TREATMENT OF ONYCHOMYCOSIS: CONVENTIONAL AND NOVEL APPROACHES

Onychomycosis, also known as tinea unguium, is a fungal infection of the nail bed or nail
plate. It affects approximately 14% of the world's population and accounts for approximately
50% of all nail diseases. Dermatophytes, non-dermatophyte moulds, and yeast are the most
common causative organism. It was initially thought to be a cosmetic issue but has recently
gained attention due to its persistent nature and difficult treatment with relapses.
Onychomycosis is typically treated with oral and topical medications. Although effective,
oral antifungal agents are hepatotoxic and cause drug-drug interactions. Topical therapy is
more patient-friendly because it does not have these side effects, but it has another
disadvantage of improper nail penetration. Efforts have been made for decades to improve
topical delivery for the effective treatment of onychomycosis. Mechanical, physical, and
chemical methods were used. Despite all efforts, the nail delivery problem remains
unresolved. For improved drug permeation and localized therapy, the emphasis has recently
shifted to novel drug delivery systems such as nanoparticles, microemulsions, polymeric
films, and nail lacquers. This review article discusses both conventional and novel
formulation approaches for the treatment of onychomycosis.