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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