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Ni Na, Zhou BingRong, Luo Dan Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China Corresponding author: Luo Dan, Email: daniluo2005@163.com ��Abstract�� Onychodystrophy represents abnormal morphology and structure of nails caused by various factors, with a high incidence rate in clinic. It can manifest as nail thinning, turbidity, deformities and so on, and multiple nail damages can simultaneously occur in some patients. The etiology of onychodystrophy is complex. Onychodystrophy can be related to other skin diseases, such as psoriasis, eczema and systemic diseases, as well as drugs and local factors. Some patients developed onychodystrophy without obvious causes, which was called idiopathic onychodystrophy. The treatment of onychodystrophy is challenging, and there are no ideal methods at present. Therapeutic approaches aimed at etiology are recommended. Besides systemic therapy, topical therapy and surgical treatment are available. Since nail plate can decrease the permeability of drugs, topical application of drugs alone has low bioavailability. Recently, newly developed methods have shown great potential, such as photodynamic therapy, 1064?nm neodymium?doped yttrium aluminium garnet ��Nd: YAG�� laser, fractional CO2 laser combined with external application drugs.