What's New in Topical Treatments and Devices for Onychomycosis?

In a presentation on new topical treatments and devices for onychomycosis, Shari Lipner, recognized as an authority in nail health, discusses the current landscape of topical antifungal medications and emerging therapies. The three FDA-approved topical treatments are cyclopyrox, eficonazole, and tavaborole, each with distinct mechanisms of action and varying efficacy rates. It is highlighted that topical treatments are typically indicated for superficial infections and are preferable for patients who cannot tolerate systemic treatments. Lipner emphasizes the effective use of topical medications in pediatric cases, especially with initial positive mycological cure rates observed in studies. She also addresses the challenge patients face with manicures while undergoing treatment, noting recent studies suggesting that topical therapies might work even alongside the use of nail polish, thus permitting patients to maintain their aesthetic preferences. Additionally, findings reveal that topical treatments show promising results for dermatophytomas, traditionally viewed as difficult to treat. Lipner discusses ongoing drug developments like ME111 and amphotericin B, and devices like microwave therapy, which are being explored in clinical trials. She concludes by stressing that while lasers provide temporary cosmetic improvements, they should not be considered as first-line treatments. Overall, the session serves to inform about evolving options and studies, suggesting that topical treatments may increasingly become the primary choice in managing certain cases of onychomycosis.