In advanced cases of onychomycosis, combination therapy is often used, in which the action of the drug substance of the medication - for example, the lacquer is strengthened by the agent used in general. This is necessary in cases of highly developed mycosis - nail matrix involvement or more than 2/3 of its area. It should be noted that long-term treatment with oral preparations themselves, even the new generation - without serious side effects, however, is a burden for the organism, and at the same time carried out until full regrowth of the plaque is quite expensive. These problems can be avoided by using an oral antifungal agent and local treatment with varnish.
An example of combination therapy in the treatment of ringworm
Combined therapy with 8% ciclopirox and oral terbinafine should be given for 3 months. After this time, when the infected area is reduced, oral treatment can be discontinued, using only varnish - usually no more than for 3 months. Oral drugs are taken at the dosage recommended by the doctor continuously for several weeks - for example, for a period of 6 weeks in the case of onychomycosis of the hands and 12 weeks with seized nails of the feet.
They infect nails with mushrooms - so-called dermatophytes. The infection is often preceded by infection with a different location, for example, foot mycosis - interdigital. However, after some time visible lesions undergo nails.
When tinea pedis is complicated by onychomycosis
If the onychomycosis of the feet (which we treat locally) is accompanied by onychomycosis, it is absolutely necessary to take general treatment. In the case of tinea fungal infections, treatment with terbinafine or pulsed therapy with itraconazole is effective - in the form of tablets used orally. For example, terbinafin therapy of toenail nails takes about 12 weeks.
An example of using lacquer with 8% ciclopirox
Both in combination therapy and in monotherapy, a varnish based on 8% cyclopirox is used as follows:
• in the first month - every day,
• in the second month - twice a week,
• from the third month (up to a maximum of 6 months) - once a week.
Reducing the frequency of use of the drug significantly reduces the costs of therapy while maintaining very high effectiveness - the average frequency of cures is 85.5%. One bottle of the product is enough for 40-50 spreads.
Before the first application of the preparation, remove as much of the changed nail as possible
Once a week, wash the entire nail polish with a nail polish remover and remove as much of the affected nail as possible again; in the event of damage to the lacquer layer, fill the cavities with a thin layer.
Hygiene rules during treatment
During the treatment of foot fungus, you need to wear airy footwear and socks of natural materials. After healing, old shoes should be thrown away.
Causes of treatment failure
The most common reasons for the lack of success in the treatment of fungal infections include: inadequate range of action of the drug and non-compliance with the patient's instructions, for example, irregular use of the drug, too early treatment or disinfection of footwear.
Treatment of ringworm and impaired circulation in the lower limbs
The course and length of therapy is also significantly influenced by circulation in the lower extremities, determining the rate of growth of nail plates.In older patients, the nails grow slower, although more and more young people with vascular pathology caused by diabetes, lipid disorders, smoking, injuries and limb fractures, etc. are more and more important. In such situations it is very important to introduce a medicine to improve the limb vascularity, which is usually it is enough to stop the antifungal treatment at the right time.
Persistent recurrences and complications of mycosis
Among the dermatological diseases involved in nail plates, athlete's foot is one of the most difficult to treat. Even after curing, her persistent relapses happen. If not treated, it can completely destroy the nail. Early detection of infection is very important, then it is easier to cure the disease with the help of more and more effective local agents, without the need to support oral treatment with an antifungal preparation.
ed. Edward Ozga Michalski, MA
comments and consultations were used from dermatologist dr n. med. Katarzyna Prystupa
