Chemical and physical strategies in onychomycosis topical treatment: A review

What is it about?

Onychomycosis is a fungal infection of the fingernails or toenails caused by dermato- phytes, nondermatophytes, moulds, and yeasts. This condition affects around 10–30% people worldwide, negatively influencing patients’ quality of life, with severe outcomes in some cases. Since the nail unit acts as a barrier to exogenous substances, its phys- iological features hampers drug penetration, turning the onychomycosis treatment a challenge. Currently, there are several oral and topical therapies available; nevertheless, cure rates are still low and relapse rates achieves 10–53%. Also, serious side effectsmay be developed due to long-term treatment. In light of these facts, researchers have fo- cused on improving topical treatments, either by modifying the vehicle or by using some physical technique to improve drug delivery trough the nail plate, hence increasing ther- apy effectiveness. Therefore, the aim of this paper is to explain these novel alternative approaches. First, the challenges for drug ungual penetration are presented. Then, the chemical and physical strategies developed for overcoming the barriers for drug pen- etration are discussed. We hope that the information gathered may be useful for the development of safer andmore effective treatments for onychomycosis.

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