Onychomycosis is a fungal infection of the nail that can cause the nail to turn yellow or brown. It can also cause the nail to thicken, crack, or even crumble.
If you have onychomycosis, your doctor may prescribe Penlac Nail Lacquer (ciclopirox). Penlac is a topical antifungal medication you paint on your fingernails or toenails.
Penlac contains ciclopirox, which helps stop the growth of fungus. However, Penlac Nail Lacquer works best when it’s part of a more comprehensive treatment program. This includes having a doctor remove the infected parts of your nail and taking good care of your nails to prevent the fungus from spreading.
If you’re considering using Penlac, it’s important to understand that it’s not a quick fix. It can take months to see results, and it’s important to follow your doctor’s instructions carefully. But for some people, Penlac can be an effective way to treat onychomycosis.
This article will cover everything you need to know about Penlac nail lacquer including how to use it, what precautions to take, what side effects to watch for, and other important information.
Ciclopirox and Penlac
Onychomycosis is a common fungal infection that causes discoloration, thickening, and sometimes separation of the nail from the nail bed. One treatment option is Penlac, a topical medication applied directly to the affected nails. But what exactly is ciclopirox, and how does Penlac work?
Ciclopirox: The active ingredient
Ciclopirox is a broad-spectrum antifungal agent, which means it’s effective against a wide range of fungi. It stops fungi from growing by interfering with their cell membranes. Think of it like poking holes in a balloon – the fungi can’t survive when their cell structure is disrupted.
Ciclopirox is available in several forms, including:
- Cream
- Gel
- Lotion
- Shampoo
- Topical solution
Penlac is a nail lacquer formulation of ciclopirox, designed for direct application to the nails.
Penlac Nail Lacquer
Penlac Nail Lacquer contains 8% ciclopirox. The lacquer formulation allows for direct application to the nail, where it can penetrate the nail plate and reach the underlying infection.
Penlac is specifically designed for the treatment of mild to moderate onychomycosis. It’s most effective when the infection involves only a small portion of the nail. More severe infections may require oral antifungal medications.
Uses and application of Penlac
Penlac is a brand name for a prescription nail lacquer containing the active ingredient ciclopirox. It’s used to treat fungal infections of the fingernails and toenails (onychomycosis).
When is Penlac appropriate?
Penlac is indicated for mild to moderate onychomycosis caused by Trichophyton rubrum and Trichophyton mentagrophytes. If you think you have a nail infection, get a diagnosis from a doctor before starting treatment with Penlac or any other medication.
How to apply Penlac
If your doctor prescribes Penlac, here’s how to use it:
- Apply Penlac once a day, preferably at bedtime, to all affected nails.
- Cover the entire nail plate evenly.
- Apply Penlac to the nail bed, hyponychium (the skin just under the free edge of your nail), and the underside of the nail plate if possible.
- Make sure your nails are clean and dry before you put on the medicine.
- Remove Penlac with alcohol once a week. At the same time, file away any loose nail material. This helps get rid of any buildup of the lacquer as well as any infected nail debris.
The role of professional nail care
Talk with a healthcare professional about professional nail care, including removal of the unattached, infected nail. This is called debridement. Professional debridement may help Penlac penetrate the nail better, and it also removes a source of infection.
Patients with diabetes or neuropathy should talk with their doctors about nail care procedures. People with these conditions may need to take extra precautions to avoid complications.
Penlac is not intended for use on the skin around the nails or for fungal infections of the skin. It’s important to follow your doctor’s instructions carefully and to complete the full course of treatment, even if your nails start to look better. Stopping treatment too early could allow the infection to come back.
Penlac: Precautions and Warnings
Before using Penlac, you should be aware of the following safety information.
General Precautions
- Flammability: Penlac is flammable, so keep it away from heat, sparks, and open flames. Don’t smoke while applying Penlac, and wait until it’s completely dry before using heat styling tools or coming into contact with anything that could ignite it.
- Topical Use Only: Penlac is only for use on your nails. Don’t swallow it or apply it to other parts of your body.
- Eye Contact: Keep Penlac out of your eyes and other mucous membranes (like your mouth and nose). If it gets in your eyes, rinse them thoroughly with water.
Specific Warnings
- Systemic Antifungals: Don’t use Penlac at the same time as you’re taking oral antifungal medications.
- Patient Education: Your doctor or pharmacist should give you clear instructions on how to apply Penlac correctly and how to take care of your nails while you’re using it. Follow these instructions carefully.
Use in Special Populations
- Pregnancy and Nursing Mothers: It’s not fully known if Penlac is safe to use during pregnancy or while breastfeeding. Talk to your doctor about the risks and benefits before using Penlac if you’re pregnant, planning to become pregnant, or breastfeeding.
- Pediatric Use: The safety and effectiveness of Penlac haven’t been studied in children.
- Geriatric Use: Older adults can use Penlac as directed. Studies haven’t shown any significant differences in safety or effectiveness between older and younger adults.
What are the side effects of Penlac?
Like any medication, including Loceryl Nail Lacquer, Penlac can cause side effects. It’s important to be aware of these potential reactions and to discuss any concerns with your doctor.
Common Side Effects
The most common side effects of Penlac are related to the application site.
- Application Site Reactions: You might experience a mild rash, redness around the nail (periungual erythema), or other nail disorders. These are usually mild and don’t last long.
- Erythema: Redness can occur around the nail or in the skin fold at the base of the nail (proximal nail fold). This was reported in clinical trials.
Less Common Side Effects
Some people may experience less common side effects.
- Nail Discoloration: Temporary nail discoloration can occur in some patients.
- Irritation: You might feel mild irritation or a burning sensation where you apply the lacquer.
Rare Side Effects
Although rare, allergic reactions to ciclopirox are possible.
- Allergic Reactions: If you experience signs of an allergic reaction, such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat, stop using Penlac and seek medical attention immediately.
It’s important to remember that this is not a complete list of all possible side effects. If you notice any other unusual symptoms while using Penlac, talk to your doctor or pharmacist.
Clinical trial data and efficacy
Before the FDA approves any prescription drug, the agency requires the manufacturer to submit data from clinical trials that show whether the drug is effective and safe.
Clinical trial results
Clinical trials using Penlac to treat onychomycosis involved double-blind studies, meaning that neither the study participants nor the researchers knew who was getting the actual drug and who was getting a placebo (inactive look-alike).
The results of those studies varied:
- Complete cure (no signs of infection): Study 312 (5.5%), Study 313 (8.5%)
- Almost clear (only minimal signs of infection): Study 312 (6.5%), Study 313 (12%)
- Negative mycology (no fungus present in nail samples): Study 312 (29%), Study 313 (36%)
These data are useful for patients and providers to understand how effective the treatment is likely to be.
Factors influencing efficacy
How well Penlac works depends on several factors, including:
- Adherence to treatment: Following the directions and applying Penlac consistently is critical.
- Professional nail care: A healthcare provider can remove (debride) infected portions of the nail to allow the medication to better reach the infection.
- Severity of infection: Penlac works best on mild to moderate infections.
Because Penlac is not very effective in clinical trials, some doctors suggest other treatments first. If those don’t work, they may suggest Penlac.
How Penlac Works
Here’s a peek at what the science says about how Penlac works on nail fungus.
Ciclopirox Pharmacokinetics
Pharmacokinetics is a fancy word that means “how a drug moves through the body.” Here’s what we know about how ciclopirox works in the body:
Systemic Absorption
When you put Penlac on your nails, very little of the ciclopirox gets into your bloodstream. Studies show that less than 5% of the dose you apply actually gets absorbed.
After two months of using Penlac once a day, the average maximum amount of ciclopirox in the blood was only 31.28 ng/mL (nanograms per milliliter). That’s a tiny amount!
Penetration
Penlac is designed to penetrate the nail so it can reach the fungus underneath. In lab tests, Penlac was shown to penetrate about 0.4 mm (millimeters) into toenails affected by onychomycosis (nail fungus).
Ciclopirox Microbiology
Microbiology is the study of microorganisms, like the fungi that cause nail infections. Here’s what we know about how ciclopirox affects these fungi:
Mechanism of Action
Ciclopirox stops fungi from growing by messing with their cell membranes, disrupting the processes that help them survive.
Spectrum of Activity
Lab studies have measured how well ciclopirox inhibits the growth of different types of fungi. These studies have determined what are called MIC values (minimum inhibitory concentration). The MIC values for common dermatophytes (fungi that cause skin infections) like Trichophyton rubrum and Trichophyton mentagrophytes are in the range of 1-20 µg/mL (micrograms per milliliter).
Frequently Asked Questions
What is the strongest over the counter medicine for toenail fungus?
Unfortunately, there isn’t a single “strongest” over-the-counter medication guaranteed to eliminate toenail fungus, but it’s worth exploring options and reading a Daktarin Nail Fungus review. While some OTC antifungal treatments can help manage mild infections, they often aren’t as effective as prescription options. Look for products containing ingredients like tolnaftate or undecylenic acid, but keep expectations realistic.
Should I wear socks after applying ciclopirox?
It’s generally recommended to wear clean socks after applying ciclopirox (Penlac) nail lacquer. This helps prevent the medication from rubbing off and protects the treated nail from further contamination. Choose breathable socks made of cotton or other moisture-wicking materials.
How long does it take for Penlac to work?
Patience is key with Penlac! It can take several months, even up to a year, to see significant improvement. This is because toenails grow slowly, and the infected nail needs to be fully replaced by healthy, fungus-free nail growth. Consistency with application is crucial.
Can I paint my nails while using ciclopirox?
It’s generally not recommended to use nail polish while using ciclopirox. Nail polish can prevent the medication from properly penetrating the nail and reaching the fungus. If you absolutely must use polish, apply Penlac first and allow it to dry completely before applying the polish, and remove the polish thoroughly before the next Penlac application.
Which is better, Penlac or Jublia?
Penlac (ciclopirox) and Jublia (efinaconazole) are both prescription medications for toenail fungus, but Jublia is generally considered more effective. Jublia’s formulation allows for better nail penetration, leading to higher success rates. However, Jublia is also typically more expensive. The “better” option depends on the severity of your infection, your individual response to the medication, and your budget, and is best determined by your doctor.
Final Thoughts
Penlac Nail Lacquer is a topical treatment that can help with mild to moderate onychomycosis, or nail fungus. While it’s not a cure on its own, it can be a valuable part of a comprehensive treatment plan.
For Penlac to work, you need to apply it daily, remove the buildup weekly, and keep up with professional nail care. It’s also important to be consistent with your treatment and follow the instructions carefully.
Before starting Penlac, make sure you understand how to apply it correctly and how important it is to stick to the treatment plan. Your doctor or pharmacist can show you the best way to apply the lacquer and answer any questions you might have about using it.
If you think you have nail fungus, talk to your doctor, and consider reading a detailed guide to determine if Daktarin Nail Tincture is right for you. They can diagnose the problem, recommend the best treatment plan for you, and help you manage any side effects that might come up. With the right approach, you can get rid of nail fungus and get your nails looking healthy again.