Have your nails changed color, lost their shine, become brittle and crumbly, or even fallen off the nail bed?It is likely onychomycosis or a fungus, an insidious disease that is very difficult to treat and often comes back, especially if you delay visiting the doctor.Which doctor treats toenail fungus and what is the proper treatment for onychomycosis?
Types of nail fungus and symptoms.
Fungal infections account for up to 15-40% of all nail diseases.Most often, the causative agents are trichophytons, parasitic fungi, and somewhat less often - Candida, yeast fungi.The risk factors are:
- male 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;
- wear synthetic socks and shoes made of unnatural materials.
The clinical manifestations of nail fungus are varied.Taking this into account, modern medicine identifies six main forms:
- Superficial white - at first, the superficial layers of the nail plate are affected, and then the degenerative process spreads deep into the tissues.Most often, this variety appears as white, crumbling lesions;less commonly, there may be white lines.
- Normotrophic - the thickness and gloss of the nail remain the same, the plate only changes color, and white and yellow spots and stripes appear.
- Hypertrophic - the nail is constantly thickened and deformed due to the active division of skin cells located under the nail plate.
- Atrophic - the nail becomes grayish-brown, while its thickness constantly decreases, as a result of which the nail bed can be completely exposed.
- Proximal – quite rare.The injury affects the nail fold, while the final sections 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 a background of reduced immunity.
Second medical opinion
Experts from leading Russian and foreign medical institutions will give their opinion on the results of tests and examinations, comment on the previously made diagnosis and prescribed treatment.
"In onychomycosis, the nail plate often loses its connection to the underlying dermis, so it can be easily removed accidentally or on purpose. 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 an objective examination and laboratory tests to determine the cause of the patient's dystrophic nail lesion.Only after this is the appropriate drug therapy selected.
In complex clinical cases, the help of a more specialized specialist, a mycologist, is required.This is a dermatologist doctor who deals exclusively 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 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 stripes, crumbling, the doctor should conduct laboratory diagnostics before prescribing treatment.To do this, the altered nail plate is collected and a part 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 fungi are clearly visible under a microscope;
- cultural research: results are evaluated only after 0.5 to 1.5 months, during which time the fungi grow to form colonies.This method allows you to identify the type of causative pathogen, as well as 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 go to in case of nail fungus, since delay in 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;
- lack of harmony in the spheres of professional and personal 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 medication is applied directly to the nail plate.
- Systemic antifungal - the drug is taken orally and, through the bloodstream, reaches the "problem" place.
Currently, combined treatment is used for onychomycosis, when local application of the drug (nail polish or medicated cream) is combined with medication.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 at the initial stage of superficial nail damage and in the presence of contraindications to systemic antifungal agents.
"If a family member is diagnosed with nail fungus, the entire family receives treatment at the same time, since onychomycosis is a particularly contagious disease."
After a course of treatment, the doctor should prescribe control tests - microscopy of the nail plate.If there is no fungus on the biomaterial, the person is considered to have fully recovered.In the future, it is important to follow prevention rules to avoid reinfection:
- wear safety shoes when visiting hotels, gyms, public baths and swimming pools;
- apply antifungal and adsorbent powders to the foot, as directed;
- wear socks made of natural fabrics;
- trim nails regularly using individual pedicure accessories;
- replace old shoes with new ones, as they can contain a large amount of dangerous fungus.
A simple rule: the sooner treatment is started, the more effective it will be;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 if I have 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 refer you to a specialist.