Are your nails discolored, losing their shine, becoming brittle, brittle, or even falling off the nail bed?This is most likely onychomycosis or fungus, an insidious condition that is difficult to treat and often comes back, especially if you delay seeing your doctor.Which doctor treats toenail fungus and what is the correct treatment for onychomycosis?
Types and symptoms of onychomycosis
Fungal infections account for 15-40% of all nail diseases.Most commonly, the causative agent is Trichophyton (parasitic fungus), and less commonly Candida (yeast).Risk factors include:
- male;
- Increased sweating of the feet;
- Nail injuries;
- Visit public baths and swimming pools;
- Diabetes, immunosuppression caused by HIV infection, long-term use of corticosteroids;
- Wear synthetic socks and shoes made from non-natural materials.
The clinical manifestations of onychomycosis are diverse.With this in mind, modern medicine identifies six main forms:
- Superficial White - Initially, the superficial layers of the nail plate are affected, then the degenerative process spreads deeper into the tissue.Most often, this variety presents as white, broken lesions; less commonly, white lines may appear.
- Nutrition is normal - the thickness and shine of the nails remain unchanged, the nail plate only changes color, white and yellow spots and stripes appear.
- Hypertrophic - Nails continually thicken and become deformed due to the active division of skin cells located beneath the nail plate.
- Atrophy - the nail turns gray-brown, continues to lose thickness, and the nail bed is completely exposed.
- Proximal – Fairly rare.The lesions affect the nail fold, while the last part of the nail remains intact, that is, undamaged, for a long time.
- Overall - the entire nail plate is involved in the pathological process and often occurs against the background of reduced immunity.
second medical opinion
Experts from leading Russian and foreign medical institutions will express their opinions on the results of examinations and examinations, comment on previous diagnoses and prescribed treatments.
"With onychomycosis, the nail plate often loses its connection to the underlying dermis and is easily removed accidentally or intentionally. Doctors call this condition onycholysis."
Which expert should I contact?
Which doctor treats onychomycosis?In most cases, a dermatologist will help resolve the issue.Doctors will perform objective examinations and laboratory tests to determine the cause of a patient's dystrophic nail lesions.Only after this can appropriate medical treatment be chosen.
In complex clinical cases, the help of a more specialized specialist - a mycologist - is needed.This is a dermatologist who specializes in treating fungal diseases of the skin, hair, and nails.
"If you don't know which doctor treats onychomycosis, make an appointment with a dermatologist. This is usually enough to make a diagnosis and begin prompt treatment."
diagnostic methods
If suspicious signs appear, such as changes in nail shape and thickness, suspicious spots and streaks, chipping, the doctor must perform a laboratory diagnosis before prescribing treatment.To do this, collect the altered nail plate - carefully cut off a part of it with special tweezers.The resulting biological material is subjected to:
- Microscopy - results are obtained almost immediately as the spores and mycelium of the fungus are clearly visible under the microscope;
- Culture studies - Results are evaluated only after 0.5-1.5 months, during which time the fungus grows to form colonies.This method allows you to identify the type of causative pathogen and assess its susceptibility to antifungal drugs.
“Polymerase chain reaction—which generates multiple copies of a stretch of DNA—is only used in difficult diagnostic cases when culture cannot identify the type of fungus that’s causing the disease.”
treat
It is important to know which doctor to contact to treat onychomycosis, as delayed treatment is not only a cosmetic problem but also a medical problem.Onychomycosis has been shown to increase the risk of:
- leg pain and discomfort;
- Difficulty walking and wearing shoes;
- Disharmony in professional and personal life areas;
- Fungal skin infections of the legs, arms, and groin are common;
- Infection of other family members;
- With the development of bronchial asthma and atopic dermatitis, the body's sensitivity to fungal antigens increases;
- Bacterial Skin Infections – Fungi violate the integrity of the dermis and pathogenic and opportunistic bacteria easily gain access to the resulting micro-cracks.
Therefore, all confirmed cases of onychomycosis must be treated.There are two types of treatment:
- Topical antifungals - apply the medication directly to the nail plate.
- Systemic antifungals – Medications are taken by mouth and travel through the bloodstream to reach the “problem” area.
Currently, onychomycosis is treated with a combination of topical medications (medicated nail polish or ointment) combined with medication.Topical monotherapy is less effective because keratin and the closely adjacent epithelial scales prevent drug penetration into the nail plate.In this way, the concentration of active ingredients can be reduced a thousand times.Therefore, topical treatment is possible only in the initial stages of superficial nail lesions and in the presence of contraindications to systemic antifungal agents.
"If one family member is diagnosed with onychomycosis, the entire family will be treated at the same time because onychomycosis is a highly contagious disease."
After a course of treatment, the doctor must perform a control test - microscopic examination of the nail plate.If there are no mushrooms in the biological material, the person is considered fully recovered.In the future, it is important to follow the preventive rules to avoid reinfection:
- Use safety shoes when going to hotels, gyms, public bathrooms and swimming pools;
- Apply antifungal powders and adsorbents to feet as indicated;
- Wear socks made from natural fabrics;
- Trim your nails regularly using a separate pedicure accessory;
- Replace old shoes with new ones as they may contain high amounts of dangerous mushrooms.
A simple rule: the sooner treatment starts, the more effective it is—and for onychomycosis, it's more effective than ever.So if you notice a change in the appearance of your nails, don't delay seeing your doctor.
Which doctor should I consult to treat onychomycosis?
If you suspect you have onychomycosis, you should seek help, such as from your GP.The doctor will perform an examination, make a diagnosis and refer you to a specialist.