Efficacy of Trichloroacetic Acid in Patients with Toenail Onychomycosis: Pilot Study with 14 Patients

Lee, Weon Ju; Park, Kyung Hea; Song, Chang Hyun; Lee, Seok Jong; Kim, Do Won

Abstract

BACKGROUND
Various methods have been employed for treatment of onychomycosis. These methods can be categorized as topical, oral, or device-related. Among them, oral therapies have been regarded as the gold standard for treatment. However, the efficacy of oral therapies on onychomycosis remains limited and safety may be an issue, leaving many patients in need of alternative treatments. As an alternative treatment for onychomycosis, topical therapies are under investigation with great interest.
OBJECTIVE
We conducted an investigation on the efficacy of trichloroacetic acid (TCA) as a new therapeutic option in treatment of onychomycosis.
METHODS
Fourteen patients with onychomycosis in both great toenails, which was confirmed by fungal examination, were enrolled. About 0.1 ml of 100% TCA solution was applied on one great toenail of the patients eight times at an interval of one week. The other great toenail of the patients was treated with vehicle.
RESULTS
At the end of the treatment period, clinical improvement of TCA-treated great toenails with onychomycosis was observed in eleven out of 14 patients. By contrast, no clinical improvement was observed in vehicle-treated great toenails with onychomycosis. Irritant contact dermatitis of the periungual nail folds occurred in 29% as an adverse effect.
CONCLUSIONS
Topical solution of TCA may become a new therapeutic option for treatment of patients with onychomycosis who desire alternatives to oral antifungal agents.