“HERBAL REMEDIES FOR ONYCHOMYCOSIS: TARGETING INFLAMMATION AND FUNGAL INFECTIONS”
Main Article Content
Keywords
Etiology, Pathogenesis, Diagnosis, Clinical Presentation, Treatment, Herbal Medicinal Products and Oils
Abstract
When fungal organisms infect the nails, their ability to cause different effect which wasa compromised.Approximately 30% of mycotic cutaneous infections are onychomycosis, a fungal nail infection caused by yeasts, dermatophytes, or non-dermatophyte molds. Predisposing factors for this fungal infection include diabetes, HIV, immunosuppressant, obesity, smoking, and advanced age.Patients might encounterpain and other negative effects from the illness, which may also interfere with their social and professional lives. This review discusses the causes, categorization, diagnosis, and treatment of onychomycosis. Onychomycosis is classified into four kinds according to the pattern and location of fungal invasion. Thecurrent gold standard for diagnosing onychomycosis is potassium hydroxide and culture, which can identify the species and show fungal vitality. Fluorescence staining, polymerase chain reaction methods, and periodic acid-Schiff staining are further diagnostic assays that are readily accessible. Patients may experience pain and other negative effects from the illness, which may also interfere with their social and professional lives. Treatment is chosen depending on the modality of nail invasion, fungus species and the number of affected nails. Oral treatments are often limited by drug interactions, while topical antifungal lacquers have less efficacy. A combination of both oral and systemic treatment is often the best choice.
References
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2. axler e, lipner sr. Antifungal selection for the treatment of onychomycosis: patient considerations and outcomes. Infect drug resist. 2024 mar 4;17:819-843. Doi: 10.2147/idr.s431526. Pmid: 38463386; pmcid: pmc10922011.
3. Faergemann j, baran r. Epidemiology, clinical presentation and diagnosis of onychomycosis. British journal of dermatology. 2003 sep 1;149(s65):1-4.
4. Yousefian f, smythe c, han h, elewski be, nestor m. Treatment options for onychomycosis: efficacy, side effects, adherence, financial considerations, and ethics. The journal of clinical and aesthetic dermatology. 2024 mar;17(3):24.
5. Frazier wt, santiago-delgado zm, stupka kc. Onychomycosis: rapid evidence review. American family physician. 2021 oct;104(4):359-67.
6. Hoy ny, leungak, metelitsa ai, adams s. New concepts in median nail dystrophy, onychomycosis, and hand, foot, and mouth disease nail pathology. International scholarly research notices. 2012;2012(1):680163.
7. Gupta ak, mays rr, versteeg sg, shear nh, piguet v. Update on current approaches to diagnosis and treatment of onychomycosis. Expert review of anti-infective therapy. 2018 dec 2;16(12):929-38.
8. Angelo t, borgheti-cardoso ln, gelfuso gm, taveira sf, gratieri t. Chemical and physical strategies in onychomycosis topical treatment: a review. Medical mycology. 2017 jul 1;55(5):461-75.
9. bodman ma, krishnamurthy k. Onychomycosis. Statpearls [internet]. Atreasure island (fl): statpearls publishing; 2019 jan- 2019 jan 5.
10. Youssef ab, kallel a, azaiz z, jemel s, bada n, chouchen a, belhadj-salah n, fakhfakh n, belhadj s, kallel k. Onychomycosis: which fungal species are involved? Experience of the laboratory of parasitology-mycology of the rabta hospital of tunis. Journal de mycologiemédicale. 2018 dec 1;28(4):651-4.
11. Raja babu kk. Nail and its disorders. In: valia rg, valia ar, editors. Iadvl textbook and atlas of dermatology. 2nd ed. Mumbai: bhalani publishing house; 2001.
12. Westerberg dp, voyackmj. Onychomycosis: current trends in diagnosis and treatment. American family physician. 2013 dec 1;88(11):762-70.
13. "onychomycosis – dermatologic disorders". Merck manuals professional edition. February 2017. Retrieved 2 june 2018.
14. Velasquez-agudelo v, cardona-arias ja. Meta-analysis of the utility of culture, biopsy, and direct koh examination for the diagnosis of onychomycosis. Bmc infectious diseases. 2017 dec;17:1-1.
15. Shemer a, davidovici b, grunwaldmh, trau h, amichai b. New criteria for the laboratory diagnosis of nondermatophytemoulds in onychomycosis. British journal of dermatology. 2009 jan 1;160(1):37-9.
16. Lipner sr, scherrk. Confirmatory testing for onychomycosis. Jama dermatology. 2016 jul 1;152(7):847-.
17. Allevato ma. Diseases mimicking onychomycosis. Clinics in dermatology. 2010 mar 1;28(2):164-77.
18. Queller jn, bhatia n. The dermatologist’s approach to onychomycosis. Journal of fungi. 2015 aug 19;1(2):173-84.
19. Elewski be. Onychomycosis: pathogenesis, diagnosis, and management. Clinical microbiology reviews. 1998 jul 1;11(3):415-29.
20. Cohen jl, scherrk, pappert as. The nail and fungus infections.
21. Pichardo-geisinger r, mora dc, newmanjc, arcury ta, feldmansr, quandtsa. Comorbidity of tinea pedis and onychomycosis and evaluation of risk factors in latino immigrant poultry processing and other manual laborers. Southern medical journal. 2014 jun 1;107(6):374-9.
22. Dompmartin d, dompmartin a, deluol am, grosshans e, coulaudjp. Onychomycosis and aids: clinical and laboratory findings in 62 patients. International journal of dermatology. 1990 jun;29(5):337-9.
23. Aly r, berger t. Common superficial fungal infections in patients with aids. Clinical infectious diseases. 1996 may 1;22(supplement_2):s128-32.
24. Piraccini bm, tosti a. White superficial onychomycosis: epidemiological, clinical, and pathological study of 79 patients. Archives of dermatology. 2004 jun 1;140(6):696-701.
25. Piraccini bm, lorenzi s, tostia. ‘deep’white superficial onychomycosis due to molds. Journal of the european academy of dermatology & venereology. 2002 sep 1;16(5).
26. Lipner sr, scherrk. Onychomycosis: clinical overview and diagnosis. Journal of the american academy of dermatology. 2019 apr 1;80(4):835-51.
27. Piraccini bm, alessandrini a. Onychomycosis: a review. Journal of fungi. 2015 mar 27;1(1):30-43.
28. Shemer a. Update: medical treatment of onychomycosis. Dermatologic therapy. 2012 nov;25(6):582-93.
29. goldsteina.o., bhatia n. Post tw, ed.up to date. Onychomycosis: epidemiology, clinical features, and diagnosis. Waltham, ma. (accessed on june 30, 2019).
30. Zaias n. Onychomycosis. Arch dermatol. 1972;105:263–274.
31. Junquiera l c, carneiro j, kelley r o. Basic histology. 8th ed. Stamford, conn: appleton&lange; 1995. Pp. 353–355.
32. Jayatilake ja, tilakaratne wm, panagoda gj. Candidal onychomycosis: a mini-review. Mycopathologia. 2009 oct;168:165-73.
33. Kaur r, kashyap b, bhalla p. Onychomycosis-epidemiology, diagnosis and management. Indian journal of medical microbiology. 2008 apr 1;26(2):108-16.
34. Arikiansr, einarson tr, kobelt‐nguyen g, schubert f, onychomycosis study. A multinational pharmacoeconomic analysis of oral therapies for onychomycosis. British journal of dermatology. 1994 apr 1;130(s43):35-44.
35. Einarson tr, arikiansr, shear nh. Cost‐effectiveness analysis for onychomycosis therapy in canada from a government perspective. British journal of dermatology. 1994 apr;130:32-4.
36. Gupta ak, versteeg sg, shear nh. Confirmatory testing prior to treating toenail onychomycosis is recommended in canada. Journal of cutaneous medicine and surgery. 2018 mar;22(2):244-5.
37. Gupta ak, stec n. Recent advances in therapies for onychomycosis and its management. F1000research. 2019 jun 25;8:f1000-aculty.
38. Hanna s, andriessen a, beecker j, gilbert m, goldstein e, kalia s, king a, kraft j, lynde c, singh d, turchini. Clinical insights about onychomycosis and its treatment: a consensus. Journal of drugs in dermatology: jdd. 2018 mar 1;17(3):253-62.
39. Lipner sr. Pharmacotherapy for onychomycosis: new and emerging treatments. Expert opinion on pharmacotherapy. 2019 apr 13;20(6):725-35.
40. Koshnick rl, lilly kk, clairks, finnegan mt, warshawem. Use of diagnostic tests by dermatologists, podiatrists and family practitioners in the united states: pilot data from a cross‐sectional survey. Mycoses. 2007 nov;50(6):463-9.
41. Sigurgeirsson b, baran r. The prevalence of onychomycosis in the global population–a literature study. Journal of the european academy of dermatology and venereology. 2014 nov;28(11):1480-91.
42. Iorizzo m, piraccini bm, rech g, tosti a. Treatment of onychomycosis with oral antifungal agents. Expert opinion on drug delivery. 2005 may 1;2(3):435-40.
43. Roberts dt, taylor wd, boyle j. Guidelines for treatment of onychomycosis. British journal of dermatology. 2003 mar 1;148(3):402-10.
44. Zaug m, bergstraesser m. Amorolfine in the treatment of onychomycoses and dermatomycoses (an overview). Clinical and experimental dermatology. 1992 sep;17:61-70.
45. Hay rj, mackie rm, clayton ym. Tioconazole nail solution—an open study of its efficacy in onychomycosis. Clinical and experimental dermatology. 1985 mar;10(2):111-5.
46. Finnen mj, hennessy a, mclean s, bisset y, mitchell r, megson il, weller r. Topical application of acidified nitrite to the nail renders it antifungal and causes nitrosation of cysteine groups in the nail plate. British journal of dermatology. 2007 sep 1;157(3):494-500.
47. Lee k, onwudiwe o, farinelli w, garibyan l, andersonrr. Absorption spectrum of onychomycoticnails:# lb13. Lasers in surgery and medicine. 2015 apr;47(4):378.
48. Gupta ak, simpson fc, heller df. The future of lasers in onychomycosis. Journal of dermatological treatment. 2016 mar 3;27(2):167-72.
49. Gupta ak, versteeg sg. A critical review of improvement rates for laser therapy used to treat toenail onychomycosis. Journal of the european academy of dermatology and venereology. 2017 jul;31(7):1111-8.
50. http://emedicine.medscape.com/article/1105828-treatment#a1127.
51. biasi-garbinrp, demittofd, amaralrc, ferreiramr, soares la, svidzinskiti, baeza lc, yamada-ogatta sf. Antifungal potential of plant species from brazilian caatinga against dermatophytes. Revista do instituto de medicina tropical de são paulo. 2016;58:18.
52. Balakumar s, rajan s, thirunalasundari t, jeeva s. Antifungal activity of ocimum sanctum linn.(lamiaceae) on clinically isolated dermatophytic fungi. Asian pacific journal of tropical medicine. 2011 aug 1;4(8):654-7.
53. Borgohain p, saikialr, mahanta j. Herbal medicine as an alternative for the treatment of onychomycosis. Int j bot stud. 2022;7:29-34.
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Jun 12, 2025
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Ms. Alka Sharma, Ms. Alka Sharma, Ms. Alka Sharma, Ms. Simranpreet Kaur, Mr. Abhay Sharma, Dr. Ravinesh Mishra, & Dr. Bhartendu Sharma. (2025). “HERBAL REMEDIES FOR ONYCHOMYCOSIS: TARGETING INFLAMMATION AND FUNGAL INFECTIONS”. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 633-650. https://doi.org/10.53555/1jpm7936
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Author Biographies
Ms. Alka Sharma
Assistant Professor, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences and Technology, Baddi, District- Solan, H.P., India
Ms. Alka Sharma
Assistant Professor, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences and Technology, Baddi, District- Solan, H.P., India
Ms. Alka Sharma
Assistant Professor, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences and Technology, Baddi, District- Solan, H.P., India
Ms. Simranpreet Kaur
Student, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences and Technology, Baddi, District- Solan, H.P., India
Mr. Abhay Sharma
Student, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences and Technology, Baddi, District- Solan, H.P., India
Dr. Ravinesh Mishra
Professor, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences and Technology, Baddi, District- Solan, H.P., India
Dr. Bhartendu Sharma
Professor, School of Pharmacy and Emerging Sciences, Baddi University of Emerging Sciences and Technology, Baddi, District- Solan, H.P., India
How to Cite
Ms. Alka Sharma, Ms. Alka Sharma, Ms. Alka Sharma, Ms. Simranpreet Kaur, Mr. Abhay Sharma, Dr. Ravinesh Mishra, & Dr. Bhartendu Sharma. (2025). “HERBAL REMEDIES FOR ONYCHOMYCOSIS: TARGETING INFLAMMATION AND FUNGAL INFECTIONS”. Journal of Population Therapeutics and Clinical Pharmacology, 32(5), 633-650. https://doi.org/10.53555/1jpm7936