Mycosis deforms the shape of nails and makes feet look ugly. It can be painful, recurring and it may lower the quality of life. Foot and nail mycosis is the most common type of dermatosis. Today, thanks to the medicines available, it is possible to completely cure this type of mycosis, as long as the treatment methods are adequate to the type of infection. How to recognize and treat athlete’s foot and toenail? Which preparations are most effective?
Skin mycosis and nail mycosis
Skin mycosis is one of the most common dermatological diseases. It is caused by three types of fungi: dermatophytes, yeast-type fungi and molds. This diseases affects smooth skin, epidermis, mucous membranes, skin folds as well as skin appendages.
It never develops on a completely healthy body.
It does attack, however, under conditions of lowered immunity, when taking certain medications, in presence of other skin diseases or under conditions of extensive maceration, humidity and irritation of epidermis. All of the factors contributing to development of mycosis can be divided into congenital, acquired and environmental ones.
The most frequently occurring and diagnosed form of mycosis is the one that affects feet and nails. The foot mycosis and toenail mycosis are mainly caused by an anthropophilic dermatophyte, Trichophyton Rubrum. It affects about 5-10% of adult population.
Dermatophytes are the most widely spread pathogenic fungi.
They most often attack keratinized body parts in humans, such as epidermis, nails and hair. Foot mycosis (tinea pedum) can take one of the three clinical forms.
The first of them is the interdigital type. In such case, the symptoms of infections are usually located within the 4th and 3rd interdigital space and they boil down to flaking and maceration of epidermis.
The vesiculobullous type is just as characteristic – it manifests itself through blisters filled with serum fluid, which over time burst and turn into scabs.
The scaly type, on the other hand, affects the soles of feet and takes form of calloused, reddened areas. On top of the types of mycosis listed above, feet are also at risk of getting infected with a nail plate fungus. In such case we’re talking about nail mycosis.
This disease may also impact fingernails, although it happens less often for obvious reasons. Feet are kept in socks and shoes everyday which exposes them to excessive humidity, they are more likely to get chafed, they’re at risk of fine wounds or development of corns. On top of that, their condition and appearance may get worse due to walking around a lot in synthetic shoes, as well as in mismatched or uncomfortable shoes.
Nail mycosis, or onychomycosis (tinea unguinum), is a disease that is often ignored by those affected, especially if it is toenail mycosis. Feet spend most of the year hidden inside shoes. Even in the summer, when it’s hot, we can continue walking around in sneakers or other types of shoes with enclosed front.
Sadly, plenty of people with both foot and nail mycosis focus on hiding it instead of actually treating it. Meanwhile, when it comes to this disease, one should not wait until later with getting a diagnosis and starting a treatment, especially since nail and foot mycosis medicines are available in an instant.
Luckily, plenty of affected individuals don’t need to be reminded this.
Because athlete’s foot and toenail (and overall all kinds of mycosis) is not only an aesthetic problem. Nail mycosis constitutes 50% of all nail infections. It is most often caused by the above mentioned dermatophytes, and then yeasts and molds.
Nail mycosis deforms the nail plate in a pretty significant and visible way. It may affect a single nail plate or several nail plates at once. The most evident symptom of infection is the nail changing its color from the natural to a white-yellow, green-brown or brown-yellow (this symptom is the so-called chromonychia).
On top of discolorations, a clearly visible symptom is change of the plate’s shape. The surface of nails affected with mycosis is ridged, wrinkled, bumpy, thick, and sometimes it becomes matte. On top of that, nails become brittle (which is called onychodystrophy) and they deform in a way that makes them look like talons or they get bent in tubular shapes.
Plate deformations of this type are obviously not the only symptoms of toenail mycosis. Depending on the type of infections and the way the fungi get in, the disease may attack the nail plate itself or the plate together with the nail bed, which is the part located directly below it. In such case, the plate gets separated from the bed, the nail gets thicker and calloused underneath.
There is also the dystrophic mycosis, which is of a secondary nature and is usually a result of remaining forms of penetration and spread of a fungus.
Its final result is complete crumbling and destruction of a nail plate.
athlete’s foot and toenail and other diseases
Everyday we’re at risk of many factors occurring that may make it easier for dermatophytes to penetrate into skin and for mycosis to develop.
Said illnesses can be classified as both acquired and congenital factors. When it comes to the former, the risk of mycosis is present in case of the peripheral system diseases, such as peripheral vessel atherosclerosis or the Raynaud’s phenomenon, as well as due to cancer or HIV infections.
The congenital diseases related to higher risk of mycosis, on the other hand, include diabetes, diseases caused by disordered functioning of the immune system, asthma, atopic dermatitis or diseases causing disordered keratinisation and flaking of skin, such as psoriasis.
The risk of mycosis is made higher not only by diseases themselves but also by the medications taken during the treatment, especially corticosteroids, antibiotics with general spectrum of action or immunosuppressive medicines. Foot and nail mycosis is also easier to get when using occlusal bandages.
What contributes to development of athlete’s foot and toenail?
Without a doubt, mycosis of this type is more common among old people and males, but women are also at risk.
On top of that, however, the development of this disease and pathogen’s penetration ability are also influenced by other factors, not necessarily related to age or gender. On top of the skin diseases listed above, they also include excessive dryness and roughness of skin, increased sweating, as well as blood flow disorders around lower limbs.
Dry or intensely sweating skin (as well as skin affected by diseases) is more prone to irritations, micro-damages to the epidermis, chafing and minor wounds, which give fungi, bacteria and viruses better access to our body and easier penetration of the skin barrier.
Another category of factors that increase the risk of development of foot and nail mycosis is environmental causes. We are more at risk of fungal infections in the conditions of higher humidity and temperature. On top of that, mycosis is easier to catch when using public restrooms, saunas, swimming pools, locker rooms and changing rooms that are humid.
Athlete’s foot and toenail is also related to poor personal hygiene, frequent traveling or wearing shoes and socks made of artificial materials.
What foot mycosis medicine to choose? Athlete’s foot medicines
Because foot and nail mycosis is one of the most common skin afflictions, pharmacies are full of different over the counter creams that allow to alleviate bothersome symptoms and cure the disease. They come in many different forms.
The product range of most pharmacies in the foot mycosis medicines category includes talcums, sprays, creams, gels, ointments, balsams or liquids.
The easiest to use are aerosols, which we can also spray on the insides of the shoes.
Not everyone will choose this solution, though – when the development of mycosis causes skin to flake and deteriorate, it is better to use ointments, which contain such things as undecylenic acid, coating the skin with a thick, solid layer of vaseline. Gels, on the other hand, get absorbed fast, thus ensuring comfort of use.
Baby powders, healing powders and soaps can be used as a support, especially by people who have a problem with excessive sweating or are prone to infections and wish to protect themselves against fungal attacks. Anti-mycosis liquids also have their advantages. Nail mycosis polish is easy to use and makes an interesting as well as effective alternative to other topical methods.
The most often used creams, however, are those in form of creams. They are also the ones that contain the highest variety of active substances with fungicidal and fungistatic properties. These include terbinafine, ketoconazole, miconazole nitrate, flutrimazole and clotrimazole.
On top of that, foot mycosis medicines also come in oral form. The form of the medicine, however, should not be the main factor deciding on choosing it. A much more important thing is its composition – that’s because different substances work on different types of mycosis.
Flutrimazole inhibits activity of yeasts.
Clotrimazole has a very broad action. Some of the substances, on the other hand, only work against fungi, but not against bacteria.
To many people, it is also important how a particular preparation is administrated. Most of them are usually rubbed into the altered areas several times a day over a course of several weeks.
There are also those, however, that are only applied for a week.
The variety of the creams available might raise doubts in us about whether we’re actually choosing the right foot mycosis and nail mycosis medicines.
Not just medicines – make sure to visit a dermatologist
Damage to the nail plate is not the only consequence of untreated (or poorly treated) nail mycosis. A long-term fungal infection leads to such ailments as painful pressure when wearing shoes and walking. Let’s also take into account that athlete’s foot and toenail can be very easily transferred to family members, as well as strangers, if we use public places and accessories while infected.
Since mycosis is a difficult disease, it’s a good idea to book an appointment with a dermatologist right after the first symptoms. It is necessary, especially if attempts at curing it on our own don’t give the desired results, and the preparations we’ve chosen turned out to be inadequate in our case. Let’s take into account that there isn’t a single method for battling athlete’s foot and toenail.
Most of us use topical treatments, but other than that, there are also general, combination or even surgical methods used. Which form of treatment will be most effective is decided by the doctor and the examination performed or ordered by them. Such examination allows to precisely determine the factor that caused the infection and to select an adequate, effective treatment.
Mycosis can be cured completely, but it requires implementing the right tools and methods. It is a consolation that the medicines used these days against mycosis are much more effective than 20-30 years ago, which motivates patients to visit a doctor and get examined. On the other hand though, plenty of dermatologists stop at making a diagnosis based on the clinical picture only, which often proves not enough.
A precise diagnosis is made possible by further tests, like a dermatoscope test, fluorescence analysis in pathological changes using a Wood’s lamp, microscope examinations as well as cultivations on a sample taken. The highest effectiveness of treatment can be achieved when also working with a podologist. This especially applies to nail mycosis.
Because the nail plate is hard and it’s difficult for active substance contained in topical medicines to penetrate it, it has to be removed, and the remaining plate needs to be cleaned in order to be able to administer the fungicidal medicine – that’s exactly what the podologist does.
How long does it take to treat athlete’s foot and toenail?
When starting a treatment of athlete’s foot and toenail, we need to take into account that it will take a long time. It is a period to be counted at least in weeks, but usually in months, when it comes to foot mycosis it might even be a year.
Some of them only involve use of medicines for a certain short period of time throughout a month.
During the break, however, patients usually use supporting methods and minimize the factors that might contribute to lower effectiveness of treatment. Let’s also take into account that some of creams are applied onto skin even for a few weeks after the symptoms are gone. It is very important not to interrupt the treatment when the signs of mycosis become invisible or the symptoms no longer bother us.
Athlete’s foot and toenail may return very fast in such case, which only weakens the condition of skin and forces us to resume the treatment. On top of that, it is important during the treatment to maintain top standards in hygiene, carefully wipe feet after a bath, disinfect the shoes and socks and also stop applying classic polishes on the nail plate, as they contain acrylic, and hybrid polishes.
The exception is obviously a medicinal nail mycosis polish.
What is clotrimazole?
Clotrimazole is an organic chemical compound with fungicidal action. It’s a substance that manufacturers pretty often include in the composition of anti-mycosis creams, not just for athlete’s foot and toenail.
It is also effective in treating pityriasis, oral mycosis or candidiasis of vagina and external reproductive organs.
The universality of using clotrimazole arises from the fact that it works on different types of fungi, and when combined with other substances, such as hexamidine, it gives preparations antibacterial properties. Clotrimazole is available in form of creams, gels, liquids, ointments or globules. It is usually applied 2-3 times a day over a period of up to 4 weeks.
This compound doesn’t get absorbed through skin, and only to a minor degree through mucous membranes. Its action consists of inhibiting the synthesis of ergosterol, a necessary steroid for building cellular membranes of fungi. Without it, the membranes become more permeable, which results in breakdown of fungus cells.
What is important, clotrimazole has no such impact on the healthy cells of human body, as they don’t synthesize ergosterol.
Ranking of over the counter athlete’s foot and toenail remedies
- Topical over the counter medicines
Medicines applied topically constitute one of the most popular treatment methods among patients suffering from athlete’s foot and toenail. Patients often choose them on their own, before they consult a doctor. These usually require to be taken everyday over a few weeks while the infection lasts, as well as a few weeks after the symptoms are gone.
When used individually, they mainly work for less advanced and less spread mycosis. A doctor may recommend taking topical medicines together with oral medicines, in such case we’re talking about a combination therapy, which in many cases is most effective. The first thing used for nails affected by mycosis is a special nail mycosis polish, liquids, creams, ointments, gels and aerosols.
The active compounds contained in creams of this kind include clotrimazole, ketoconazole, amorolfine, bifonazole or ciclopirox. The composition of preparations contains such supporting substances as urea. Nail and foot mycosis medicines used topically are no strain on the body, as the active substances in them are absorbed to a very minor degree.
The only exception might be allergic reactions.
- Oral nail mycosis medicines – terbinafine and itraconazole
Oral medicines are considered to be among the most effective in treating nail mycosis. When choosing this form of administrating the medicine, the available options are terbinafine or itraconazole.
They are especially used when topical treatment hasn’t yielded satisfying results, and the changes caused by development of mycosis cover more than 50% of the nail plate. Terbinafine is taken orally over a period of 12 weeks everyday, whereas itraconazole is a medicine administrated through the pulsation method, for one week in a month, over a period of about 3 months. An oral therapy might be a load on the digestive and neurological system, cause headaches and liver disorders, and in extreme cases even congestive heart failure.
Oral medicines used for nail mycosis are mostly derivatives of triazole.
Disinfectants, mainly aerosols and liquids, support the treatment of athlete’s foot and toenail through easier maintenance of feet and shoes hygiene. On top of that, they have an antiseptic action on the skin and provide protection against fungi.
Pharmacies and drugstores offer creams in aerosol intended specifically for disinfection of shoes and foot skin. Other things that can be used for that purpose are iodine solution, colloidal silver or essential oils. Also effective for disinfection when it comes to mycosis is ozonation.
- Powders and baby powders
Powders and baby powders with fungicidal action can have medicinal (medicinal powders) and preventive action. They are especially used against foot mycosis, when there’s a possibility of relapse and in case of excessive sweating of foot skin.
- Herbs and natural preparations (powders, soaps, bath preparations, ointments)
Essential oils, herbal bath salts for feet, powders with plant extracts, as well as herbal ointments – these are natural methods that might prove effective in battling athlete’s foot and toenail.
Plenty of plants contain compounds with fungistatic, fungicidal and antibacterial action. When administrated as an oil, in form of thick ointment or even added to bath, they also support protection and regeneration of skin. The most often used herbs when it comes to athlete’s foot and toenail include greater celandine, rosemary, thyme, yarrow, oregano, garden sage or garlic.
Particularly noteworthy here are natural essential oils. They mainly consist of terpenes with small particle sizes that can penetrate the nail plate and reach the fungus cells. Most essential oils have fungicidal properties, but the most effective ones in this regard are the tea tree oil, rosemary oil, lavender oil and oregano oil.
Their proper use comes with a minor risk of side effects occurring.
nail and athlete’s foot prevention
athlete’s foot is a hard to cure, recurring disease. It also constitutes an aesthetic and cosmetic problem that lowers the quality of life.
It is worth it to be aware of the fact that preventing it is not difficult. However, it remains incredibly important especially for those who: have already had problems with infections of this type around skin, limbs and nails; suffer from excessive foot sweating; have a dry, irritated and damaged skin by such things as environmental factors or diseases. Let’s remember that nail and athlete’s foot as well as foot mycosis can affect anyone, that’s why the most important thing is body and foot hygiene.
By that we mean showering often enough, wearing protective footwear in public places such as swimming pools; using cosmetics and foot perspiration controlling agents (talcums, creams, antimicrobial antiperspirants). Those particularly at risk of athlete’s foot and toenail should also choose high quality shoes, especially socks made of materials that expel humidity.