Jessner's Peel as Adjuvant for Onychomycosis Treatment

Onychomycosis is a common infection, particularly in the toenails of the elderly, who frequently have other comorbidities that require them to take multiple drugs. Onychomycosis treatment can be oral or topical, the former being the one with higher cure rates but is also associated with the risk of drug interactions, as well as more chances of adverse effects. Topical treatments in lacquer are readily available and without the risks associated with systemic options, but with disappointing overall cure rates, as the nail plate penetration is an important limitation. We included 10 adults with low-medium onychomycosis severity index (OSI) scores to participate in this pilot study. Initially, Jessner peel was applied to the affected nail plate, and the patient was sent home with 8% ciclopirox lacquer to be applied daily for 3 months, with monthly evaluations and reapplication of Jessner’s peel. The final evaluation was after three more months, adding up to a total of 6 months of follow-up. This work has important limitations because of the sample size and lack of a control group; however, we think it is an area for further research since it has fewer adverse effects, lower cost than oral drugs, and great feasibility.