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Zhu Xiaomei, Yao Zhiyuan. Department of Dermatology and Venereology, China-Japan Friendship Hospital, Beijing 100029, China Corresponding author: Yao Zhiyuan, Email: zryhyao@126.com ��Abstract�� Onychomycosis is very hard to treat, and present therapeutic approaches include local treatment and oral antifungal treatment alone or in combination. Unfortunately, the treatment outcome is usually influenced by multiple factors. The prognosis of onychomycosis is mainly affected by local factors of nails, including clinical type of onychomycosis, growth rate and thickness of nail plate, involvement of nail matrix, coexistence of subungual dermatophytoma or streak-like lesions. Other prognostic factors include a history of prior nail infection, hereditary factors, choice of drugs, comorbidities such as diabetes or psoriasis, etc. Fully understanding of prognostic factors for onychomycosis can help clinicians to determine treatment protocols and length of follow-up, so as to improve recovery rate and life quality of patients with onychomycosis.