Many people face diseases that affect the nails. But not everyone knows which doctor treats toenail and toenail fungus. Refusal of treatment leads to the development of dystrophy. It can be dangerous, as the infection constantly progresses and "captures new territory". It is important to seek help from specialists immediately 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, the 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, turns 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 plaque 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 falls. 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 crackling, the toes are covered with painful cracks.
What needs to be done to cure mycosis
You can restore your nails to their previous healthy appearance by applying complex antifungal therapy. Patients are prescribed oral antifungals in tablets. They act on pathogenic microorganisms located in the deeper layers of the stratum corneum. The active ingredients of topical preparations cannot reach them, therefore, the treatment of the affected nails 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 yeast-like molds and fungi. The appointment is made after the identification of the causative agent of the nail fungus. For this purpose, a scraping from the affected area is performed. The biological material is sent for microscopy and bacteriological culture. They also make it possible to determine the sensitivity of pathogenic microorganisms to a particular group of antifungal drugs.
Which doctor should I contact if there is 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 types of skin diseases caused by various provoking factors. It is to him that you need to go 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 fungal infection. He knows all 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 pedicure master with a medical background. He treats cosmetic defects, the development of which can cause foot deformity. His task is to detect and identify any pathological changes in the early stages of development and to produce a therapy that can be implemented in a beauty salon (remove an ingrown nail, clean the stratum corneum, eliminate calluses and cracks). If problems are identified that he cannot address, the doctor writes a referral to a narrow specialist (to a dermatologist, surgeon or mycologist).
Initial examination by a physician
To whom the patient is addressed, the first examination is the same everywhere:
- First, the doctor interviews the patient, collects all complaints, describes the history of the pathology in history.
- Then a visual inspection of the affected nails is performed, the condition of the skin surrounding the infected nails is evaluated.
- According to the patient's complaints, based on the characteristics of the course of the disease, based on the symptoms, the specialist tries to make a preliminary diagnosis and differentiate a fungal infection from psoriasis, lichen.
- So he necessarily writes a direction for laboratory tests. They allow to confirm the diagnosis, identify the pathogen and indicate the degree of its sensitivity to existing drugs.
Only according to the results of a laboratory study, treatment tactics are developed. In any case, the treatment regimen can be different - it all depends on the stage at which the disease is located.
Treatment of nail fungus in the initial stage
The initial stage of the infection develops without visible symptoms.
But it is also easy to diagnose if you pay attention to small 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 evident when compared with the thickness of healthy nails.
- If the feet sweat, a characteristic acrid odor appears.
When one or three of the listed signs are detected, an appointment with a mycologist should be made. 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 folk remedies and antifungal drugs intended for topical treatment. The therapeutic scheme in this case is as follows:
- Every day the legs are pre-welded in the baths with the addition of decoctions of chamomile or potassium permanganate. They disinfect the skin and prevent the adhesion of the bacterial component. It is best to do them at night.
- After the nails are thoroughly dried with a towel, a cotton swab is applied to the affected dishes, 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 to them 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 during the first month it is necessary to cover the nails with antifungal varnish. During the second month, the paint is used twice a week, in the following months once every seven days.
Experts recommend carrying out the treatment until the healthy nail plate completely regrows (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 overcome the fungal infection, the specialist may decide to remove the affected nail. This can be done in several ways.
A surgical intervention 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 contraindications to surgical intervention, the nail is removed using special patches. They are glued to the plates and left there for five or six days, after which the condition of the nail is evaluated. If necessary, the procedure is resumed. The composition of the patches contains substances that soften and dissolve the stratum corneum. The remnants 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 with this.
Preventive measures for the patient and his family
The fungus reproduces by spores, disperse over long distances with air currents and inseminate any surface. 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. It is forbidden:
- wearing the shoes of a sick person with bare feet;
- she uses her bathroom accessories and the tools with which she does a pedicure;
- walking around the house with bare feet;
- neglect the rules of personal hygiene.
It is useful, when entering the bathroom, tub or sauna, to wear interchangeable 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, consult a doctor.