Topical therapy of onychomycosis – from preventive treatment to reinfection prophylaxis

Sergeev V.Y., Burtseva G.N., Baranova M.O.

All-Russian National Academy of Micology
Central Research Dermatology Clinic, Moscow, Russia

Onychomycosis topical treatment is based on several forms
of antifungals specialized for nail application. Among them
naftifine 1% solution and amorolfine 5% nail lacquer are
leading in current use in Russia. These formulations have certain
pharmacokinetic properties that may fit various clinical
settings in onychomycosis. Early onychomycosis demands
prompt recognition and is suitable for application of nail lacquer
alone. Rationale for onychomycosis topical treatment
is not limited to clinical peculiarities per se. General health
condition, comorbidities and their therapy, as well as personal
demands of the patient also influence treatment decisions.
Efficacy of topical therapy may be limited in onychomycosis
with longer history and more severe presentation, where
combinations of topical and systemic antifungals may apply.
We have conducted pharmacoepidemiological analysis that
shows growing demand for amorolfine 5% nail lacquer in
Russia. This formulation may be used in prophylactic treatment
of onychomycosis, maintaining effective antifungal
concentrations in the nail after course of systemic therapy,
and for prevention of reinfection from external source.