Onychomycosis, a stubborn fungal infection of the nails, impacts a large percentage of people all over the globe. Some estimates show that roughly 5.5% of the world’s population deals with this condition. It’s even more common among older adults and people with weakened immune systems.
Urea is a substance that serves a dual purpose in skincare and medicine. As a keratolytic agent, urea breaks down the outer layer of skin. It’s used to exfoliate and moisturize. Urea is naturally produced by the body, and it’s also a waste product created when the body breaks down proteins.
This article will explore the evidence for the antifungal properties of urea, including whether it can be used alone or in combination with other treatments. What are the benefits? What are the risks? We’ll explore these questions, with a particular focus on how urea is used to treat onychomycosis and other similar skin conditions.
However, it’s important to acknowledge that the research in this area is somewhat limited, and we’ll be sure to point out those limitations as we go.
So, is urea antifungal? Read on to find out!
Understanding Urea: Properties and Mechanisms of Action
Urea is a compound that occurs naturally in your body and can also be made in the lab for use in a wide range of products.
Your body produces urea as a waste product when it breaks down proteins. In skin care, however, the urea used is almost always synthetic (lab-created).
Urea’s chemical structure makes it good at performing a few key functions.
How Urea Works
Urea works in a few different ways, depending on its concentration in a product.
One thing urea does is act as a keratolytic. That means it helps break down keratin, a protein that makes up the outer layer of your skin. At high concentrations (around 40%), urea can even break down proteins.
Urea is also a humectant. That means it attracts water. When you apply a cream with urea in it, the urea pulls water into your skin, hydrating it and helping it feel less dry. Creams with a 10% urea concentration are particularly good at hydrating the skin.
Finally, urea can help other ingredients penetrate your skin more effectively. In other words, it helps your skin absorb the active ingredients in skin care products.
A 2019 study even found that urea can help antifungal treatments work better when applied to the skin.
Urea in the treatment of onychomycosis: A critical review of evidence
Urea is a chemical compound found in many over-the-counter and prescription skin and nail treatments. It’s known for its ability to soften and break down keratin, a protein that makes up skin and nails. Because of this, urea is sometimes used to treat fungal nail infections (onychomycosis). But how well does it work?
Urea as a monotherapy
The evidence suggests that urea isn’t a particularly effective treatment for nail fungus on its own. Studies haven’t shown it to be better than standard treatments. Some studies have even found it to be less effective than treatments like topical amorolfine (a common antifungal nail lacquer), but other over-the-counter options like Blue Star Ointment are also available.
Urea as an adjunct therapy
While urea might not be great on its own, there’s some evidence that it can help when used with other antifungal medications, either topical (applied to the nail) or oral (taken by mouth). A review of six studies suggested that urea, when added to other treatments, might improve how well those treatments work.
Some studies have shown statistically significant improvements when urea is used alongside topical or oral antifungals. This is likely because urea’s keratolytic properties (its ability to break down keratin) help antifungal medications penetrate the nail better and reach the fungus.
One way urea is used is in chemical nail avulsion. This involves using a high concentration of urea to soften and detach the infected nail, allowing topical antifungal medications to be applied directly to the nail bed. One study found that urea-based chemical nail avulsion had an 86.3% success rate, compared to 60.8% in a control group.
Limitations of existing research
It’s important to note that much of the research on urea for nail fungus has limitations. These include:
- Small sample sizes
- Different ways of measuring success
- Short follow-up periods
These limitations make it difficult to draw firm conclusions about how well urea works. More research is needed, with larger and better-designed studies, to fully understand urea’s role in treating onychomycosis.
Urea’s effects depend on how much you use
Urea is useful at different concentrations.
Low concentrations (3-10%)
At low concentrations, urea works as a humectant. That means it attracts water to the skin, helping to keep it hydrated. Lotions and creams with 10% urea are often recommended for people with dry skin. If you’re looking for a general moisturizing cream or lotion, check the label for urea.
Medium concentrations (20-30%)
When urea is present in higher concentrations (20–30%), it helps to break down keratin, a protein that makes up the outer layer of skin. This can reduce itching and decrease the thickness of the skin. For this reason, products with medium concentrations of urea are helpful in improving scaly skin conditions such as ichthyosis.
High concentrations (40%)
At a high concentration of 40%, urea has a proteolytic effect. That means it can dissolve proteins. A 40% urea product may be used to dissolve or peel away dystrophic nails. These are nails that have thickened, become discolored, or become deformed due to infection or injury.
It’s important to follow the directions and precautions on the label of any product containing urea. Using too much urea or using it too often can cause skin irritation. If you have any questions about using urea, talk to your doctor or other healthcare provider.
Is urea safe to use?
Urea is generally considered safe for topical use, but it’s always a good idea to be aware of potential side effects and precautions.
Common Side Effects
The most common side effects from urea products are mild and temporary, but if you are looking for a gentler alternative, consider if a herbal foot soak for fungus is right for you.
- Stinging
- Itching
- Irritation
- Burning
These usually go away on their own as your skin adjusts to the treatment. To minimize irritation, avoid using urea around sensitive areas like your eyes and lips.
Who Shouldn’t Use Urea?
While urea is generally safe, there are certain situations where it’s best to avoid it.
- Pregnancy and Nursing: If you’re pregnant or nursing, it’s best to steer clear of urea-containing products. There isn’t enough research to know whether it’s safe for you or your baby.
- Children: Keep urea products out of reach of children. Topical medications are for external use only, and you don’t want kids accidentally ingesting them.
If you have any concerns about using urea, it’s always a good idea to talk to your doctor or dermatologist. They can assess your individual situation and help you decide if urea is right for you.
Clinical Implications and Future Directions
So, what does this all mean for treating fungal nail infections?
Well, urea shows promise as a helpful addition to onychomycosis treatment, especially for people who can’t take oral medications. It’s cheap and easy to get, making it a practical option in podiatry. Because of its kerotolytic properties, it could help to remove portions of the nail that are affected by the fungus, improving the efficacy of topical antifungal products and allowing them to penetrate deeper into the nailbed.
However, we still need more research to figure out the best way to use it. Future studies should focus on:
- Determining the most effective concentrations of urea
- Finding the best application techniques
- Establishing optimal treatment regimens
Additionally, scientists could explore ways to incorporate urea into new drug delivery systems to boost antifungal power. Imagine tiny carriers that deliver both urea and antifungal medications directly to the site of infection. That could be a game-changer!
Frequently Asked Questions
What is urea ointment used for?
Urea ointment is primarily used as a moisturizer to treat dry, rough, scaly, itchy skin and nail problems. It works by increasing the water content of the skin and breaking down keratin, a protein that makes up the outer layer of skin. This helps to soften and exfoliate dead skin cells.
What are the disadvantages of urea cream?
While generally safe, urea cream can cause some side effects. Common ones include mild burning, stinging, itching, or irritation at the application site. In rare cases, more severe allergic reactions can occur. It’s also important to note that urea can sometimes exacerbate existing skin conditions if not used appropriately.
What happens if you use too much urea?
Using too much urea cream can increase the risk of skin irritation, redness, and peeling. It’s crucial to follow the instructions provided by your doctor or on the product label. Applying a thin layer and gently rubbing it in is typically recommended.
Can I use urea cream every day?
Whether you can use urea cream every day depends on the strength of the cream and your individual skin condition. Lower concentrations (e.g., 10%) are often safe for daily use, while higher concentrations may be used less frequently. Always consult your doctor or dermatologist for personalized advice.
What are the disadvantages of urea?
Besides the potential for skin irritation mentioned earlier, urea can have an unpleasant odor, especially in higher concentrations. It’s also not suitable for use on broken or infected skin. While it’s primarily a moisturizer, some people might mistake it for an antifungal, which is incorrect. Always use urea as directed and for its intended purpose.
The Bottom Line
Urea is useful in treating fungal infections, especially toenail fungus, but for other conditions, like athlete’s foot, you may want to explore options like FungiCURE Anti-Fungal Liquid. It works by softening the nail, which makes it easier for antifungal medications to penetrate and fight the infection.
Urea can be used on its own, but research has found that it works best when used along with other antifungal treatments, whether topical or oral. Urea can help those treatments work better, but more research is needed to know exactly how much it helps.
While research points to urea as a potentially effective antifungal, more rigorous studies are needed to fully understand its antifungal properties and how to best use it in a clinical setting.