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Why Medication Did Not Work

Terbinafine is perceived to be the best anti-fungal agent. Although the drug is demonstrably the most effective agent in dermatophyte onychomycosis a consistent failure rate of 30–40% is found in most studies. If the most obvious causes of treatment failure, notably poor compliance, poor absorption, imunosuppression, dermatophyte resistance and zero nail growth are excluded, the commonest cause of failure is likely to be a condition known as Subungual dermatophytoma. It is a tightly packed mass of fungus, which prevents penetration of the drug in adequate concentrations.

Patient previously treated with oral terbinafine remain susceptible to new fungal infections for an indefinite period of time. It is very frustrating for these patients to see the fungus relapse after a temporary clearance of the nails. Most of them will be reluctant to take the toxic medication again, and for obvious reasons.

The truth is: none of the monotherapies, including oral medication, the most effective one in the traditional medicine, will work against fungus. A comprehensive and long term treatment and preventive program is required to succeed in destroying fungus and keeping dermatophytes away.

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