Have your nails changed color, lost their shine, become brittle and crumbling, or even fallen off the nail bed?It is likely that it is onychomycosis, or a fungus, an insidious disease that is very difficult to cure and often relapses, especially if you delay a visit to the doctor.Which doctor treats toenail fungus and what does the proper treatment for onychomycosis look like?
Types of nail fungus and symptoms
Fungal infections account for up to 15-40% of all nail diseases.Most often, the causative agents are trichophyton - parasitic fungi and a little less often - candida - yeast fungi.The risk factors are:
- masculine gender;
- increased sweating of the feet;
- nail injuries;
- visit public baths and swimming pools;
- immunosuppression due to diabetes mellitus and HIV infection, long-term use of corticosteroids;
- wearing synthetic socks and shoes made from non-natural materials.
The clinical manifestations of nail fungus are varied.Taking this into account, modern medicine identifies six main forms:
- White surface: initially the superficial layers of the nail plate are affected, then the degenerative process spreads deep into the tissues.Very often this variety presents as white, friable lesions;less commonly, there may be white lines.
- Normotrophic: the thickness and shine of the nail remain the same, the plaque only changes color and white and yellow spots and stripes appear.
- Hypertrophic - the nail constantly thickens and deforms due to the active division of skin cells located under the nail plate.
- Atrophic: the nail becomes gray-brown, while its thickness constantly decreases, as a result of which the nail bed can be completely exposed.
- Proximal – rather rare.The lesion affects the nail fold, while the final sections of the nail remain intact for a long time, i.e. undamaged.
- Total – the entire nail plate is involved in the pathological process and often develops against a background of reduced immunity.
Second medical opinion
Experts from leading Russian and foreign medical institutions will express their opinions on the results of tests and examinations, comment on the previously made diagnosis and prescribed treatment.
"With onychomycosis, the nail plate often loses its connection to the underlying dermis, so it can easily be removed accidentally or intentionally. Doctors call this condition onycholysis."
Which specialist should I contact?
Which doctor treats nail fungus?In most cases, a dermatologist will help solve this problem.The doctor will perform a physical examination and laboratory tests to determine the cause of the patient's dystrophic nail lesion.Only then is the appropriate drug therapy chosen.
In complex clinical cases, the help of a more specialized specialist, the mycologist, is necessary.This is a dermatological doctor who deals exclusively with fungal diseases of the skin, hair and nails.
"If you don't know which doctor treats nail fungus, make an appointment with a dermatologist. This is usually enough to establish a diagnosis and start timely therapy."
Diagnostic methods
If there are suspicious signs, such as changes in the shape and thickness of the nail, suspicious spots and streaks, crumbling, the doctor should conduct laboratory diagnostics before prescribing treatment.For this purpose, the altered nail plate is collected: a part of it is carefully cut off with special tweezers.The resulting biomaterial is subjected to:
- microscopic examination: the results are obtained almost immediately, since the spores and mycelium of the mushrooms are clearly visible under the microscope;
- cultural research: the results are evaluated only after 0.5-1.5 months, during which the fungi grow to form colonies.This method allows you to identify the type of causative pathogen and evaluate its sensitivity to antifungal drugs.
“The polymerase chain reaction – the creation of multiple copies of a piece of DNA – is used only in difficult diagnostic cases when culture cannot determine the type of causative fungus.”
Therapy
It is important to know which doctor to contact for nail fungus, since delayed treatment is not only a cosmetic problem, but also a medical one.It turns out that onychomycosis increases the risk of the following conditions:
- pain and discomfort in the legs;
- difficulty walking and wearing shoes;
- disharmony in the professional and personal spheres of life;
- generalization of fungal infection on the skin of the legs and arms, groin;
- infection of other family members;
- increased sensitivity of the body to fungal antigens with the development of bronchial asthma and atopic dermatitis;
- bacterial skin infections: fungi violate the integrity of the dermis, and pathogenic and conditionally pathogenic bacteria easily enter the resulting microcracks.
Therefore, treatment is necessary in all cases of diagnosed nail fungus.The therapy is divided into two types:
- Topical antifungal: the drug is applied directly to the nail plate.
- Systemic antifungal: the drug is taken orally and through the bloodstream reaches the "problem" site.
Currently, combined treatment is used for onychomycosis, when the local application of the drug (polish or medicated cream) is associated with drugs.Topical monotherapy is less effective because keratin and closely adjacent epithelial scales prevent the drug from penetrating the nail plate.Therefore, the concentration of the active component can decrease a thousand times.Therefore, local therapy is possible only in the initial stage of superficial damage of the nail and in the presence of contraindications to systemic antifungal agents.
"If a family member is diagnosed with nail mycosis, the whole family is treated at the same time, since onychomycosis is a particularly contagious disease."
After a course of treatment, the doctor must prescribe control tests: microscopy of the nail plate.If there are no fungi in the biomaterial, the person is considered to have fully recovered.In the future, it is important to comply with prevention rules to avoid reinfection:
- use safety shoes when going to hotels, gyms, public bathrooms and swimming pools;
- apply antifungal and adsorbent powders to the foot - as directed;
- wear socks made from natural fabrics;
- regularly trim nails using individual pedicure accessories;
- replace old shoes with new ones, as they may contain a large number of dangerous fungi.
A simple rule: the earlier treatment is started, the more effective it is: in the case of onychomycosis it works more than ever.Therefore, do not delay your visit to the doctor if you notice that the appearance of your nail has changed.
Which doctor should I see for toenail fungus?
If you suspect onychomycosis, you should seek help, for example, from a general practitioner.The doctor will prescribe tests, after which he will make a diagnosis and send a specialist.