Comparative study between topical clotrimazole manufactured by nanotechnology alone and with neodymium‐doped yttrium aluminum garnet laser (1064 nm) compared with neodymium‐doped yttrium aluminum garnet laser alone in the treatment of onychomycosis

Background Onychomycosis is defined as a fungal infection of the nail. It is caused by dermatophytes, nondermatophytes, and yeasts. Nanosuspension is defined as a submicron colloidal dispersion of any of the drug particles. Neodymium‐doped yttrium aluminum garnet (Nd : YAG) laser has been reported to be effective for treating onychomycosis. The aim was to compare topical clotrimazole-loaded gel alone and with Nd : YAG laser compared with Nd : YAG laser only in patients with mycologically proven onychomycosis. Patients and methods A total of 60 patients presented with onychomycosis. All patients were subjected to a full history taking, dermoscopic and clinical examination, assessment of severity by using the onychomycosis severity index, and culture. Results There was a statistically significant response (decrease in onychomycosis severity index, dermoscopic features, and mycological clearance) in patients treated by both topical clotrimazole and Nd : YAG laser compared with laser alone or topical clotrimazole-loaded gel alone. Conclusion Clotrimazole-loaded gel showed high efficacy against Candida and can be used as an adjuvant to systemic or topical antifungal treatment for onychomycosis or laser system.