Non-traumatic topical treatment of onychomycosis with urea associated with bifonazole

The need for a topical, non-traumatic treatment for onychomycoses of different etiologies has led to a search for increased effectiveness by associating products which have different and complementary effects, as is the case of the keratoplastic and broad-spectrum antifungal agents. Using a 40% urea and 1% bifonazole cream, 42 nails with fungal infections (28 patients) were treated until the infected area softened and could be removed, after which 1% bifonazole cream was applied. After a 6 to 12 month follow-up, the treatment success rate has been 93.8% for fingernails and 88.5% for toenails. The cultures became negative within 3 weeks after starting therapy with urea and bifonazole. Tolerance was good and it was not necessary to stop treatment in any patient. The topical, combined use of urea and bifonazole is a good alternative in the treatment of onychomycoses of different etiologies, provided that strict compliance by the patient is ensured, and that the application instructions are followed correctly.