Onychomycosis: Treatment and prevention of recurrence

Abstract

Onychomycosis is a fungal nail infection caused by dermatophytes, nondermatophytes, and yeast, and is the most common nail disorder seen in clinical practice. It is an important problem because it may cause local pain, paresthesias, difficulties performing activities of daily living, and impair social interactions. The epidemiology, risk factors, and clinical presentation and diagnosis of onychomycosis were discussed in the first article in this continuing medical education series. In this article, we review the prognosis and response to onychomycosis treatment, medications for onychomycosis that have been approved by the US Food and Drug Administration, and off-label therapies and devices. Methods to prevent onychomycosis recurrences and emerging therapies are also described.

Keywords: booster therapy; ciclopirox; clinical cure; complete cure; efinaconazole; fluconazole; fungal nail infection; itraconazole; lasers; mycologic cure; onychomycosis; photodynamic therapy; plasma therapy; pulse dosing; tavaborole; terbinafine; treatment.