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The topical treatment of nail fungal infections has been a focal point of nail research in the past few decades as it offers a much safer and focused alternative to conventional oral therapy. Although the current focus remains on exploring the ways of enhancing permeation through the formidable nail barrier, the understanding of the nail microstructure and composition is far from complete. This article reviews our current understanding of the nail microstructure, composition and diseases. A few of the parameters affecting the nail permeability and potential causes of the recurrence of fungal nail infection are also discussed.

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Chemical penetration enhancers are widely used in transdermal pharmaceuticals as well as cosmetic products. Selection of suitable enhancers in topical formulations requires an understanding of the mechanism of action of these enhancers. The objective of the present study was to evaluate the enhancement effects of a number of commonly known enhancers and cosmetic ingredients on permeation across human epidermal membrane (HEM). The potencies of these chemical enhancers -maximum enhancement, E max -were compared at their highest thermodynamic activity in equilibrium with HEM (i.e., solubility equilibrium). This was achieved by the treatment of HEM with the enhancer or phosphate buffered saline (PBS) saturated with the enhancer. Passive transport experiments were then conducted with a model permeant corticosterone to determine the effects of these enhancers on the lipoidal pathway of HEM. The results suggest that E max of an enhancer is related to its octanol/water partition coefficient and its solubility in the HEM lipid domain. A relationship between enhancer E max and its solubility in silicone elastomer was also observed, suggesting the use of silicone solubility to predict enhancer potency. Based on the E max results, some common topical ingredients were found to be more potent enhancers than a number of well-known chemical enhancers.

Transungual iontophoretic transport of model neutral permeants mannitol (MA), urea (UR), and positively charged permeant tetraethylammonium ion (TEA) across fully hydrated human nail plates at pH 7.4 were investigated in vitro. Four protocols were involved in the transport experiments with each protocol divided into stages including passive and iontophoresis transport of 0.1 and 0.3 mA. Water and permeant uptake experiments of nail clippings were also conducted to characterize the hydration and binding effects of the permeants to the nails. Iontophoresis enhanced the transport of MA and UR from anode to cathode, but this effect (electroosmosis) was marginal. The transport of TEA was significantly enhanced by anodal iontophoresis and the experimental enhancement factors were consistent with the Nernst-Planck theory predictions. Hindered transport was also observed and believed to be critical in transungual delivery. The barrier of the nail plates was stable over the time course of the study, and no significant electric field-induced alteration of the barrier was observed. The present results with hydrated nail plates are consistent with electrophoresis-dominant (the direct field effect) transungual iontophoretic transport of small ionic permeants with small contribution from electroosmosis.

This work is not only significant for wearable sweat biosensing technology, but could also have broader impact for those studying topical skin products, antiperspirants, textiles and medical adhesives, nerve disorders, the effects of perspiration on skin-health, skin related diseases such as idiopathic pure sudomotor failure and hyperhidrosis, and other skin- and perspiration-related applications.

MRI can be a useful technique in the study of the penetration of probe compounds in the eye during and after iontophoresis, such as in iontophoresis protocol and device testing. Ocular pharmacokinetic studies using MRI are noninvasive and provide real-time data without perturbation and compound redistribution that can occur during dissection and assay in traditional pharmacokinetic studies. With MRI, it was shown that transscleral iontophoresis, transcorneal iontophoresis, and intravitreal injection deliver ions to different parts of the eye.

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