Fractional carbon dioxide laser assisted delivery of topical tazarotene versus topical tioconazole in the treatment of onychomycosis

Background: Onychomycosis is a chronic fungal infection of the nails, and the treatment has been proven to be a challenge to healthcare professionals. Objective: To evaluate the efficacy of fractional carbon dioxide laser-assisted delivery of topical tazarotene versus topical tioconazole in the treatment of onychomycosis. Materials and Methods: A total of 102 patients with onychomycosis were randomly assigned to groups A and B, and both groups were treated with four sessions of fractional CO2 laser and followed by topical tazarotene 0.1% in Group A and topical tioconazole 28% in Group B. The clinical effect, KOH examination, and culture for the affected nails in the two groups were analyzed. Results: One month after the last session, regarding clinical response, 35.3% showed complete improvement in Group A versus 33.3% in Group B without significant difference. There was a significant difference between the two studied groups as regards KOH test and culture result before and after treatment (p value<.001), they were turned negative in 91.7% and 100% of patients in Group A and 78.3% and 95.5% of patients in Group B, respectively. Conclusion: Fractional CO2 laser-assisted drug delivery is an effective and safe treatment option for onychomycosis.