Which medication is a first-line treatment for fungal nail infections?

Terbinafine is recognized as a first-line treatment for fungal nail infections, specifically onychomycosis. This oral antifungal medication works effectively against dermatophytes, which are the most common pathogens responsible for nail infections. Terbinafine targets the synthesis of ergosterol, a key component of fungal cell membranes, disrupting their structure and function, ultimately leading to cell death.

In clinical practice, terbinafine has been shown to have a higher success rate in achieving complete cure and is generally preferred due to its favorable safety profile and shorter treatment duration compared to other options. The typical regimen for terbinafine involves a course of therapy lasting approximately 12 weeks for fingernail infections and up to 24 weeks for toenail infections, which is quite effective.

While fluconazole, ketoconazole, and itraconazole are indeed antifungal medications, they are not the first choice for treating nail infections. Fluconazole and ketoconazole are better suited for systemic fungal infections and certain yeasts, while itraconazole, although effective for onychomycosis in some cases, is often not as effective as terbinafine and has a more complex dosing regimen. Thus, terbinafine stands out as the preferred first