Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Mar 4:17:819-843.
doi: 10.2147/IDR.S431526. eCollection 2024.

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

Eden Axler  1 , Shari R Lipner  1
Affiliations
Review

Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes

Eden Axler et al. Infect Drug Resist. .

Abstract

Onychomycosis, a common fungal nail infection, affects >20% of adults over age 60 and >50% of people over age 70. Onychomycosis may cause pain, psychosocial problems, and secondary infections, therefore meriting treatment. This review describes the range of treatment modalities, including FDA-approved systemic drugs and topical therapies. Additionally, new and emerging oral and topical therapies are discussed. We emphasize the importance of tailoring onychomycosis therapy to individual patient characteristics, comorbidities, preferences, extent of nail involvement, and fungal species, such that physicians may optimize treatment outcomes, patient satisfaction, and safety.

Keywords: dermatophyte; fungal susceptibility; nail infection; systemic treatment; topical therapy; treatment guidelines.

PubMed Disclaimer

Conflict of interest statement

Eden Axler reports no conflicts of interest in this work. Dr Shari Lipner reports grants from Moberg Pharmaceuticals, Belle Torus Corporation; personal fees from Hoth Therapeutics, Ortho Dermatologics, and Eli Lilly, outside the submitted work. Dr. Lipner has also served as a consultant for Ortho-Dermatologics, Eli Lilly, Moberg Pharmaceuticals, and BelleTorus Corporation.

Figures

Figure 1
Figure 1
Algorithm of First-Line Therapeutic Recommendations for Confirmed Onychomycosis.
See this image and copyright information in PMC

References

    1. Veiga FF, Gadelha MC, da Silva MRT, et al. Propolis extract for onychomycosis topical treatment: from bench to clinic. Front Microbiol. 2018;9:779. doi: 10.3389/fmicb.2018.00779 - DOI - PMC - PubMed
    1. Nickles MA, Lio PA, Mervak JE. Complementary and alternative therapies for onychomycosis: a systematic review of the clinical evidence. Skin Appendage Disorders. 2022;8(4):269–279. doi: 10.1159/000521703 - DOI - PMC - PubMed
    1. Lipner S, Scher RK. Onychomycosis: current and future therapies. Cutis. 2014;93(2):60–63. - PubMed
    1. Lipner SR, Scher RK. Onychomycosis: treatment and prevention of recurrence. J Am Acad Dermatol. 2019;80(4):853–867. doi: 10.1016/j.jaad.2018.05.1260 - DOI - PubMed
    1. Bodman MA, Krishnamurthy K. Onychomycosis. In: StatPearls. StatPearls Publishing LLC.; 2023. - PubMed