Onychomycosis therapy: past, present, future

Methods to treat onychomycosis are varied, using therapies that can be categorized as topical, oral or device-related. Since their development, oral therapies have represented the gold standard for treatment over other methods. However, efficacy with oral therapies remains limited, and safety may be an issue, leaving many patients requiring alternative treatments. With research advances, topical therapies as alternatives for onychomycosis are being investigated with greater interest as new technologies are overcoming previous limitations of topical treatments, such as lack of nail penetration. New device-related topical therapy methods are particularly noteworthy, as they may allow for shorter, more convenient treatments for patients, reducing issues with topical compliance, and, in cases of non-drug light-based therapies, they will avoid potential for drug reactions. Research in these fields is preliminary, and the impact these methods may have on the future of onychomycosis remains to be seen.