Nail fungus (onychomycosis) can be treated with special varnishes, creams or oral agents. However, sufferers need a lot of patience.

The most important things at a glance

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• Recognize nail fungus: which symptoms are typical
• Causes: How do you get nail fungus?
• Nail fungus: This is how the doctor makes the diagnosis
• Treat nail fungus: paint, tablets & Co.
• Home remedies for toenail fungus
• Prevent nail fungus

Nail fungus is not uncommon. It is estimated that it affects between 3 and 12 out of 100 people. Elderly people are particularly affected. In principle, however, children and younger adults can also become ill. Nail Fungus often forms on the foot, for example as a result of an athlete’s foot infection.

Good to know: Nail fungus is not usually dangerous. However, it spreads further without therapy – and simply looks ugly. Last but not least, onychomycosis is contagious. Those affected should therefore treat their nail fungus (or have it treated) in any case.

Nail fungus: which doctor is the right one?
If nail fungus is suspected, the family doctor’s practice can be the first point of contact. This is especially true if only individual nails are affected. However, if the fungus has already spread visibly, it is advisable to consult a dermatologist directly.

Recognize nail fungus: which symptoms are typical

Nail fungus can be recognized by the following symptoms: The affected nail

• turns white-yellowish or brown and becomes dull,
• thickens,
• changes shape and/or
• becomes brittle.

Onychomycosis occurs particularly frequently on the foot. The little or big toe is particularly affected by nail fungus. The fungus rarely attacks the fingers.

Identify different types of nail fungus

Depending on which part of the nail is affected, doctors distinguish between different types or manifestations of nail fungus.

The mushroom can

• the lateral or front edge of the nail,
• the upper layers of the nail or
• affected the nail root.

A nail fungus can also progress so far that the entire nail is destroyed (so-called total onychodystrophy). However, this rarely happens.

Especially on the front or side edge of the nail, fungi have an easy time. This so-called distolateral subungual onychomycosis is by far the most common form of nail fungus: 95 out of 100 sufferers are affected. On the underside of the nail, where the nail is connected to the fingertip, the pathogens can penetrate the nail particularly easily and spread from there.

More rarely, the pathogen only affects the upper layers of the nail (so-called superficial white onychomycosis). This form of nail fungus can be recognized by a white discoloration of the nails. This can either appear as small white dots or spread out over a large area.

Also rarely penetrates the fungus in the nail root (nail matrix). It is the production site for the cells that make up the fingernails and toenails. Experts speak of proximal subungual onychomycosis.

In particular, people with a weakened immune system are at risk of developing it. For example, the immune system can be weakened by a serious illness (e.g. AIDS). There are also certain drugs that specifically suppress the immune system, for example after an organ transplant.

Recognize nail fungus: initial stage, progression and final stage

In the early stages of nail fungus, the first symptoms can usually be seen on the free front or side edge of the nail. The nail becomes increasingly brittle. Affected people also notice the first discolouration.

If left untreated, onychomycosis will spread further down the nail. The fungus can occupy the entire nail plate. If surrounding nails show symptoms such as discoloration or thickening, this is a sign that the fungus has also infected them.

In the final stage of nail fungus, the fungus has attacked the entire nail, including the nail root. This destroys the nail plate and the nail can detach.

Aside from these symptoms, otherwise healthy people do not have to worry about serious or life-threatening consequences. In people with diabetes or a weakened immune system, however, nail fungus can promote bacterial inflammation of the surrounding skin.

If a nail is severely thickened by the fungus, the affected person may feel pain when walking. It can also happen that the fungus deforms the nail in such a way that it grows into the skin.

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Skin fungi on different parts of the body

Causes: How do you get nail fungus?

Nail fungus can penetrate the skin and nails through fine cracks or small injuries. Certain thread-like skin fungi are almost always the cause: dermatophytes. In particular, the dermatophyte species Trichophyton rubrum is often behind the nail fungus, more rarely Trichophyton interdigitale is responsible for it.

Experts assume that nail fungus often develops from athlete’s foot. Athlete’s foot is also caused by dermatophytes.

Less common causes of nail fungus include yeast or mold infections. Yeast fungi can be found in particular on the nails of the fingers.

Mixed infections are also possible: then different pathogens have infested the nail.

Nail fungus is contagious

Nail fungus can not only spread to neighboring nails. An infected person can infect others – either through direct skin contact or through flakes of skin on which the fungus is located. Above all, a warm, humid environment offers optimal survival conditions for fungi.

Outside the body, fungi can sometimes survive for a very long time in the form of so-called spores, for example in the grooves of swimming pools or on bath mats. There is therefore an increased risk of infection in (public) warm interior rooms with high humidity, for example

• in the sauna,
• in pools,
• in the pool,
• in gym locker rooms or
• in showers of sports facilities.

It is therefore advisable to wear bathing shoes in the swimming pool, sauna etc. People can also become infected with nail fungus in private households, for example through shared towels or nail scissors/files.

These factors favor nail fungus

Nail fungus is basically contagious. However, this does not mean that everyone who shares the same shower with a sick person, for example, is automatically infected. Rather, certain risk factors must be added that promote infection or the onset of the disease.

Anyone who sweats a lot and prefers tight shoes increases the risk of onychomycosis. Under these conditions, a fungus can multiply optimally and easily penetrate the skin. Shoes that are too tight can lead to minor injuries, through which fungi can penetrate the skin and nails.

Other possible causes or risk factors for nail fungus are:

• Injuries to the nails, for example through improper nail care or through sports
• Circulatory problems in hands or feet
• foot deformities
• slow nail growth
• metabolic diseases, e.g. B. Diabetes mellitus
• a weak immune system, e.g. B. by certain diseases such as HIV or medication
• Skin diseases such as psoriasis
• poor circulation in the feet, e.g. B. by a peripheral arterial occlusive disease (PAOD)
• excessive sweating
• wet hands, e.g. B. by frequent cleaning work

Last but not least, predisposition plays a certain role: some people are more easily infected with nail fungus than others.

Nail fungus: This is how the doctor makes the diagnosis

A doctor can often identify nail fungus based on the typical symptoms. However, there are diseases that are associated with a similar appearance, for example

• a psoriasis,
• white nail discoloration caused by certain medications, e.g. B. beta-blockers,
• damage from chemotherapy drugs or drugs that suppress the immune system,
• Bacterial nail infections
• circulatory disorders,
• lichen planus or
• tumors.

To be on the safe side, the doctor can scrape a nail sample and have it examined for fungal spores in the laboratory. The sample can also be used to determine what type of fungus it is. To do this, the laboratory employees have to create a fungal culture. After about three weeks, the result is known.

Treat nail fungus: paint, tablets & Co.

What to do with nail fungus? Even if it is usually harmless, you should (have) treated nail fungus , because it usually does not go away on its own. On the contrary: it gradually destroys the nail plate. In addition, it often spreads to surrounding nails. Last but not least, there is a risk that you will infect other people.

With proper treatment, onychomycosis is usually curable. Which means are used depends on how much the fungus has spread. On the other hand, which fungus is behind the infection plays a role.

In order to avoid spreading it again, it is important to completely remove the nail fungus. Varnishes or creams for application can be helpful for treatment. However, these funds are rarely sufficient or the fungus returns after a short time. Then tablets have to be used. They work much better, but are associated with side effects.

Irrespective of the type of treatment, sufferers should pay attention to thorough hygiene so that the fungus does not have any further targets for attack.

Lengthy therapy
Nail fungus can be very stubborn. Anyone who wants to treat it therefore needs patience: With tablets, it takes several months until the fungus is completely eliminated. A treatment with creams or varnish can last over a year.

External therapy: treat nail fungus with varnish or cream

In the pharmacy you can get various non-prescription varnishes or creams against nail fungus. They contain active ingredients such as ciclopirox, amorolfine (in the form of varnish) or bifonazole (in the form of a cream). These substances have an antifungal effect, i.e. they kill fungi or stop them from multiplying.

External treatment with colorless varnish or cream is only an option in mild cases of nail fungus. She may be suitable if

• the toenail or fingernail is not completely affected by the fungus,
• only individual nails are affected and
• the nail root is not affected.

Children also usually receive an external treatment. Their nails grow faster and are thinner than adults’, so polish or cream may work better on them than on older people.

Before nail fungus varnish is used, sufferers must carefully cut and file the nail. The paint is then regularly applied to the affected areas. Before each treatment, the old paint must be removed with alcohol.

Varnishes with the active ingredient amorolfine should be applied once or twice a week. Products with the active ingredient ciclopirox apply to those affected every other day in the first month, at least twice a week in the second month and then once a week.

An alternative to varnish are special treatment sets with creams: First, the toe or finger must be softened in warm water. Patients then apply a cream containing urea to the affected part of the nail and stick a plaster on the nail. The cream ensures that the layers of the nail gradually soften.

Once a day, sufferers must remove the plaster, soak their toe or finger in warm water again, scrape off the already softened part with a spatula, and then apply the cream again. After two weeks, the entire nail can be scraped off. A cream containing the active ingredient bifonazole is then applied to the underlying skin area for several weeks.

Treat nail fungus with tablets or infusions

Nail fungus is persistent. It can often not be completely removed with varnish or cream. This is especially true when the nail root is affected or when multiple nails are infected.

Then a treatment with tablets is necessary – if necessary in combination with varnishes or creams. Alternatively, the doctor can administer an antifungal agent as an infusion. It is important to continue the therapy with tablets or infusions consistently until there are no more fungi. This takes several months.

Nail fungus tablets require a prescription. The type of active ingredient used depends primarily on which fungus it is. Preparations are an option

• terbinafine,
• itraconazole or
• fluconazole.

Tablets with the active ingredient terbinafine are used particularly frequently. This is particularly effective against dermatophytes – the pathogens that are almost always the cause of nail fungus. Treatment with terbinafine lasts about three to four months. Sick people can take the tablets either continuously or in higher doses with breaks in between:

• In the case of continuous treatment, a daily intake (usually 250 mg) over a period of three months is necessary.
• In treatment with breaks, sufferers take the tablets daily for one to four weeks, depending on the dosage, and then take a three- to four-week break from taking them.

Terbinafine is considered to be well tolerated. Possible side effects of terbinafine include gastrointestinal problems or a temporary loss of taste and smell. Interactions can occur if taken at the same time as certain heart medications or antidepressants. Terbinafine is not suitable for pregnant and breastfeeding women. Since the risk of liver damage is increased, people with liver disease should only take the drug in exceptional cases.

Tablets with the active ingredient itraconazole are particularly suitable if yeast or mold are involved in the disease. They are also effective against dermatophytes, but somewhat weaker than terbinafine. The tablets can be taken either continuously or with breaks. Treatment with itraconazole should not last longer than three months.

Possible side effects include headache, dizziness, gastrointestinal upset, and rash. Interactions can occur in combination with certain other medications (e.g. cholesterol-lowering drugs). Itraconazole should not be taken by pregnant or breastfeeding women and/or people with heart failure. In the case of people with liver disease, the doctor will carefully weigh up its use.

The active ingredient fluconazole must be taken for a significantly longer time to completely combat nail fungus. Treatment is usually required for a period of between six and twelve months. The doctor will only prescribe tablets with fluconazole if other treatments have not worked sufficiently or are not an option. The patient takes fluconazole once a week.

Surgically remove the nail?
Doctors today refrain from surgically removing an affected nail. The procedure could damage the surrounding skin, increasing the risk of infection. Last but not least, removing a nail can sometimes be painful.

Eliminate nail fungus completely: hygiene is the be-all and end-all

Thorough hygiene is essential for nail fungus to disappear completely.

• Change bed linen, towels, socks and stockings frequently and wash them at a temperature between 60 and 95 degrees Celsius.
• Do not share towels and nail scissors with others.
• Clean the nail scissors or file with a disinfectant or 70% alcohol after use.
• Disinfect shoes, socks and stockings.
• Dry feet and hands thoroughly or blow dry them.

Also, be temporarily cautious about going to the swimming pool or sauna. The damp heat offers the fungus optimal conditions to multiply again. This also applies to tight shoes that make you sweat easily. Instead, put on airy, not too tightly laced shoes and air-permeable socks or stockings.

Last but not least, you should check whether other people in your household are infected. If so, they should also be treated.

Home remedies for toenail fungus

Many sufferers try to get rid of the nail fungus with home remedies. Popular home remedies for toenail fungus

• (Apple Cider Vinegar,
• tea tree oil or
• baking powder or baking soda.

For example, the nail fungus is said to regress if the affected nail is dabbed with vinegar or tea tree oil several times a day or rubbed with a mixture of baking soda and water. Alternatively, a nail bath with vinegar or tea tree oil is said to fight the fungus. In addition, toothpaste, fresh lemon juice or your own urine should help against onychomycosis, if you believe the home remedy supporters.

• Home remedies for toenail fungus : what really helps?

However, there is no clear scientific evidence of the effectiveness of such home remedies for nail fungus. They can also be associated with undesirable side effects.

Prevent nail fungus

With these measures you can prevent a nail fungus a bit:

• Wear bathing shoes in the swimming pool, by the pool or in the sauna.
• Thoroughly dry the spaces between your toes and fingers, because fungi prefer moisture.
• Wear breathable, comfortable footwear. Avoid very tight shoes and tight-fitting socks or stockings.
• Always use your own towel, for example when exercising, and do not share it with others.
• When cutting your nails, be careful not to injure the surrounding skin to prevent fungi from entering.
• Take off your shoes as often as possible and try not to wear a pair two days in a row.

Source:uslifestyler

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