Many people face diseases that affect the nails. But not everyone knows which doctor treats toenail and fingernail fungus. Refusal of treatment leads to the development of dystrophy. It can be dangerous, as the infection is constantly progressing and "capturing new territories". It is important to immediately seek the help of specialists when the first symptoms of an injury appear. The choice of a doctor largely depends on the general condition of the patient.
Symptoms of mycosis
In the early stages, fungal infection does not manifest itself in any way. The appearance of the first symptoms goes unnoticed. A healthy nail is pink and shiny. When infected, it fades, turning dirty gray.
Gradually, the nail plate thickens, it becomes difficult to cut the free edge with scissors. In the later stages, hyperkeratosis develops, the nails turn yellow and brittle. Over time, the plaque moves away from the nail bed. As a result, the resulting voids are filled with pathogenic microorganisms that are part of the microflora of the skin. Immunity falls. There are complications in the form of attachment of a bacterial component. In advanced stages, the fungus spreads to the periungual ridges and the foot becomes infected. The skin is very itchy and bursts, the toes are covered with painful cracks.
What needs to be done to cure mycosis?
You can restore your nails to their former healthy appearance by applying complex antifungal therapy. Patients are prescribed oral antifungal tablets. They act on pathogenic microorganisms located in the deepest layers of the stratum corneum. The active substances of topical preparations cannot reach them, therefore, the treatment of the affected nail plates with creams and ointments, solutions and varnishes that have antifungal properties, without systemic preparations, does not allow to achieve the desired therapeutic effect.
There are several groups of antifungals. Some of them are active against dermatophytes, others against molds and yeast-like fungi. The appointment is made after the identification of the causative agent of nail fungus. For these purposes, a scraping of the affected area is performed. Biological material is sent for microscopy and bacteriological culture. In addition, they allow to determine the sensitivity of pathogenic microorganisms to a particular group of antifungal drugs.
Which doctor should I contact if there is a toenail fungus?
To conduct an examination and make a correct diagnosis, you need to contact a dermatologist, mycologist or podiatrist.
- A dermatologist is a generalist who treats all kinds of skin diseases caused by various provoking factors. It is to him that you should turn for first aid, if necessary, you can redirect the patient to a mycologist.
- A mycologist is a specialist with a narrow profile. He is engaged in the treatment and prevention of infections, the development of which occurs after fungal infection. He knows everything about these pathogenic microorganisms, so he can easily identify the type of infection and select the right drugs to suppress it.
- A podiatrist is a master pedicure with a medical education. He treats aesthetic defects, the development of which can lead to foot deformity. His task is to detect and identify any pathological changes in the early stages of development and produce a therapy that can be implemented in a beauty salon (remove an ingrown nail, clean the stratum corneum, remove calluses and cracks). If problems are identified that he cannot deal with, the doctor writes a referral to a narrow specialist (a dermatologist, a surgeon, or a mycologist).
Initial examination by a doctor
Whoever the patient turns to, the first examination is the same everywhere:
- First, the doctor interviews the patient, collects all the complaints, describes the history of the pathology in the history.
- Then a visual inspection of the affected nails is carried out, the condition of the skin surrounding the infected nails is evaluated.
- According to the patient's complaints, according to the features of the course of the disease, according to the symptoms, the specialist tries to formulate a preliminary diagnosis and differentiate a fungal infection from psoriasis, lichen.
- Then you necessarily write an address for laboratory tests. They allow you to confirm the diagnosis, identify the pathogen and indicate the degree of sensitivity to existing drugs.
Only according to the results of a laboratory study, treatment tactics are developed. In each case, the therapeutic regimen may be different: it all depends on what stage the disease is at.
Treatment of nail fungus in the initial stage.
The initial stage of infection develops without visible symptoms.
But it is also easy to diagnose if you pay attention to minor changes in the structure of the nail plate.
- First, the free edge of the nail turns slightly yellow.
- The thickness of the stratum corneum increases, and this is noticeable compared to the thickness of healthy nails.
- If the feet sweat, a characteristic sour smell appears.
When one or three of the listed signs are detected, you should make an appointment with a mycologist. If there is no such doctor in the clinic, a consultation with a dermatologist will be useful. At this stage, the infection can be treated with home remedies and antifungal medications intended for topical treatment. The therapeutic scheme in this case is as follows:
- Every day, the legs are pre-soldered in baths with the addition of decoctions of chamomile or potassium permanganate. They disinfect the skin and prevent the fixation of the bacterial component. It is better to do them at night.
- After thoroughly drying the nails with a towel, a cotton pad is applied to the affected plates, abundantly moistened with a solution of apple cider vinegar, vodka and glycerin (the first two ingredients are mixed in half, one tablespoon of the third component is added). After half an hour, the compress is removed. The fungus does not tolerate an acidic environment, so it stops multiplying.
- In the morning, a few drops of iodine (5%) are applied daily to the affected plaque.
- Every other day for the first month, you should cover your nails with antifungal varnish. During the second month, the varnish is used twice a week, in the following months once every seven days.
Experts recommend that the treatment be carried out until the healthy nail plate grows back completely (about three to four months). Periodically it is useful to visit your doctor and monitor the effectiveness of the therapy used with him. If necessary, a dermatologist or mycologist can make changes to the treatment regimen by adding antifungal ointments or disinfectant solutions.
Advanced mycosis therapy
If a comprehensive treatment regimen does not help to overcome the fungal infection, the specialist may decide to remove the affected nail. This can be done in several ways.
A surgical operation allows to solve the indicated problem in the shortest possible time. For its implementation, the patient receives a referral to the surgeon. The doctor removes the nail with a scalpel, then stitches and an antiseptic bandage are applied to the wound. The recovery period lasts two weeks. The patient undergoes a course of antibacterial therapy, goes every day to bandage the operated finger. After being discharged home.
If there are any contraindications to surgical intervention, the nail is removed using special patches. They are glued to the plates and left there for five to six days, after which the condition of the nail is assessed. If necessary, the procedure is resumed. The composition of the patches contains substances that soften and dissolve the horny layer. The remains of the nail are then removed with scissors.
To remove the plaque, the patient may be offered laser therapy. With the help of a special light pulse, the stratum corneum is burned. This procedure is painless, is performed under local anesthesia and there is no postoperative period. To achieve a therapeutic result, it is necessary to perform eight procedures. Many people are not happy about this.
Preventive measures for the patient and their relatives
The fungus reproduces by spores, which are dispersed over long distances by air currents and inseminate any surface. The infection is transmitted indirectly through contact with contaminated objects. Therefore, if there is a sick person in the house, his family members should take special precautions. Is prohibited:
- put on the shoes of a sick person with bare feet;
- use your bathroom accessories and tools with which you do a pedicure;
- walk barefoot around the house;
- neglect the rules of personal hygiene.
It is useful, when entering the bath, bath or sauna, to put on changeable shoes on the feet. It is important to properly care for the feet, constantly strengthen the immune system and enrich the diet with foods rich in vitamins and minerals. At the first signs of infection, see a doctor.