Clinical Service
CustomNail Clinical Services
Clinical services for comprehensive nail care.
What is the Customnail Clinical Service?
The Customnail Clinical Service is a targeted approach to managing nail infections complicated by biofilm. Onychomycosis, the most common nail condition, is notoriously difficult to treat because the infecting fungi can form a biofilm within the nail structure that shields them from standard antifungal therapy.
Using molecular diagnostics, our pharmacists identify the specific organisms present in the nail and provide clinical interpretation to guide treatment. This allows for a precise, personalized compounded prescription delivered topically to penetrate the nail bed, disrupt biofilm, and clear the infection.
How it works
Our PharmD i3 process (Identify, Interpret, Intervene) guides every clinical service engagement:
- Identify: Molecular diagnostics pinpoint the specific fungi, bacteria, and resistance genes present in the nail environment.
- Interpret: Our pharmacists provide clinical interpretation of diagnostic results to support your provider in selecting the most appropriate therapy.
- Intervene: A personalized TargetedRx is compounded in a topical formulation designed to penetrate the nail bed, disrupt biofilm, and treat the identified infection.
Who is this service for?
This service is designed for patients and providers managing:
- Onychomycosis that has not cleared with standard oral or topical antifungal therapy
- Recurrent nail infections with suspected biofilm involvement
- Patients seeking a pharmacist-guided, compounded topical approach to nail infection management
- Providers looking for a precise, diagnostics-driven treatment option for difficult nail cases
What is onychomycosis?
Onychomycosis is a fungal infection of the nail that can also involve bacteria. Biofilm formation makes it resistant to standard topical treatments.
When should it be treated?
Treatment is recommended when the infection causes discomfort, spreads, or does not respond to standard therapy. Signs include:
- Thickened, discolored, or brittle nails.
- Nail separation from the nailbed.
- Pain or discomfort when walking.
Early treatment improves outcomes and reduces the risk of spreading to other nails.
How is it treated?
The Duo-Step program uses a two-step compounded approach to disrupt biofilm and deliver targeted therapy directly to the nail.
- Step 1: Compounded cleansing formula breaks down debris and biofilm.
- Step 2: TargetedRx suspension treats the identified pathogens.
Onychomycosis affects up to 14% of the general population, making it one of the most common nail disorders encountered in clinical practice. Prevalence increases significantly with age, reaching up to 48% in patients over 70 years old.
Gupta AK, et al. Onychomycosis: a review. J Eur Acad Dermatol Venereol. 2020;34(9):1972–1990.
Recurrence rates for onychomycosis following standard oral antifungal therapy can reach up to 53% within 3 years of completing treatment. The persistent biofilm within the nail bed shields residual organisms from treatment, allowing reinfection to take hold once therapy ends.
Piraccini BM, Alessandrini A. Onychomycosis: a review. J Fungi (Basel). 2015;1(1):30–43.
DuoStep Nail Program treatment steps
The Duo-Step Nail Program offered at Customedico Pharmacy + Wellness is a comprehensive, on-going initiative to remove and prevent biofilms, treat an infection with a topical TargetedRx, and restore any imbalance to the microenvironment.
Spray and massage compounded prescription cleansing formula to penetrate and break down debris to prep for treatment step.
After cleansing, apply TargetedRx compounded prescription suspension to nail and surrounding nailbed to treat pathogens identified in the underlying nail infection.
Learn MoreConnect with us
Customicro Clinical Services is partnered with Customedico Pharmacy + Wellness, an independently owned compounding pharmacy dedicated to the provision of personalized medications to meet the unique needs of our patients.
Reach out to learn how Customicro Clinical Services can support your patients.
10900 N. Scottsdale Rd #403, Scottsdale, AZ 85254
480-946-1345
