PO Antifungals (first line)
Terbinafine - 250mg QD for 12 weeks (toenail) or 6 weeks (fingernail) - most effective therapy
Itraconazole - 200mg QD for 12 weeks
"Pulse dosing" may be as effective as continuous dosing
Fluconazole and ketoconazole are less effective and should not be used
Topical Antifungals
Creams are generally ineffective
Lacquer preparations are more effective due to longer contact times, but should only be used if fungus covers <50% of nail
Ciclopirox 8% - daily application for 4 months
Amorolfine 5% - 1-2 times per week for 6-12 months
Efinaconazole 10% - newer agent
Terbinafine - 250mg QD for 12 weeks (toenail) or 6 weeks (fingernail) - most effective therapy
Itraconazole - 200mg QD for 12 weeks
"Pulse dosing" may be as effective as continuous dosing
Fluconazole and ketoconazole are less effective and should not be used
Creams are generally ineffective
Lacquer preparations are more effective due to longer contact times, but should only be used if fungus covers <50% of nail
Ciclopirox 8% - daily application for 4 months
Amorolfine 5% - 1-2 times per week for 6-12 months
Efinaconazole 10% - newer agent
Onychomycosis
Otomycosis
Tinea versicolor
Dermatophytosis
Leprosy
Candida dermatitis
Herpes labialis
Tinea capitis