Dermatophyte Infection - Nail
Dermatophyte infection - nail
Oral terbinafine is more effective than oral azole.
Liver reactions rare with oral antifungals.
Send nail clippings if treatment failure.
If candida or non-dermatophyte infection confirmed, use oral itraconazole.
Stop treatment when continual, new, healthy, proximal nail growth.
For children, seek specialist advice.
To prevent recurrence: apply weekly 1% topical antifungal cream to entire toe area.
First line: terbinafine
fingers: 6-12 weeks
toes: 3-6 months
Second line: itraconazole
7 days monthly
fingers: 2 courses
toes: 3 courses
Third line for very superficial as limited evidence of effectiveness: amorolfine 5% nail lacquer
fingers: 6 months
toes: 12 months