2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T73c,Antifungals are the standard treatment for onychomycosis. However, oral antifungals present contraindications and potential drug-drug interactions, while topical antifungals suffer from limited efficacy and penetration. Recently, researchers have explored physical therapies, including laser and photodynamic therapy. To evaluate the clinical efficacy of combining diode laser therapy with photodynamic therapy and ciclopirox 8% hydroxypropyl chitosan (HPCH) nail lacquer in treating onychomycosis. We conducted a randomised controlled clinical trial involving patients with onychomycosis. A total of 26 patients were enrolled and followed for 12 months. Participants received either eight sessions of laser treatment combined with three sessions of photodynamic therapy, or daily treatment with ciclopirox 8% HPCH. The clinical cure rate was 94.1% in the group treated with laser and photodynamic therapy, compared to 53.3% in the group treated with ciclopirox 8% HPCH (p = 0.008). All patients who achieved clinical cure with either treatment also reached mycologic and complete cure, with a rate of 100%. The average time to healing was significantly shorter for the group receiving laser and photodynamic therapy (3.6 ± 1.2 months) than for those treated with ciclopirox 8% HPCH nail lacquer (9.2 ± 1.6 months) (p < 0.001). In the laser and photodynamic therapy group, adverse events, specifically subungual hematoma and blisters, occurred in 11.4% of patients, with a recurrence rate of 33.3%. No adverse events or recurrence were observed in patients treated with ciclopirox 8% HPCH. Treatment of onychomycosis using diode laser and photodynamic therapy results in higher clinical cure rates and shorter healing times compared to the reference treatment with 8% ciclopirox HPCH. ClinicalTrials.gov identifier: NCT05809297.31:T9bb,ABSTRACTBackgroundAntifungals are the standard treatment for onychomycosis. However, oral antifungals present contraindications and potential drug–drug interactions, while topical antifungals suffer from limited efficacy and penetration. Recently, researchers have explored physical therapies, including laser and photodynamic therapy.ObjectiveTo evaluate the clinical efficacy of combining diode laser therapy with photodynamic therapy and ciclopirox 8% hydroxypropyl chitosan (HPCH) nail lacquer in treating onychomycosis.MethodsWe conducted a randomised controlled clinical trial involving patients with onychomycosis. A total of 26 patients were enrolled and followed for 12 months. Participants received either eight sessions of laser treatment combined with three sessions of photodynamic therapy, or daily treatment with ciclopirox 8% HPCH.ResultsThe clinical cure rate was 94.1% in the group treated with laser and photodynamic therapy, compared to 53.3% in the group treated with ciclopirox 8% HPCH (p = 0.008). All patients who achieved clinical cure with either treatment also reached mycologic and complete cure, with a rate of 100%. The average time to healing was significantly shorter for the group receiving laser and photodynamic therapy (3.6 ± 1.2 months) than for those treated with ciclopirox 8% HPCH nail lacquer (9.2 ± 1.6 months) (p < 0.001). In the laser and photodynamic therapy group, adverse events, specifically subungual hematoma and blisters, occurred in 11.4% of patients, with a recurrence rate of 33.3%. No adverse events or recurrence were observed in patients treated with ciclopirox 8% HPCH.ConclusionsTreatment of onychomycosis using diode laser and photodynamic therapy results in higher clinical cure rates and shorter healing times compared to the reference treatment with 8% ciclopirox HPCH.Trial RegistrationClinicalTrials.gov identifier: NCT0580929725:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Topical Antifungal: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Topical Antifungal (modality). Clinician-written summaries and actionable practice insights. 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All patients who achieved clinical cure with either treatment also reached mycologic and complete cure, with a rate of 100%. The average time to healing was significantly shorter for the group receiving laser and photodynamic therapy (3.6 ± 1.2 months) than for those treated with ciclopirox 8% HPCH nail lacquer (9.2 ± 1.6 months) (p < 0.001). In the laser and photodynamic therapy group, adverse events, specifically subungual hematoma and blisters, occurred in 11.4% of patients, with a recurrence rate of 33.3%. No adverse events or recurrence were observed in patients treated with ciclopirox 8% HPCH.","abstract":"$30","keywords":["ciclopirox","laser","onychomycosis","photodynamic therapy","toluidine","topical antifungal","treatment"],"pubmed_id":"41024682","conclusions":"","publication_date":"2025-09-30T00:00:00"},"crossref":{"DOI":"10.1111/myc.70121","URL":"https://doi.org/10.1111/myc.70121","ISSN":["0933-7407","1439-0507"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/myc.70121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"10","score":1,"title":["Diode Laser and Red‐Laser Photodynamic Therapy Versus Ciclopirox 8% HPCH Nail Lacquer for the Treatment of Onychomycosis: A Randomised Controlled Trial"],"author":[{"given":"Sara","family":"García‐Oreja","sequence":"first","affiliation":[{"name":"University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry Complutense 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Madrid Health Research Institute of the San Carlos Clinical Hospital (IdISSC) Madrid Spain"}]},{"given":"José Luis","family":"Lázaro‐Martínez","sequence":"additional","affiliation":[{"name":"Diabetic Foot Unit, University Podiatry Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid Health Research Institute of the San Carlos Clinical Hospital (IdISSC) Madrid 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Time to healing was shorter with laser+PDT (3.6±1.2 vs 9.2±1.6 months; p<0.001); adverse events occurred in 11.4% of treated nails (all laser+PDT; subungual hematoma/blisters) and recurrences occurred in 6/24 cured nails (33.3% of laser+PDT patients), with none in the ciclopirox group.","limitations":"Small, single-center, open-label study with all procedures performed by one podiatrist. Microbiologic cultures were only repeated in clinically cured nails, which may overstate mycologic cure. Post‑treatment observation time and visit intensity differed between groups, potentially affecting recurrence and adherence.","practice_takeaway":"For adults who cannot take oral antifungals, an 8‑session diode laser plus red‑laser PDT protocol achieved higher clinical cure and faster healing than daily ciclopirox 8% HPCH, but with mild local adverse events and more recurrences in this small RCT. Consider selectively, pending confirmation in larger, blinded, multicenter trials."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Topical Antifungal"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Topical Antifungal"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Topical Antifungal"}}}]]

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