From the Guidelines
The primary treatment for dystrophic nails involves a combination of podiatry support, topical keratolytic agents, and proper nail care, as recommended by the most recent evidence 1. To manage dystrophic nails, the following steps can be taken:
- Keep toenails trimmed straight across to prevent further irritation and pressure on the nail bed 1.
- File nail surfaces with an emery board after softening the nails by soaking in warm saline water or a bath to reduce thickness and prevent cracking 1.
- Apply a urea-based cream, such as a keratolytic agent, to reduce the thickness of the nails, daily to weekly, depending on the age of the individual and thickness of the nail 1. It is essential to involve podiatrists in the care of patients with dystrophic nails, especially those with epidermolysis bullosa (EB), as they can provide expert advice and treatment to manage the condition and prevent complications 1. Regular assessment and care plans developed by podiatrists can help improve the quality of life for patients with dystrophic nails, and it is recommended that patients with EB have access to specialist podiatry services 1.
From the FDA Drug Label
Nuvail™ is indicated for managing signs and symptoms of nail dystrophy, i.e., nail splitting and nail fragility, for intact or damaged nails. Nuvail coats and adheres to the nail surface preventing direct abrasion and friction on the nail surface while also providing protection against the effects of moisture. The treatment option for dystrophic nails (nail dystrophy) is amorolfine (Nuvail), which helps manage signs and symptoms such as:
- Nail splitting
- Nail fragility It works by coating and adhering to the nail surface to prevent abrasion and friction, and provide protection against moisture 2.
From the Research
Treatment Options for Dystrophic Nails
The treatment options for dystrophic nails (nail dystrophy) vary depending on the underlying cause and severity of the condition.
- Topical antifungal treatments, such as antifungal lacquers (5% amorolfine and 8% ciclopirox), can be effective in treating fungal nail infections, with cure rates of around 30% 3.
- Oral antifungal medications, such as terbinafine, can be effective in treating fungal nail infections, but may have severe side effects in some cases 3.
- Surgical options, such as total and partial nail avulsion, as well as chemical and excisional matrixectomies, may be necessary in some cases of dystrophic nails 4.
- Trimming, filing, or grinding the nail, in addition to topical or oral treatments, may also be beneficial in treating dystrophic nails 3.
Considerations for Treatment
When considering treatment options for dystrophic nails, it is essential to:
- Accurately diagnose the underlying cause of the condition, as treatment may vary depending on whether the cause is fungal, bacterial, or other 5.
- Assess the severity of the condition and the potential risks and benefits of treatment 3.
- Consider the potential for secondary fungal superinfection and treat it before surgery if necessary 6.
Available Techniques
Various surgical techniques are available for treating dystrophic nails, including: