Tiny Droplets Big Impact: Emerging Nanoemulsion Strategies for Enhanced Nail Penetration in Onychomycosis Therapy

Background

As the nail plate is not very permeable and has a high density of keratinization, onychomycosis is one of the most common types of mycological nail contamination and is characterized by high recurrence. Despite the clinical effectiveness of systemic antifungal agents such as Terbinafine and Itraconazole, their use is often limited by adverse effects, treatment duration, drug interactions, and patient compliance. The restrictions have necessitated the use of state-of-the-art topical delivery systems to improve drug permeation into the nail plate.

Materials and Methods

This review evaluates the efficacy of nanoemulsions in drug delivery systems for onychomycosis. Nanoemulsions are colloidal suspensions of droplets between 20 to 200 nm, designed to enhance drug delivery via transdermal and transungual routes. Physicochemical properties, formulations, stability and incorporation of antifungal drugs. Antifungal agents such as Terbinafine, Itraconazole, Ciclopirox and Amorolfine were tested, and their interactions with natural oils and keratolytic agents were tested.

Results

Nanoemulsion systems exhibited higher drug solubility, surface area, and nail plate permeation. These formulations enabled sustained drug delivery to the site of infection, enhanced nail plate hydration, and partially disrupted the keratin barrier. Antifungal agents, when combined with natural oils or keratolytic enhancers, showed better antifungal activity, especially against resistant fungal strains. Preclinical research found significant increases in transungual penetration and fungal removal, and clinical trials reported higher cure rates and shorter treatment times compared with conventional formulations.

Conclusion

Onychomycosis can be effectively managed with a nanoemulsion-based delivery system, which is an emerging, safe, and effective method. These next-generation topical antifungal therapies have the potential to replace current antifungals due to their improved therapeutic effects and better patient compliance, even though they face drawbacks such as limited formulation stability, temperature sensitivity, and a risk of microbiological contamination.