Skip to main content
SpringerLink
Log in

New Topical Antifungals

  • Chapter
  • First Online:
Book cover Onychomycosis

  • 1195 Accesses

Abstract

Until recently, topical treatments for onychomycosis employed lacquer formulations (e.g., ciclopirox). These are organic solutions of film-forming polymers. Upon application to the surface of the nail, the solvent evaporates, leaving a water-resistant polymer film on the nail plate. This occlusive film acts as a drug reservoir that facilitates the release and penetration of the drug into and through the nail. One must then remove the film either mechanically or with organic solvents and apply fresh lacquer to replenish the drug reservoir [1, 2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Murdan S. The nail: anatomy, physiology, diseases and treatment. In: Murthy SN, Maibach HI, editors. Topical nail products and ungual drug delivery. Boca Raton: Taylor and Francis Group, CRC Press; 2013. p. 1–36.

    Google Scholar 

  2. Sparavigna A, Setaro M, Frisenda L. Physical and microbiological properties of a new nail protective medical device. J Plastic Dermatol. 2008;4(1):5–12.

    Google Scholar 

  3. Gupta AK, Joseph WS. Ciclopirox 8 % nail lacquer in the treatment of onychomycosis of the toenails in the United States. J Am Podiatr Med Assoc. 2000;90(10):495–501.

    Article  CAS  PubMed  Google Scholar 

  4. Baran R, Kaoukhov A. Topical antifungal drugs for the treatment of onychomycosis: an overview of current strategies for monotherapy and combination therapy. J Eur Acad Dermatol Venereol. 2005;19(1):21–9.

    Article  CAS  PubMed  Google Scholar 

  5. Lecha M, Effendy I, de Chauvin M F, Di Chiacchio N, Baran R. Treatment options—development of consensus guidelines. J Eur Acad Dermatol Venereol. 2005;19(Suppl 1):25–33.

    Article  PubMed  Google Scholar 

  6. Murdan S. Drug delivery to the nail following topical application. Int J Pharm. 2002;236(1–2):1–26.

    Article  CAS  PubMed  Google Scholar 

  7. Baker SJ, Hui X, Maibach HI. Progress on new therapeutics for fungal nail infections. Annu Rep Med Chem. 2005;40:323–34.

    Article  CAS  Google Scholar 

  8. Mertin D, Lippold BC. In-vitro permeability of the human nail and of a keratin membrane from bovine hooves: influence of the partition coefficient octanol/water and the water solubility of drugs on their permeability and maximum flux. J Pharm Pharmacol. 1997;49(1):30–4.

    Article  CAS  PubMed  Google Scholar 

  9. Kobayashi Y, Komatsu T, Sumi M, Numajiri S, et al. In vitro permeation of several drugs through the human nail plate: relationship between physicochemical properties and nail permeability of drugs. Eur J Pharm Sci. 2004;21(4):471–7.

    Article  CAS  PubMed  Google Scholar 

  10. Tatsumi Y, Yokoo M, Senda H, Kakehi K. Therapeutic efficacy of topically applied KP-103 against experimental tinea unguium in guinea pigs in comparison with amorolfine and terbinafine. Antimicrob Agents Chemother. 2002;46(12):3797–801.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Baraldi A, Jones SA, Guesne S, et al. Human nail plate modifications induced by onychomycosis: implications for topical therapy. Pharm Res. 2015;32(5):1626–33.

    Article  CAS  PubMed  Google Scholar 

  12. Tosti A, Daniel R, Piraccini BM, Iorizzo M. Color atlas of nails. Berlin: Springer; 2010. p. 15–22.

    Book  Google Scholar 

  13. Hamilton JB, Terada H, Mestler GE. Studies of growth throughout the lifespan in Japanese: growth and size of nails and their relationship to age, sex, heredity, and other factors. J Gerontol. 1955;10(4):401–15.

    Article  CAS  PubMed  Google Scholar 

  14. Elewski BE, Rich P, Wiltz H, et al. Effectiveness and safety of tavaborole, a novel boron-based molecule for the treatment of onychomycosis: results from two phase 3 studies. Poster presented at Winter Clinical Meeting. Waimea: Hawaii; 2014.

    Google Scholar 

  15. Elewski BE, Aly R, Baldwin SL, et al. Efficacy and safety of tavaborole topical solution, 5 %, a novel boron-based antifungal agent, for the treatment of onychomycosis: results from 2 randomized phase-III studies. J Am Acad Dermatol. 2015;73:62–9. doi:10.1016/j.jaad.2015.04.010.

    Article  CAS  PubMed  Google Scholar 

  16. Elewski BE, Rich P, Pollak R, et al. Efinaconazole 10 % solution in the treatment of toenail onychomycosis: two phase III multicenter, randomized, double-blind studies. J Am Acad Dermatol. 2013;68(4):600–8.

    Article  CAS  PubMed  Google Scholar 

  17. Singh G, Haneef NS, Uday A. Nail changes and disorders among the elderly. Indian J Dermatol Venereol Leprol. 2005;71(6):386–92.

    Article  PubMed  Google Scholar 

  18. Thatai P, Sapra B. Transungual delivery: deliberations and creeds. Int J Cosmet Sci. 2014;36(5):398–411.

    Article  CAS  PubMed  Google Scholar 

  19. Kobayashi Y, Miyamoto M, Sugibayashi K, et al. Drug permeation through the three layers of the human nail plate. J Pharm Pharmacol. 1999;51(3):271–8.

    Article  CAS  PubMed  Google Scholar 

  20. Monti D, Tampucci S, Chetoni P, et al. Ciclopirox vs amorolfine: in vitro penetration through human health nails of commercial nail lacquers. J Drugs Dermatol. 2014;13(2):143–7.

    CAS  PubMed  Google Scholar 

  21. Monti D, Saccomani L, Chetoni P, et al. Validation of bovine hoof slices as a model for infected human toenails: in vitro ciclopirox transungual permeation. Br J Dermatol. 2011;165(1):99–105.

    Article  CAS  PubMed  Google Scholar 

  22. Hui X, Baker SJ, Wester RC, et al. In vitro penetration of a novel oxaborole antifungal (AN 2690) into the human nail plate. J Pharm Sci. 2007;96(10):2622–31.

    Article  CAS  PubMed  Google Scholar 

  23. Sakamoto M, Sugimoto N, Kawabata H, et al. Transungual delivery of efinaconazole: its deposition in the nail of onychomycosis patients and in vivo fungicidal activity in the human nails. J Drugs Dermatol. 2014;13(11):1338–92.

    Google Scholar 

  24. Bhatt V, Pillai R. Efinaconazole topical solution, 10 %: formulation development program of a new topical treatment of toenail onychomycosis. J Pharm Sci. 2015;104:2177–82. doi:10.1002/jps.24459.

    Article  CAS  PubMed  Google Scholar 

  25. Elewski BE, Pollak RA, Pillai R, et al. Access of efinaconazole topical solution 10 % to the infection site by spreading through the subungual space. J Drugs Dermatol. 2014;13(11):1394–8.

    CAS  PubMed  Google Scholar 

  26. Elewski BE, Pollak RA, Pillai R, et al. Access of efinaconazole topical solution, 10 %, to the infection site by spreading through the subungual space. J Drugs Dermatol. 2014;13:1394–8.

    CAS  PubMed  Google Scholar 

  27. Zeichner JA, Stein Gold L, Korotzer A. Penetration of (14C)-efinaconazole solution does not appear to be influenced by Nail Polish. J Clin Aesthet Dermatol. 2014;7(9):45–8.

    Google Scholar 

  28. Elewski BE, Tosti A. Tavaborole for the treatment of onychomycosis. Expert Opin Pharmacother. 2014;15(10):1439–48.

    Article  CAS  PubMed  Google Scholar 

  29. Vlahovic T, Merchant T, Chanda S, et al. In vitro nail penetration of tavaborole topical solution, 5 % through nail polish on ex vivo human fingernails. J Drugs Dermatol. 2015;14(7):675–8.

    CAS  PubMed  Google Scholar 

  30. Del Rosso JQ. Advances in the treatment of superficial fungal infections: focus on onychomycosis and dry tinea pedis. J Am Osteopath Assoc. 1997;97:339–46.

    CAS  PubMed  Google Scholar 

  31. Sigurgeirsson B, Billstein S, Rantanen T, et al. L.I.ON. Study: efficacy and tolerability of continuous terbinafine compared to intermittent itraconazole in the treatment of toenail onychomycosis. Br J Dermatol. 1999;141(Supp 56):5–14.

    Article  PubMed  Google Scholar 

  32. Baran R, Tosti A, Hartmane I, et al. An innovative water-soluble biopolymer improves efficacy of ciclopirox nail lacquer in the management of onychomycosis. J Eur Acad Dermatol Venereol. 2009;23:773–81.

    Article  CAS  PubMed  Google Scholar 

  33. Baran R, Sigurgeirsson B, de Berker D, et al. A multicenter, randomized, controlled study of the efficacy, safety and cost-effectiveness of a combination therapy with amorolfine nail lacquer and oral terbinafine compared with oral terbinafine alone for the treatment of onychomycosis. Br J Dermatol. 2007;157(1):149–57.

    Google Scholar 

  34. Hay RJ. The future of onychomycosis therapy may involve a combination of approaches. Br J Dermatol. 2001;145:3–8.

    Article  PubMed  Google Scholar 

  35. Rosen T. Evaluation of gender as a clinically relevant outcome variable in the treatment of onychomycosis with efinaconazole topical solution 10 %. Cutis. 2015;96(3):197–201.

    PubMed  Google Scholar 

  36. Rodriguez DA. Efinaconazole topical solution, 10 % for the treatment of mild and moderate toenail onychomycosis. J Clin Aesthet Dermatol. 2015;8(6):24–9.

    PubMed  PubMed Central  Google Scholar 

  37. Markinson B, Caldwell B. Efinaconazole topical solution, 10 %: efficacy in onychomycosis patients with co-existing tinea pedis. J Am Podiatr Med Assoc. 2015;105(5):407–11.

    Article  PubMed  Google Scholar 

  38. Genadur PI. Medimetriks. http://medimetriks.com/PIs/Genadur_PI.pdf.

  39. Cantoresi F, Sorgi P, Arcese A, et al. Improvement of psoriatic onychodystrophy by a water-soluble nail lacquer. J Eur Acad Dermatol Venereol. 2009 Jul;23(7):832–4.

    Article  CAS  PubMed  Google Scholar 

  40. Nuvail PI. Innocutis. http://innocutis.com/wp-content/uploads/2012/06/nuvail-pi_0612.pdf.

  41. Nasir A, Goldstein B, van Cleff M, Swick L. Clinical evaluation of safety and efficacy of a new topical treatment for onychomycosis. J Drugs Dermatol. 2011;10(10):1186–91.

    PubMed  Google Scholar 

  42. Scheinfeld N, Dahdah MJ, Scher R. Vitamins and minerals: their role in nail health and disease. J Drugs Dermatol. 2007;6(8):782–7.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Podiatric Medicine, Temple University School of Podiatric Medicine, 148 N 8th Street, Philadelphia, 19107, PA, USA

    Tracey C. Vlahovic DPM, FFPM RCPS (Glasg)

Authors
  1. Tracey C. Vlahovic DPM, FFPM RCPS (Glasg)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tracey C. Vlahovic DPM, FFPM RCPS (Glasg) .

Editor information

Editors and Affiliations

  1. Department of Dermatology & Cutaneous Surgery, University of Miami, Miami, Florida, USA

    Antonella Tosti

  2. Department of Podiatric Medicine, Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA

    Tracey C. Vlahovic

  3. Mycology Section, Dr. Manuel Gea González General Hospital, México, DF, Mexico

    Roberto Arenas

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Vlahovic, T.C. (2017). New Topical Antifungals. In: Tosti, A., Vlahovic, T., Arenas, R. (eds) Onychomycosis. Springer, Cham. https://doi.org/10.1007/978-3-319-44853-4_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-44853-4_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44852-7

  • Online ISBN: 978-3-319-44853-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation