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. 2022 Jul;8(4):269-279.
doi: 10.1159/000521703. Epub 2022 Feb 9.

Complementary and Alternative Therapies for Onychomycosis: A Systematic Review of the Clinical Evidence

Melissa A Nickles  1 , Peter A Lio  2   3 , Julie E Mervak  4
Affiliations

Complementary and Alternative Therapies for Onychomycosis: A Systematic Review of the Clinical Evidence

Melissa A Nickles et al. Skin Appendage Disord. 2022 Jul.

Abstract

Introduction: Onychomycosis is notoriously difficult to treat. While oral antifungals are the most efficacious treatment for onychomycosis, they are contraindicated in certain patient populations, and patients may desire lower risk and accessible alternatives to systemic agents. In this study, we examine the clinical evidence supporting the use of complementary and alternative therapies in the treatment of onychomycosis.

Methods: PubMed, Embase, and Cochrane Library were searched for clinical trials, observational studies, and case reports/case series, examining the efficacy of a complementary or alternative therapy for the treatment of onychomycosis.

Results: We identified 17 articles studying a complementary and alternative therapy for onychomycosis, including tea tree oil (n = 5), Ageratina pichinchensis (n = 3), Arthrospira maxima (n = 2), natural coniferous resin lacquer (n = 2), Vicks VapoRub® (n = 2), propolis extract (n = 2), and ozonized sunflower oil (n = 1).

Conclusion: Given the rise of antifungal resistance, complementary and alternative therapies should continue to be studied as adjunctive or alternative therapy for onychomycosis. While preliminary evidence exists for several complementary and alternative therapies in the treatment of onychomycosis, large-scale, randomized, placebo-controlled trials are needed prior to endorsing their use to patients.

Keywords: Ageratina pichinchensis; Arthrospira maxima; Complementary and alternative medicine; Onychomycosis; Tea tree oil.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
PRISMA diagram outlining literature searches and study selection.
See this image and copyright information in PMC

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