Are your nails discolored, dull, brittle and broken, or even falling out of the nail bed?Most likely, it is onychomycosis or a fungus, an insidious disease that is very difficult to treat and often recurs, especially if you delay visiting a doctor.Which doctor treats toenail fungus and what does proper treatment for onychomycosis look like?
Types and symptoms of nail fungus
Fungal infections account for 15-40% of all nail diseases.Most often, the causative agents are trichophytons - parasitic fungi, and a little less - candida - yeast fungi.Risk factors include:
- male gender;
- increased sweating of the feet;
- nail injuries;
- visiting public baths and swimming pools;
- immunosuppression due to diabetes mellitus and HIV infection, long-term use of corticosteroids;
- wearing synthetic socks and shoes made of unnatural materials.
Clinical manifestations of nail fungus are different.With this in mind, modern medicine defines six main forms:
- White surface - initially the surface layers of the nail plate are affected, then the degenerative process spreads deep into the tissues.Often this variety appears as white, disintegrating lesions;daha az hallarda ağ xətlər ola bilər.
- Normotrophic - the thickness and shine of the nail remain the same, the plate only changes color, white and yellow spots and stripes appear.
- Hypertrophic - due to the active division of skin cells located under the nail plate, the nail is constantly thickened and deformed.
- Atrophic - the nail becomes gray-brown, its thickness constantly decreases, as a result, the nail bed can be completely exposed.
- Proximal - extremely rare.The lesion affects the nail layer, and the last parts of the nail remain intact for a long time, that is, without damage.
- Total - the entire nail plate is involved in the pathological process and often develops against the background of reduced immunity.
Second medical opinion
Specialists from leading Russian and foreign medical institutions will give their opinions on the results of tests and examinations, comment on the previously established diagnosis and prescribed treatment.
"With onychomycosis, the nail plate often loses contact with 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 conduct an objective examination and laboratory tests to determine the cause of the patient's dystrophic nail lesion.Only after that, appropriate drug treatment is selected.
In complex clinical cases, the help of a more specialized specialist - a mycologist - is required.This is a dermatologist who deals only with fungal diseases of the skin, hair and nails.
"If you don't know which doctor treats nail fungus, then make an appointment with a dermatologist. This is usually enough to make a diagnosis and start treatment in time."
Diagnostic methods
If there are suspicious signs such as changes in the shape and thickness of the nail, suspicious spots and stripes, collapse, the doctor should conduct laboratory diagnostics before prescribing treatment.For this purpose, the modified nail plate is collected - a part of it is carefully cut with special tweezers.The resulting biomaterial is subject to:
- microscopic examination - the results are obtained almost immediately, because the spores and mycelia of fungi are clearly visible under the microscope;
- cultural studies - the results are evaluated only after 0.5-1.5 months, during which time the fungi grow to form colonies.This method allows to determine the type of the causative pathogen, as well as to assess its sensitivity to antifungal drugs.
"Polymerase chain reaction - the creation of multiple copies of a piece of DNA - is only used in difficult diagnostic situations when culture cannot identify the causative fungus species."
Therapy
It is important to know which doctor to consult for nail fungus, because delayed treatment is not only a cosmetic problem, but also a medical one.Onychomycosis has been found to increase the risk of the following conditions:
- pain and discomfort in the legs;
- difficulty walking and putting on shoes;
- disharmony in professional and personal areas of life;
- generalized 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 destroy 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.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 reaches the "problem" site with the bloodstream.
Currently, combined treatment for onychomycosis is used when local application of the drug (medicated nail polish or cream) is combined with the drug.Topical monotherapy is less effective, because keratin and closely adjacent epithelial scales prevent the drug from penetrating the nail plate.Thus, the concentration of the active component can be reduced by a thousand times.Therefore, local therapy is possible only in the initial stage of superficial nail damage and in case of contraindications to systemic antifungal agents.
"If a family member is diagnosed with nail fungus, since onychomycosis is a particularly contagious disease, the entire family is treated at the same time."
After the course of treatment, the doctor should prescribe control tests - microscopy of the nail plate.If there is no fungus in the biomaterial, then the person is considered fully cured.To prevent re-infection in the future, it is important to follow the rules of prevention:
- use safety shoes when visiting hotels, gyms, baths and swimming pools;
- apply antifungal powders and adsorbents to the foot - according to indications;
- wear socks made of natural fabrics;
- trim nails regularly using individual pedicure accessories;
- replace old shoes with new ones, as they may contain a large number of dangerous fungi.
A simple rule: the sooner the treatment is started, the more effective it is - in the case of onychomycosis, it works more than ever.Therefore, if you notice a change in the appearance of your nails, do not delay your visit to the doctor.
Which doctor should I see for nail fungus?
If you suspect onychomycosis, for example, you should seek help from a general practitioner.The doctor will prescribe tests, after which he will make a diagnosis and refer to a specialist.