"Black spots" suddenly appeared under the nails. Could it be onychomycosis?

Onychomycosis is medically known as "onychomycosis". It is a phenomenon in which the normal nail structure is destroyed due to fungal infection at the nail wound.

But many people only know that onychomycosis is contagious, but do not know the specific symptoms of onychomycosis. Some people suddenly find a "black spot" under their toenails and think they have onychomycosis. But in fact, this "black spot" is not onychomycosis. So, what exactly is this "black spot"? What are the symptoms of onychomycosis?

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1. Do not misjudge subungual bleeding

Generally speaking, people who wear shoes that squeeze their feet or walk downhill for a long time are prone to "black spots" under their toenails. This is because the toes are squeezed for a long time, which will cause the local small blood vessels under the toenails to rupture, resulting in congestion and swelling under the nail, which is a "black spot".

Subungual bleeding usually comes and goes quickly and generally does not require treatment. The color of the bleeding spot will gradually lighten and disappear within a month.

But onychomycosis is different. Its onset is an extremely slow process. It will not form overnight, and will last for months to years. Onychomycosis is a relatively difficult to treat stubborn chronic infectious disease that cannot heal itself. Patients need to go to the hospital for antifungal treatment.

So, what are the symptoms of onychomycosis?

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2. The main manifestations of onychomycosis

The main symptoms of onychomycosis are thickening of the nails, black-gray color or yellow-white spots, and loss of luster. The clinical manifestations vary depending on the site and degree of invasion of dermatophytes.

1. White superficial onychomycosis

The superficial layer of the nail plate has one or more dots or irregular white turbidity, which may gradually expand, fuse and turn light yellow. The nail is brittle and easy to break, and the surface is dull or slightly uneven.

2. Distal lateral subungual onychomycosis

The nails become thicker, the nail plate becomes grayish yellow and turbid, the texture becomes increasingly brittle and easily damaged. In addition, the nails may also appear moth-eaten, making the surface of the nail plate uneven.

3. Proximal subungual onychomycosis

The lunula, or the half-moon at the base of the nail, has white spots, which then progress to a rough, thickened lunula and base of the nail. The surface of the nail also becomes uneven and easily damaged.

4. Onychomycosis of the nail plate

The nail plate is white or grayish white, and there are no other obvious symptoms.

5. Onychomycosis that destroys the entire nail

The entire nail plate becomes thickened and grayish yellow or grayish brown in color, and the nail plate may partially or completely fall off [1].

Therefore, if your nails begin to thicken and turn grayish white, or if your nails become rough or even broken, it is best to go to the hospital for a check-up as soon as possible to see if you have onychomycosis.

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3. Say no to onychomycosis

To prevent onychomycosis, you need to pay attention to the following points:

1. Onychomycosis often occurs secondary to tinea pedis . Tinea pedis is caused by fungal infection. If the patient's nails are accidentally damaged at this time, the fungus will invade the inside of the nails, causing onychomycosis. Therefore, to prevent onychomycosis, we must pay attention to the prevention and treatment of tinea pedis.

2. Do not lend daily necessities to each other . For example, personal items such as shoes and socks worn on the feet should not be shared with others to prevent indirect infection.

**3. Develop good hygiene habits. **For example, pay attention to the cleanliness of your feet.

4. People who sweat a lot should pay special attention to preventing onychomycosis in summer . Such people can choose some products that inhibit local sweating to keep dry and hygienic.

5. Pay more attention to environmental hygiene to prevent pathogenic fungi from surviving in an external environment. The room should be ventilated frequently, bedding can be put out in the sun to dry, and sheets and underwear should be washed regularly to ensure that there is no fungus.

6. Enhance the body's ability to resist pathogenic fungi . We can strengthen physical exercise and pay attention to nutrition, which can improve the body's ability to resist pathogenic fungi.

After recovery, patients with onychomycosis should also prevent re-infection. It is best to pay more attention to the following aspects:

1. Self-infection

Although some patients' onychomycosis has been cured, their tinea pedis and tinea manuum have not been cured at the same time, which may lead to the onychomycosis recurring.

2. Failure to consolidate medication

Some patients with onychomycosis think that their diseased nails are completely cured in the later stages of treatment and stop taking medication, but they should still continue taking medication for a period of time to prevent recurrence of onychomycosis.

3. Nail malnutrition

If the nails are malnourished, onychomycosis will recur. Therefore, ensuring nail nutrition can also reduce the possibility of onychomycosis recurrence to a certain extent.

4. Chemical stimulation

Long-term contact with substances such as gasoline, paint, detergents and strong alkaline soaps will reduce the pH and defense capabilities of the normal nail plate surface, allowing pathogenic fungi to find opportunities to take advantage.

In short, once you get onychomycosis, it is difficult to cure in a short time, so you should pay more attention to personal hygiene, always improve your awareness of prevention, and be responsible for yourself and others. And don't worry if you have onychomycosis, actively cooperate with treatment, and recovery is just around the corner.

References

[1] Menglong. It is not easy to completely cure small onychomycosis[J]. Everyone's Health, 2022(14):20-21.

Reviewer: Zhang Shuyuan, Chief Physician, Beijing Huayi Integrated Traditional Chinese and Western Medicine Dermatology Hospital