New treatment options for onychomycosis

Area of Science:

• Dermatology
• Medical Mycology
• Laser and Light Therapies

Background:

• Onychomycosis is the most prevalent nail disease, commonly caused by dermatophytes, yeasts (Candida), and molds.
• Superficial onychomycosis, without matrix involvement, is typically treated with topical antifungal agents.
• Emerging light-based treatments offer new therapeutic avenues for onychomycosis.

Purpose of the Study:

• To review current and emerging treatment options for onychomycosis.
• To evaluate the efficacy and mechanisms of novel light-based therapies, including thermal lasers, non-thermal lasers, and photodynamic therapy.

Main Methods:

• Review of existing literature on onychomycosis treatments.
• Analysis of data regarding thermal laser therapy, noting a required temperature increase of approximately 50 °C for efficacy.
• Examination of photodynamic therapy (PDT) utilizing 5-aminolevulinic acid and red light activation of protoporphyrin IX.

Main Results:

• Topical antifungals remain a standard for superficial onychomycosis.
• Thermal lasers show promise, contingent on achieving specific temperature thresholds.
• Clinical data for non-thermal lasers are inconclusive, and their mechanism of action is unclear.
• Photodynamic therapy involves light activation of a photosensitizer for therapeutic effect.

Conclusions:

• While topical antifungals are established, light-based therapies present novel options for onychomycosis management.
• Further extensive clinical studies with prolonged follow-up are essential to ascertain the definitive value of laser and photodynamic therapies for onychomycosis.