Onychomycosis

 Onychomycosis

L ' onychomycosis is an' infection in load of the nails , both hands and feet, caused by different types of pathogens such as dermatophytes, yeasts and molds (fungi). Onychomycosis is an infectious process that causes thickening and deformity of the nails as well as a certain change in the color of the nail.

Nail Fungus Treatments Products

Among the various nail diseases, statistics indicate that mycoses occur with an incidence ranging from 30% to 50% and that males are more affected than women.

The toenails are more frequently affected than those of the hands because the hot and humid environment, present in the shoes, is the best condition for allowing the fungi to develop. Furthermore, the toenails are often affected by external trauma from wearing tight shoes or following sports activity.

What are the causes of onychomycosis?
They are caused by several fungi , including Candida albicans, Trichophyton, and Epidermophyton. One of the main risk factors is represented by the frequentation of hot-humid and common environments , such as the changing rooms of gyms and swimming pools, which represent an excellent ground for the proliferation of fungi.

The incorrect habit of wearing tight socks and shoes (which prevent perspiration), associated with excessive sweating and poor hygiene increase the chances of contracting nail fungus.

What are the symptoms of nail fungus?
This nail infection may initially manifest as a small white or yellow spot , affecting a small portion of the nail (usually the distal edge of the nail plate). In a less common variety of onychomycosis, called " superficial white onychomycosis ", the nail turns white instead of yellow or brown and the surface is smooth, dry and dusty. If left untreated, the fungus tends to spread, even involving the other nails.In general, symptoms include:

• increased fragility of the affected nail ;
• deformation of the nail;
• lamina opaque and raised distally;
• inflammation of the tissues near the nail;
• Infected nails can also lift and detach from the nail bed (onycholysis), as well as emit a foul odor .

The diagnosis
The suspicion of onychomycosis, which occurs during a dermatological examination , must be confirmed through direct microscopic observation and culture examination.. The latter is carried out after taking fragments of the nail. The sampling necessary for the culture can only be done if treatment based on antifungals has been suspended for at least two weeks. Through the cultural examination it is possible to identify exactly the fungus responsible for onychomycosis and consequently the most suitable type of therapy can be chosen. The exam is not annoying, but the response times are not particularly short (it takes about thirty days to communicate the result). The mycotic culture is not always positive (about 30% of false negative tests) and this represents an undoubted diagnostic problem.

In particular cases it may be necessary to resort to histological examination , an invasive method that can be quite annoying.

The Treatments
The choice of the type of treatment for onychomycosis basically depends on the form of the pathology, the seriousness of the clinical picture and the number of nails that have been affected by the infection.

Whenever possible, most of the infected nail should be removed . This can be done by cutting it with a nail clipper, filing it or dissolving it with products containing a high percentage of urea.

Depending on the type of onychomycosis, the therapy is based on the use of antifungals to be used locally (by applying nail polishes, lotions or creams) or systemically, ie using a drug to be taken orally.

In severe cases, when the fungi are resistant to treatment, the nail can be surgically removed .

It will take a certain period of time (in the order of months) for the nails affected by onychomycosis to return to their normal appearance. The relapse rate is quite high.

Prevention
To prevent the development of fungal nail requires a proper hygiene of the hands and feet :

• keep nails short, dry and clean;
• wearing socks that allow the feet to perspire, changing them often;
• do not walk barefoot in the changing rooms and showers of gyms and swimming pools;
• do not cut the skin around the nails because this facilitates the access of germs;
• do not hide nail fungus infections with nail polish: it contributes, in fact, to worsening the infection.