Which animal grew nails first

health : Fungal nail disease: what grows under our nails

For a long time, Volker Senger was very little interested in the children's song verse "Show your feet". For almost ten years, the 34-year-old struggled with an ailment that many are familiar with and like to keep silent. Up until a few months ago, Senger suffered from a nail fungus. His toenails were yellowing, wrinkled, and brittle. "They have literally crumbled," says the pain-tested.

He kept cutting and filing his nails down as far as possible, rasping them as thin as paper in order to eradicate the foci in the horny layer, but it was in vain. Because at some point the filing hurt too much, the fungus remained in remnants and spread again when the nail grew again.

Unfortunately, Senger was often careless, interrupting the treatment with ointments and tinctures when the success apparently did not appear even after weeks. Once a dermatologist, who was ultimately at a loss, even pulled out an extremely affected large toenail. After the local anesthesia subsided, this was not only very painful, but also pointless, if only because five other nails were affected.

The mushroom victim was ashamed, hid his feet from prying eyes and avoided situations that would have forced him to go barefoot. At the masseur he kept his stockings on and in the sauna he covered his toes with the towel. Others didn't notice his game of hide-and-seek, "because I could always make it look very casual and make good excuses," as he says. Even today he is so embarrassed about his suffering that he doesn't want to see his real name printed.

Dermatologists are well aware of this shameful way of dealing with fungal nail disease (onychomycosis). Because the affliction plagues millions: According to an estimate published in the Deutsches Ärzteblatt, every eighth German citizen is infected with nail fungus, around 80 percent on the toenails. Women suffer from fingernail fungus more often than men because their hands come into contact with detergents and cleaning agents more often. And nails softened and damaged by water and household chemicals are much more likely to allow fungi to penetrate than healthy ones.

According to various estimates, only one in three or even sixth of those affected can be treated. Nail fungi are also on the advance in North America: As a study in the journal "Journal of the American Academy of Dermatology" reports, almost 14 percent of a test group of 2,000 people were infected. In a similar study 20 years ago, it was around two percent.

The inhibition threshold to visit a specialist is not only high because of unsavory looking nails. Some people affected therefore prefer to exchange hot tips on the Internet - for example a certain "Kermit" who recently wanted to know whether he should have his sick nails pulled or "put his feet in Domestos". "Two thirds of those affected do not go to the doctor because they believe that their nail will inevitably be pulled or that the treatment is futile anyway," says Hans-Jürgen Tietz, microbiologist at the Berlin Charité Dermatology Clinic. Both worries are unfounded: pulling a nail is "a torture method" and "the worst" thing a doctor can do. The disease can be treated more effectively and much more gently.

According to Tietz, it is crucial to see the dermatologist as quickly as possible. This should clarify whether diseases such as diabetes, diseases of the blood or nerves promote the fungal attack. Recurring nail injuries, for example in the case of nail crooks and soccer players, or a particularly unhealthy foot climate, for example gym shoes that make you sweat, can also play a role. It is not for nothing that athlete's foot is called "athlete's foot" and it can also infect the nails. You can get infected anywhere it is humid and warm: in swimming pools and saunas, but also in borrowed shoes and the mat in the bathroom.

According to Tietz, nail fungi are "not just a cosmetic problem"; Destroyed nails can be entry points for other infectious agents. The number of fungi is estimated at 100,000 to 250,000, but for all that is known, only about 180 species can infect humans or animals. In humans, the nails are attacked more often than the skin, one of the reasons for which is the almost non-stop wearing of closed shoes. For this reason alone, fungal pathogens are popular in winter.

Dermatologists differentiate between dermatophytes, yeasts and molds. They determine the annoying pests involved in each case by means of a painless nail swab with a scalpel: some horned rasps are cultivated on nutrient media, observed as they continue to grow, and then determined. A very common yeast is "Candida albicans"; together with mold, he also made life difficult for Volker Senger.

But there is no place for resignation: As a rule, you can get rid of a nail fungus. Most dermatologists try to attack the fungus locally with nail polish. Its active ingredients penetrate the nail plate and inhibit fungal growth by damaging the cell membrane of the fungi. Far advanced fungal infections that have penetrated deep into the nail often have to be combated with a tablet treatment lasting several weeks. According to Tietz's experience, "only the combination therapy of tablets and varnish is promising". In any case, patients have to carry out the therapy very conscientiously. This can take months, sometimes over a year, because of the slow growth in healthy nail substance. Volker Senger only got rid of his mushrooms when he attacked them in combination with tablets and varnish.

Even that only led to success when a dermatologist sent him to the drugstore in addition to the pharmacy. "I not only had to buy a disinfectant spray there and spray it on all of my shoes at certain intervals, but also a disinfectant detergent for my socks," reports the now healed man. The fungal spores and yeast are stubborn and are only killed at high washing temperatures. And as is well known, socks are only washed at 90 degrees if you never want to wear them again.

More on the subject at: www.g-netz.de, enter "Nagelpilz" in the search mask. Or via the homepage of the German Dermatological Society www.derma.de.

To home page