Topical Medications: From the Outside In

Until recently, topical antifungals were all available over-the-counter. Although as convenient as painting your toenails, these medications are, for the most part, ineffective at curing fungal nails. This is not to say that they do not work, but their likelihood of success is small (<10%). These medications can help control the spread of the fungus, but often will not eliminate it completely or permanently. Why? Simply because these medications are not strong enough to penetrate the entire thickness of the nail. Additionally, as is the case with all antifungal medications, it takes several months before noticeable results can be seen (you may recall that it can take upwards of 10 months to grow a toenail).

Recently, the FDA approved a prescription-strength topical antifungal agent for treating onychomycosis. Penlac lacquer (Ciclopirox 8%) offers a more effective alternative than the traditional topical medications. Though more powerful than over-the-counter topical medications, Penlac’s cure rate is still only 34% [7].