Have your nails changed color, lost their shine, become brittle and brittle, or even fallen off the nail bed?It is likely to be onychomycosis, or fungus, an insidious disease that is very difficult to treat and recurs frequently, especially if you delay seeing a doctor.Which doctor treats nail fungus and what is the appropriate 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 a little less often - candida - yeast fungi.The risk factors are:
- masculine gender;
- increased foot sweating;
- nail injuries;
- visit public baths and swimming pools;
- immunosuppression due to diabetes mellitus and HIV infection, prolonged use of corticosteroids;
- wear synthetic socks and shoes made from unnatural materials.
The clinical manifestations of nail fungus are varied.Taking this into account, modern medicine identifies six main forms:
- White surface - 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, crumbly lesions;less commonly, there may be white lines.
- Normotrophic - the thickness and shine of the nail remain the same, the plate only changes color and white and yellow spots and stripes appear.
- Hypertrophic - the nail constantly thickens and becomes 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, and the nail bed may be completely exposed.
- Proximal – quite rare.The lesion 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
Specialists from leading Russian and foreign medical institutions will give 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 resolve this issue.The doctor will perform an objective examination and laboratory tests to determine the cause of the patient's dystrophic nail damage.Only after this is appropriate drug therapy selected.
In complex clinical cases, the help of a more specialized specialist – a mycologist – is required.He is a dermatological doctor who treats exclusively 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 therapy in a timely manner."
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 must perform laboratory diagnosis before prescribing treatment.To do this, the altered nail plate is collected - 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 fungi are clearly visible under the microscope;
- cultural research - results are evaluated only after 0.5-1.5 months, during which time the fungi grow to form colonies.This method makes it possible to identify the type of causative pathogen, as well as assess its sensitivity to antifungal drugs.
“The polymerase chain reaction – the creation of multiple copies of a piece of DNA – is only used in difficult diagnostic cases, when culture cannot determine the type of fungus causing it.”
Therapy
It is important to know which doctor to see to treat nail fungus, as 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;
- disharmony in 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 nail fungus diagnosed.Therapy is divided into two types:
- Topical antifungal - the medicine is applied directly to the nail plate.
- Systemic antifungal - the medication is administered orally and, through the bloodstream, reaches the “problematic” location.
Currently, combined treatment is used for onychomycosis, when local application of the medication (medicated nail polish or cream) is associated with the medication.Topical monotherapy is less effective because keratin and tightly adjacent epithelial scales prevent the medication from penetrating the nail plate.Thus, the concentration of the active component can decrease a thousand times.Therefore, local therapy is possible only at the initial stage of superficial damage to the nails and in the presence of contraindications to systemic antifungal drugs.
“If a family member is diagnosed with nail fungus, the entire family is treated at the same time, as 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 mushrooms in the biomaterial, the person is considered to have fully recovered.In the future, it is important to follow the prevention rules to avoid re-infection:
- wear safety footwear when visiting hotels, gyms, public baths and swimming pools;
- apply antifungal powders and adsorbents to the foot - as indicated;
- wear socks made from natural fabrics;
- trim your nails regularly using individual pedicure accessories;
- replace old shoes with new ones, as they may contain a large amount of dangerous mushrooms.
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 postpone a visit to the doctor if you notice that the appearance of your nail has changed.
Which doctor should I see for nail fungus?
If you suspect onychomycosis, 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.