis not achieve a complete cure if it is not combined with taking antifungal drugs inside a tablets, capsules, solutions or other pharmaceutical forms, since the fungus spores can persist for a long time destroyed tissue in a viable condition.
Currently, effective topical antifungal drugs that are indicated for use in the treatment of onychomycosis, are the following:
- Formulations econazole (Pevara et al.);
- Formulations isoconazole (travogen, Travokort);
- terbinafine formulations (Atifin, Binafin, Lamisil, Mikonorm etc.);
- Formulations naftifine (Exoderil);
- Preparations containing clotrimazole (Amiklon, imides, Kandibene, Canison etc.);
- Preparations containing miconazole (Daktarin, Mikozon);
- Formulations bifonazole (bifaces, bifonazole, Bifosin, Mikospor);
- amorolfine preparations (Lotseril);
- ciclopirox olamine preparations (Batrafen, Fonzhial).
To improve microcirculation and accelerate the growth of new healthy nail plate shows the use of the following physical therapy in the complex treatment of onychomycosis:
- Amplipulse therapy paravertebral region in the lumbosacral and cervical-thoracic within 7 - 10 days in a row;
- UHF therapy paravertebral region in the lumbosacral and cervical-thoracic within 7 - 10 days in a row;
- Nadsosudistoe laser irradiation of blood in peripheral blood vessels. Irradiation is performed at a power of 15 to 60mW duration of 6 - 10 minutes for each portion;
- Diathermy paravertebral region on a lumbosacral within 7 - 10 days.
These drugs improve blood flow to the fingers and toes, and, therefore, guarantee the delivery of an antifungal agent to the nails to the desired concentration.
For this purpose it is expedient to use the following drugs:
- Pentoxifylline (Trental, Agapurin et al.), 400 mg of 2 - 3 times per day;
- Calcium dobesilate (Hem-Doxey, Doksium) 250 - 500 mg 3 times a day;
- Nicotinic acid 150 - 300 mg 3 times a day, or 15 injections of 1 ml of a 1% solution.
All of the above drugs have serious side effects, so the choice of the drug is carried out Only a doctor on the basis of microbiological research data and tailored to the individual contraindications. If any signs of intolerance receiving the drug should be discontinued and pick another drug.
Removing nail
Currently, the surgical removal of the nail affected by fungus, almost not practiced. The main indication for this is the addition of a bacterial infection or a complete lack of effect of drug treatment (resistant forms of fungi). Joining a secondary infection occurs frequently in advanced onychomycosis, severe destruction of the nail plate and poor personal hygiene.
If a fungal infection is usually limited to the nails and the skin surface, then bacteria can attack and surrounding tissue. This leads to the formation of pus, its accumulation and development of severe inflammation. In such cases, it is recommended to remove the nail for a more thorough treatment of a bacterial infection. It should be understood that even the removal of the nail is not a radical solution to the problem with onychomycosis. Regardless of this acceptance of antifungal drugs should be continued, because the infection is still present in the body and there is a risk of other nails.
An alternative to surgery is the artificial "dissolution" of the affected nail (avulsion). There are several drugs (nogtivit and analogs thereof) that facilitate rapid keratinization nail and layer-withering away. This method is now widely practiced due to the possibility of painless and in the home. However, to resort to it should be only after consultation with a dermatologist.
Folk remedies
As mentioned above, a complete cure of onychomycosis is only possible with the help of drugs with a strong antifungal effect. However, some recipes of traditional medicine can help to slow down the destruction of the nail plate or even stop the process at any time. Many doctors even approve of the use of these funds after a course of treatment to relapse prevention.
following traditional methods of treatment is recommended for the prevention of recurrence of onychomycosis:
- Known means of combating a fungus on the nails is a poultice of tea fungus. For this purpose, take a piece of ripe tea fungus and primatyvayut to the nail with a bandage, first carefully washing their feet and a little steamed. Such a compress is imposed on all night. In the morning, remove the poultice, wash your nails with warm water and remove the dead skin areas after which process the nail and the surrounding skin with an alcohol solution of iodine, or any other antiseptic. Kombucha treatment should continue for several weeks.
- One method is to treat the affected nail portions of 5% aqueous iodine solution, 2 times a day. This may feel a burning sensation. If it is weak, it's all right - a means of producing the desired effect. If the pain is intense, the iodine treatment should be stopped /
- Folk medicine recommends a decoction of sweet flag, which must be taken by two - three times a day. Along with this, treatment with nail onychomycosis should become a regular procedure, it is necessary to cut the nails grow back, rough skin. The effect will be noticeable within a few weeks. To prepare the broth you need 1-2 hours. l. calamus rhizomes grind and pour boiling water (100 ml). Boil for 1 minute, then drain. The tool can be washed down with water, because it has a bitter taste.
Regardless of the selected recipe, feet or hands, you must first steam out, thoroughly wash and dry. It is also desirable to remove all the dead skin particles appeared. All deposited formulation is better to leave at night, that will significantly enhance the overall health benefits.
prevention
Having a treatment program should pay particular attention to the subsequent prevention of disease. Doctors recommend to stick to simple rules to help avoid infection onychomycosis in the future:
- Use personal shoes in saunas, swimming pools, gyms and other public places.
- Lead a healthy lifestyle, follow the procedures that strengthen the body's immune system.
- Adhere to the norms and rules of hygiene, such as regularly washing your hands and feet.
Hygiene requirements are also necessary in the course of treatment. Only in this way will be able to completely get rid of the unpleasant disease.
Forecast
The treatment of fungal infection in the early stages can be carried out with antifungals for topical antifungals. When withering largely nail plate recommended treatment surgically. Removal of the fungal infection of the nail will significantly reduce the duration of reception antimycotics accelerate the recovery of the patient.
