Treatment and management strategies of onychomycosis

Area of Science:

• Dermatology
• Pharmaceutics
• Drug Delivery

Background:

• Onychomycosis is a prevalent nail fungal infection causing nail thickening and disintegration.
• Current oral and topical treatments for onychomycosis have low efficacy and high relapse rates (25-30%).
• Systemic toxicity and side effects limit oral therapies, while topical treatments suffer from poor nail plate penetration.

Purpose of the Study:

• To analyze treatment procedures for onychomycosis.
• To identify factors influencing drug permeation across the nail plate.
• To review chemical, mechanical, and physical methods for improving topical drug delivery in onychomycosis management.

Main Methods:

• Review of existing literature on onychomycosis treatments.
• Analysis of drug penetration enhancers (chemical methods).
• Evaluation of physical and mechanical techniques for enhancing nail drug delivery.

Main Results:

• Penetration enhancers like Thioglycolic acid, Hydroxypropyl-β-cyclodextrin (HP-β-CD), Sodium lauryl sulfate (SLS), carbocysteine, and N-acetylcysteine show promise in improving drug penetration.
• Physical techniques including iontophoresis, laser, and Photodynamic therapy demonstrate promising results for onychomycosis treatment.
• Further research is needed to determine the long-term suitability of these advanced delivery devices.

Conclusions:

• Improving drug delivery across the nail plate is crucial for effective onychomycosis treatment.
• Chemical enhancers and physical/mechanical techniques offer potential solutions to overcome the limitations of conventional topical therapies.
• Continued investigation into novel drug delivery systems is essential for advancing onychomycosis management.