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Table 4 Efficacy of urea for the treatment of onychomycosis

From: The use of urea for the treatment of onychomycosis: a systematic review

 

Medicament/s

Chemical avulsion

Clinical improvement

Clinical cure

Mycological cure

Complete cure (clinical + mycological)

Adverse effects

Bassiri -Jahromi et al. 2012 [30]

40% urea with 1% fluconazole cream (urea in combination)

 

77.1%

 

82.8%

 

1 (of 70) reported mild irritation

1% fluconazole cream

 

68%

 

62.8%

  

Lahfa et al. 2013 [31]

40% urea then 1% bifonazole cream (urea as adjunct)

86.3%

40.4%

 

42.6%

27.7%

94.1% tolerability

40% urea with 1% bifonazole cream (urea in combination)

60.8%

29.2%

 

58.3%

20.8%

 

Bunyaratavej at al. 2016 [32]

40% urea

 

48%

20%

32%

20%

NR

5% amorolfine lacquer

 

85.7%

50%

89.3%

50%

 

Fraki et al. 1997 [33]

40% urea for 1 week then 150 mg fluconazole (urea as adjunct)

  

71%

69%

  

150 mg fluconazole

  

51%

84%

  

Escalante et al. 2013 [34]

40% urea

  

7%

8.3%

 

3 of 12 reported periungual maceration. 1 of 12 reported onychocryptosis

250 mg terbinafine

  

43%

8%

  

40% urea and 250 mg terbinafine (urea in combination)

  

50%

57%

  

Baran and Tosti 2002 [35]

40% urea

100%

    

Nil adverse effects reported