Combination Therapy Effective for Onychomycosis


Studies using combination therapy for the treatment of onychomycosis demonstrated positive results, according to Anil Kumar Bhatta, MD, who presented this late-breaking research in procedural dermatology at the 2016 American Academy of Dermatology meeting on March 5, 2016, in Washington, DC.

Fractional carbon-dioxide laser therapy combined with the topical antifungal ointment terbinafine (Lamisil) was found to be effective in the treatment of onychomycosis. However, randomized clinical studies are needed before it can be widely used in clinics, he said.

“The inability of topical medication to penetrate via the nail plate brings a great challenge to clinicians in treating onychomycosis. Furthermore, oral medications are not appropriate for all patients because of drug interactions, adverse effects and contraindications,” Dr. Bhatta noted.

The study included 75 patients with 356 onychomycotic nails confirmed by mycological examination. All the affected nails received 3 sessions of laser therapy at 4 weeks interval and once daily application of ointment terbinafine for 3 months. The results demonstrated that 95% and 92% of the treated patients were KOH and culture negative respectively at 3 months. Similarly, 84% and 80% were KOH and culture negative respectively after 6 months of treatment. Using SCIO electronic calculator, 73% of patients scored >6 and 27% of patients scored ≤6. Among those who scored >6 were evaluated clinically and found that 98% of patients showed response to treatment in 3 months and 78% in 6 months.