Topical and surgical treatment of onychomycosis.

Dermatophytes, yeasts, and molds can be the causative organisms of fungal nail infections. Alternatives to the systemic management of onychomycosis include topical and surgical treatments. Traditionally, topical agents used as monotherapy for onychomycosis are only able to inhibit the growth of fungal nail infections; clinical and mycologic cures have recently been observed after treatment with some of the newer preparations. In contrast, surgical treatments almost always need to be used in conjunction with either topical or systemic antifungal therapy. An efficacious topical treatment alternative for onychomycosis involves applying antifungal agents concurrently or sequentially with the removal or debridement of the infected nail structures. Alternatively, the application of antifungal lacquer to fingernail and toenail fungal infections may also be an effective topical therapy for the treatment of less severe forms of onychomycosis.