Dermatophyte Infection - Nail

Dermatophyte infection - nail

CKS

Take nail clippings: start therapy only if infection is confirmed by laboratory.

Oral terbinafine is more effective than oral azole.

Liver reactions rare with oral antifungals.

If candida or non-dermatophyte infection confirmed, use oral itraconazole.

For children, seek specialist advice.

First line: terbinafine

250mg OD 

fingers: 6-12 weeks

toes: 3-6 months

Second line: itraconazole

200mg BD

fingers: 7 days monthly

toes: 2 courses

Third line for very superficial as limited evidence of effectiveness: amorolfine 5% nail lacquer

1-2x/weekly

fingers: 6 months

toes: 12 months