Ciclopirox

Topical hydroxypyridone antifungal (ciclopiroxolamine) with a broad fungicidal and sporocidal effect.

Effective against dermatophytes, yeasts and molds (DHS). An efficacy gap as with some azole antifungals or resistances have not yet been described.

Primary fungicidal effect through inhibition of numerous key enzymes in the protein biosynthesis of fungal cells, because mRNA synthesis is massively disrupted. In addition, inhibition of catalase leads to the accumulation of _H2O2within fungal cells, which secondarily leads to cell death.

The antibacterial effect (e.g. against accompanying germs in fungal infections) is also remarkable. In addition, Ciclopirox shows good anti-inflammatory effects through competitive inhibition of key enzymes (5-lipoxygenase, cyclooxygenase) in arachidonic acid metabolism. This secondarily inhibits the synthesis of inflammatory mediators such as leukotrienes and prostaglandins.

• Mycoses: Apply a thin layer of cream to the affected skin areas 1-3 times/day for 3-4 weeks, if necessary apply powder once/day for follow-up treatment.
• In the case of candidiasis or mycosis of the vagina, insert one applicator filling of vaginal cream deep intravaginally once a day (treat your partner as well!).
• Tinea unguium: Apply varnish 1x/day to the affected nail, file nail 1x/week, use for max. 6 months.

1 % as a solution, cream or powder, 1 % as a vaginal cream, 8 % as a nail polish (Sonthalia S et al. 2019)

1. Lipner SR et al (2019) Onychomycosis: Treatment and prevention of recurrence. J Am Acad Dermatol 80:853-867.
2. Sonthalia S et al (2019) Topical Ciclopirox Olamine 1%: Revisiting a Unique Antifungal. Indian Dermatol Online J 10: 481-485.