Table 4. The treatment of onychomycosis (usual duration: 6 weeks for fingernail involvement, 12 weeks for toenail involvement)^*.

Treatment	Indication	Active agent	Dosing schedule and cure rate(culture)	Level of evidence
Atraumatic nail extraction	Prior to specific treatment	20–40% urea with occlusion	DailyCure rate unknown	III
Antifungal nail varnish	Monotherapy only if <50% of the nail surface is affected and no more than 3 nails are affected, without matrix involvement	Ciclopiroxolamine	Daily for 48 weeks, 58.3%	Ia
		Amorolfin	1 × / week for 48 weeks, 26.7%	Ia
Systemic antifungal treatment	Involvement of >50% of the nail surface or of >3 nails, or if there is proximal subungual onychomycosis	Terbinafin	250 mg qd for 6–12 weeks, 76%	Ia
		Itraconazole	200 mg bid for 1 week, then pause for 3weeks and repeat	Ia
			6–12 weeks (pulse therapy), 63%	Ia
			200 mg qd for 6–12 weeks (continuous treatment), 69%	Ia
		Fluconazole	150–300 mg 1 ×/ week for 3–12 months, 48%	Ia
Laser therapy	Currently debated	Various kinds of laser	–	IV

^*modified from (40)