Onychomycosis Treatment

Onychomycosis
Treatment
Treatment of onychomycosis depends on the type of clinical disease, the number of nails affected and the severity of damage to the nail. Systemic therapy in onychomycosis is always necessary to form the proximal and distal subunghiala involving lunulata side. White superficial onychomycosis may be treated with topical agents. Combining topical agents with the system grows the cure rate.
Topical antifungals. Their use should be limited to cases involving damage of more than half of the nail or for patients who can not tolerate systemic therapy. Agencies include amorolfina, Ciclopirox and bifonazole / urea. Topical treatments can not cure onychomycosis alone due to the insufficient penetration of the nail. And amorolfina Ciclopirox penetrates the nail but not effective enough for use as monotherapy.
Oral antifungals. New generation of oral antifungal (itraconazole and terbinafine) has replaced older therapies in onychomycosis. These shows high cure rates, shorter treatment regimens and fewer side effects. Fluconazole is an alternative to itraconazole and terbinafine. Efficacy of new antifungal agents is based on increased ability to penetrate the nail. To decrease adverse effects and duration of therapy will be associated nail avulsion and topical antifungal.
Surgical therapy. Surgical methods in treating onychomycosis include avulsion mechanical, chemical or surgical nail. Chemical removal using 50% urea. It is painless and useful in patients with thick nails. Nail removal is a treatment adjunct to oral therapy patients. Combination oral therapy, topical and surgical increase effectiveness and reduce cost.
After antifungal therapy healthy nail growth should be measured at each visit. Nail should grow by 1. 5-2 mm per month and require up to a year before the complete development. Damage to adjacent skin nail allows colonization by other body that increases the risk of infection. Complications described the elderly and people with diabetes include cellulitis, osteomyelitis, sepsis and tissue necrosis. Onychomycosis caused by nondermatofiti, especially Fusarium species not usually respond to treatment. Recurrence is common onychomycosis. Nail fungal infections hands has a better prognosis than that of toenails.