title: Toenail onychomycosis: current and future treatment options.
abstract: Onychomycosis is a common disease affecting as much as 8% of the general population. Treatment of onychomycosis is challenging, complicated by low cure rates and relatively high relapse rates. This paper reviews the efficacy of current oral, topical, and surgical treatment options. Currently, the treatment of choice for toenail onychomycosis is oral terbinafine because of its high efficacy, low relapse rates, and cost-effectiveness. Oral itraconazole or fluconazole could be considered for infections caused by Candida. Topical therapies may be a useful adjunct to these systemic therapies, but are less effective when used alone. More research is needed to determine the best measures for preventing reinfection.
authors.affiliation: University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Finch
authors.forename: Erin M
authors.initials: EM
authors.lastname: Warshaw
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000077768:Ciclopirox; D003880:Dermatology / Q000639:trends; D004359:Drug Therapy, Combination; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use; D005533:Foot Dermatoses / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D006118:Griseofulvin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use; D009025:Morpholines / Q000008:administration & dosage / Q000627:therapeutic use; D009281:Naphthalenes / Q000008:administration & dosage / Q000627:therapeutic use; D014009:Onychomycosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D011728:Pyridones / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D009025:Morpholines; D009281:Naphthalenes; D011728:Pyridones; D000077768:Ciclopirox; D017964:Itraconazole; D006118:Griseofulvin; D015725:Fluconazole; C038974:amorolfine; D000077291:Terbinafine