title: Chemical and physical strategies in onychomycosis topical treatment: A review.
abstract: Onychomycosis is a fungal infection of the fingernails or toenails caused by dermatophytes, 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 physiological 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 effects may be developed due to long-term treatment. In light of these facts, researchers have focused 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 therapy 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 penetration are discussed. We hope that the information gathered may be useful for the development of safer and more effective treatments for onychomycosis.
authors.affiliation: Laboratory of Food, Drugs and Cosmetics (LTMAC). School of Health Sciences, University of Brasília. Campus Universitário Darcy Ribeiro, s/n, 70910-900, Brasília, DF, Brazil.
authors.forename: Tamara
authors.initials: T
authors.lastname: Angelo
authors.affiliation: School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo. Avenida do Café, s/n, 14040903, Ribeirão Preto, SP, Brazil.
authors.forename: Lívia Neves
authors.initials: LN
authors.lastname: Borgheti-Cardoso
authors.affiliation: Laboratory of Food, Drugs and Cosmetics (LTMAC). School of Health Sciences, University of Brasília. Campus Universitário Darcy Ribeiro, s/n, 70910-900, Brasília, DF, Brazil.
authors.forename: Guilherme Martins
authors.initials: GM
authors.lastname: Gelfuso
authors.affiliation: School of Pharmacy, Federal University of Goiás. Rua 240 c/5ª. Avenida, s/n, Setor Leste Universitário, 74.605-170, Goiânia, GO, Brazil.
authors.forename: Stephânia Fleury
authors.initials: SF
authors.lastname: Taveira
authors.affiliation: Laboratory of Food, Drugs and Cosmetics (LTMAC). School of Health Sciences, University of Brasília. Campus Universitário Darcy Ribeiro, s/n, 70910-900, Brasília, DF, Brazil.
authors.forename: Tais
authors.initials: T
authors.lastname: Gratieri
mesh_terms: D000287:Administration, Topical; D000935:Antifungal Agents / Q000008:administration & dosage*; D016503:Drug Delivery Systems / Q000379:methods* / Q000592:standards; D005533:Foot Dermatoses / Q000188:drug therapy*; D006801:Humans; D009262:Nails / Q000033:anatomy & histology / Q000737:chemistry / Q000382:microbiology*; D014009:Onychomycosis / Q000188:drug therapy*; D011788:Quality of Life
chemical_list: D000935:Antifungal Agents
keywords: Onychomycosis; fungal infection; nail; ungual penetration