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Onychomycosis: Management

Adam O Goldstein, MD, MPH
Neal Bhatia, MD
Section Editors
Robert P Dellavalle, MD, PhD, MSPH
Moise L Levy, MD
Ted Rosen, MD
Deputy Editor
Abena O Ofori, MD


Onychomycosis, fungal infection of the nail, can cause disfigurement of the nail, pain, and may increase risk for soft tissue bacterial infection in immunocompromised patients. Dermatophytes, particularly Trichophyton rubrum, are the most common causes of onychomycosis. Yeast (eg, Candida albicans) and nondermatophyte molds can also cause onychomycosis. (See "Onychomycosis: Epidemiology, clinical features, and diagnosis".)

Therapeutic options for onychomycosis include oral antifungal medications, topical antifungal medications, and physical interventions. Factors such as the causative organism, severity of nail involvement, treatment side effects, and patient preference influence treatment selection.

The management of onychomycosis will be reviewed here. The clinical features and diagnosis of onychomycosis are reviewed separately. (See "Onychomycosis: Epidemiology, clinical features, and diagnosis".)


Patient selection — Treatment of onychomycosis is not mandatory in all patients. We suggest treating onychomycosis in:

Patients with a history of cellulitis of the lower extremity, especially if repeated, who have ipsilateral toenail onychomycosis

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Literature review current through: Nov 2017. | This topic last updated: May 30, 2017.
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