Transethosomes a novel nanocarrier approach for enhanced transungual drug delivery in the management of onychomycosis: A comprehensive review

Onychomycosis is a chronic fungal infection of the nails that remains difficult to manage due to the dense keratinized nail plate, which significantly limits drug permeation. Oral antifungal therapies are often associated with systemic adverse effects and prolonged treatment duration, while conventional topical formulations frequently fail to achieve therapeutic drug concentrations at the site of infection. Transethosomes are ultra-deformable lipid vesicular systems composed of phospholipids, ethanol, and edge activators. These nanocarriers have gained attention for transungual drug delivery because of their ability to penetrate deeply into the nail structure, enhance drug retention, and provide sustained release at the infected site.This review summarizes nail anatomy, fungal pathogenesis, limitations of existing therapies, and the formulation principles and evaluation of transethosomal systems. Particular emphasis is placed on their incorporation into medicated nail lacquers to improve residence time and antifungal efficacy. Overall, transethosomes represent a promising and patient-friendly strategy for improving therapeutic outcomes in onychomycosis.