Many people are faced with diseases that affect the nails. But not everyone knows which doctor treats toenail and handnail 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 help from specialists when the first symptoms of a lesion appear. The choice of a doctor largely depends on the general condition of the patient.
Symptoms of mycosis
In the early stages, the fungal infection does not manifest itself in any way. The appearance of the first symptoms goes unnoticed. A healthy nail is pink and glossy. When infected, it fades, becomes 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 become yellow and brittle. Over time, the plate moves away from the nail bed. As a result, the resulting voids are filled with pathogenic microorganisms that are part of the skin microflora. Immunity drops. There are complications in the form of attachment of a bacterial component. In the advanced stages, the fungus spreads to the periungual ridges, and the foot becomes infected. The skin is very itchy and bursting, the toes are covered with painful cracks.
What needs to be done to cure mycosis
You can return your nails to their former healthy appearance by applying complex antifungal therapy. Patients are prescribed oral antimycotics in 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 affected nail plates with creams and ointments, solutions and varnishes that have antifungal properties, without systemic preparations, does not allow achieving the desired therapeutic effect.
There are several groups of antimycotics. Some of them are active against dermatophytes, others against molds and yeast-like fungi. Appointment is made after identification of the causative agent of nail fungus. For these purposes, a scraping is made from the affected area. Biological material is sent for microscopy and bacteriological culture. They additionally allow to determine the sensitivity of pathogenic microorganisms to a particular group of antifungal drugs.
Which doctor should I contact if there is a fungus of the toenails
To conduct an examination and make a correct diagnosis, you need to contact a dermatologist, a mycologist or a podologist.
- A dermatologist is a generalist who treats all types of skin diseases caused by various provocative factors. It is to him that you need to turn for first aid, if necessary, he can redirect the patient to a mycologist.
- A mycologist is a narrow-profile specialist. He is engaged in the treatment and prevention of infections, the development of which occurs after infection with fungi. 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 podologist is a pedicure master with a medical education. It treats cosmetic defects, the development of which can provoke foot deformity. Its task is to detect and identify any pathological changes in the early stages of development and produce therapy that can be implemented in a beauty salon (remove an ingrown nail, clean the stratum corneum, eliminate corns and cracks). If problems are identified that he cannot cope with, the doctor writes out a referral to a narrow specialist (to 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 complaints, describes the history of pathology in the history.
- Then a visual inspection of the affected nails is performed, the condition of the skin surrounding the infected nails is assessed.
- According to the patient's complaints, according to the characteristics of the course of the disease, according to the symptoms, the specialist tries to formulate a preliminary diagnosis and differentiate a fungal infection from a psoriasis lesion, lichen.
- Then he necessarily writes out a direction for laboratory tests. They allow you to confirm the diagnosis, identify the pathogen and indicate the degree of its sensitivity to existing medications.
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 at 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 becomes noticeable when compared with 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 need to make an appointment with a mycologist. If there is no such doctor in the clinic, then a consultation with a dermatologist will be useful. At this stage, the infection can be treated with folk remedies and antifungal drugs 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 attachment of the bacterial component. It is better to make them at night.
- After the nails are thoroughly dried with a towel, then 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, a spoonful of the third component is added to them). 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 plate.
- Every other day during the first month you need to 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 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.
Therapy of advanced mycosis
If a comprehensive treatment regimen does not help to overcome mycosis, the specialist is able to 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 dressing are applied to the wound. The recovery period lasts two weeks. The patient is undergoing a course of antibacterial therapy, goes daily 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 stratum corneum. The remains of the nail are then removed with scissors.
To remove the plate, the patient may be offered laser therapy. With the help of a special light pulse, the stratum corneum is burned. This procedure is painless, it is performed under local anesthesia, and there is no postoperative period. To achieve a therapeutic result, it is necessary to carry out eight procedures. Many people are not happy with this.
Preventive measures for the patient and his family members
The fungus reproduces by spores, they scatter over long distances with 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, members of his family should take special precautions. It is forbidden:
- put on the shoes of a sick person on bare feet;
- use his bath accessories and tools with which he does a pedicure;
- walk around the house barefoot;
- neglect the rules of personal hygiene.
It is useful, when entering the bathroom, bath or sauna, to put on changeable shoes on your feet. It is important to properly care for the feet, constantly strengthen the immune system and enrich the diet with foods high in vitamins and minerals. At the first signs of infection, consult a doctor.