Novel Treatment of Onychomycosis using Over-the-Counter Mentholated Ointment: A Clinical Case Series

Methods

The study protocol was approved by the institutional review board of the Malcolm Grow US Air Force Medical Center. Participants were recruited from an outpatient family medicine clinic that serves both an active duty and civilian (dependent and retiree) populations. Information posters were placed in the clinic lobbies to advertise the study. Patients used contact details on the posters to arrange an appointment with study investigators. During the initial appointment, the study was explained and informed consent for participation was obtained. Demographic data (age, sex, military status) was obtained along with historic data (duration of dystrophic nail, prior treatment for onychomycosis, chronic medical diseases, medication use, and allergy history).

Inclusion criteria were men and women older than 18 years of age with clinical onychomycosis that was evident on at least one great toenail. Exclusion criteria included any history of allergic sensitivity to Vicks VapoRub or its active ingredients (thymol, camphor, menthol, or oil of Eucalyptus); any use of oral antidermatophyte medication within the last year; any deformity of the affected nail that would preclude sampling for potassium hydroxide (KOH) and culture or prevent adequate photographic assessment of the nail; and a negative culture of fungal infection from the sampling taken during the initial visit.

After consent was obtained, a digital photograph of the affected nail was taken, and then a nail wedge/clipping was collected for KOH microscopy and culture. The participant was then supplied with the study treatment (Vicks VapoRub) and instructed to apply a small amount of Vicks VapoRub with a cotton swab or finger to the affected nail at least once daily. If the culture of the nail sample was negative for fungal infection, volunteers were contacted and removed from the study. Volunteers with positive cultures were contacted for follow-up assessments at 4, 8, 12, 24, 36, and 48 weeks. Repeat digital photographs, assessment for adverse reactions, treatment effect, patterns of VapoRub use, and the patient’s perceived tolerability of treatment were performed/assessed during each visit.

The primary outcome measures for the study were mycological cure at 48 weeks, defined as negative KOH and culture of nail sample, and clinical cure (clearance of dystrophic nail). Clearance of dystrophic nail was assessed by gross appearance at the end of the study period as “complete,” “partial,” or “no change.” Clearance was quantified through serial digital photography of the affected nail. Photographic editing software (Photoshop CS3, Adobe Systems, Inc., San Jose, CA) was used to define the nail edges and the borders of the affected nail region so areas (in pixel units) of total nail and affected nail could be calculated. Using these areas, the ratio of affected nail area to total nail area was calculated for each photograph taken during the course of the study. A secondary outcome measured was patient satisfaction with the appearance of the affected nail at the end of the study period; this was assessed using a single-item questionnaire scored on a 5-point Likert scale (1 = very satisfied, 2 = satisfied, 3 = neither satisfied nor dissatisfied, 4 = dissatisfied, and 5 = very dissatisfied).


— Update: 30-12-2022 — cohaitungchi.com found an additional article Why Does Vicks VapoRub Help Against Some Nail Fungus & Not Others? from the website www.peoplespharmacy.com for the keyword does vaporub help with nail fungus.

Home remedies are rarely studied in double-blind, placebo-controlled trials. As a result, we don’t often have scientific research to show how well-or not-they may work. It is unusual for us to have a solid explanation for the success of certain popular home remedies. One example is the use of Vicks VapoRub for toenail fungus.

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Fighting Toenail Fungus:

Q. I have lived with a fungus infection of one big toenail for several years. Various over-the-counter remedies I tried did not work.

I read the following article in the “CR Health” department of the March, 2006 issue of Consumer Reports magazine:

I purchased a tube of Vicks Greaseless Cream VapoRub in mid-February, and have applied it morning and evening to the affected toenail. I use only a small amount, enough to scrape off my finger under the front of the nail and around the cuticle.

To my immense gratification, IT WORKS! (At least for me.) After six weeks of use, the nail has lost most of its previous black color and is showing about a quarter of an inch of fresh, healthy-looking nail coming out of the cuticle as the nail grows. It’s worth trying – nowhere near as expensive as the ineffective stuff they sell for the purpose!

How Well Does Vicks VapoRub Work?

A. Over the years we have heard from many people who have had success with Vicks VapoRub in the treatment of nail fungus. You will read some of their stories below. Others tell us this remedy is totally worthless.

That is not surprising. Many people report failure with pricey prescription anti-fungal products too. Some people spend quite a bit of money on oral antifungal medicine and take it for many months, only to have the fungus return after a temporary “cure.”

It seems as if nail fungus is surprisingly variable. This may be due both to the range of fungal pathogens that can affect nails and to differences among the hosts’ immune systems. Some people never get nail fungus even though they walk barefoot in the garden, in the shower or at a locker room. Others find all their toenails are thick, yellowish-brown and misshapen. Not only do they look ugly, but they are hard to clip. One treatment may work for awhile, but the fungus seems to come back relentlessly.

We often wonder whether there are different fungi at work or if the relationship between the immune system and the fungi have something to do with this problem.

The Research on Vicks VapoRub for Nail Fungus:

As for Vicks VapoRub, there actually have been a few studies showing benefit against nail fungus. In one, people with AIDS (whose immune systems do not function well) had their nail fungus treated with Vicks. The conclusion: safe and effective (Journal of the Association of Nurses in AIDS Care, Jan-Feb., 2016).

Previously, a pilot study had shown results in 15 out of 18 people using Vicks VapoRub on the nails daily for 48 weeks (Journal of the American Board of Family Medicine, Jan-Feb., 2011). Even before that, a study of some of the essential oils in Vicks VapoRub showed that they are active against five different species of fungus that infect nail tissue (Phytotherapy Research, April, 2003). Camphor, menthol, thymol and oil of eucalyptus are effective against these organisms. Moreover, fungi rarely develop resistance to them (Mycopathologia, Feb. 2016).

Vicks VapoRub Stories and Experiences from Readers over the Years:

Tom N. touts the house brand at lower cost:

We have no opinion as to the quality of generic Vicks VapoRub. The relatively low cost of either the name brand or the house brand does not make this a big issue for us. Keep in mind that a jar will last a long time, even with daily applications.

Vagisil for Nail Fungus?

Jim P. offers a different option–a vaginal anti-itch product:

Resorcinol has been around for more than 150 years. It has been used topically as an antiseptic and to treat a variety of skin conditions including psoriasis, eczema and acne. Not surprisingly, it has antifungal activity, which might account for why it could be useful against nail fungus.

Amber Listerine & White Vinegar:

Jen says Listerine and vinegar are her go-to solution:

We have lost count of the number of people who insist that when all else fails, white vinegar and Listerine foot soaks do the job. We are not surprised. Listerine has a good dose of alcohol and other ingredients that attack fungi.

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Vinegar also makes the environment inhospitable to fungi. It does take the kind of patience that Jen describes to work the magic.

Cornmeal Mush Foot Soaks:

K.B. offers one of the stranger home remedies we keep hearing about. His baggie trick is quite clever:

K.B.’s innovative approach is quite different from anything we have heard when it comes to cornmeal. The more typical remedy is to make a cornmeal batter. Here is one example:

Larry loves cornmeal mush. We are still astonished that it could work SO fast. It kind of defies logic, but hey, there’s not much to lose giving it a try:

We make no promises about any nail fungus remedy. What works for Larry may not work for Sue or Henry or Mary. You will have to experiment to discover whether Vicks VapoRub or some other remedy is the best approach for you.

Please share your own experience in the fight against nail fungus in the comment section below.


— Update: 30-12-2022 — cohaitungchi.com found an additional article Fact or Fiction: Vicks VapoRub Kills Toenail Fungus from the website www.struthealth.com for the keyword does vaporub help with nail fungus.

If you have nail fungus, you’ve probably heard of the home-remedy “cure” of using Vicks VapoRub. But can this over-the-counter topical cough suppressant really kill toenail fungus? 

While this would be a cost-effective cure, running around five bucks a bottle, is it backed by science? 

In this article, we’ll go over a scientific study that was out to answer the same question. 


What’s the connection between Vicks VapoRub and toenail fungus? 

You’re probably familiar with the strong smell of this over-the-counter topical cough suppressant by Procter & Gamble. Giving Vicks VapoRub its infamous smell is camphor, eucalyptus oil and menthol.

The connection between toenail fungus and VapoRub comes down to the two active ingredients: camphor, eucalyptus oil. These ingredients have been seen to have antifungal properties.

While their intended use is to soothe a cough when applied to the chest, there are some that swear it’s strong enough to kill toenail fungus.

Toenail fungus can be caused by a few different strains of fungi. Can VapoRub act as a catch-all and kill all toenail fungus? 

Let’s find out. 


Consulting the scientific research 

It’s time to get science-y.

In 2011, an interesting study researching over-the-counter cures for toenail fungus was published. In this study, researchers used Vicks VapoRub against toenail fungus. 

The first thing to note here is there are a few types of toenail fungus. Toenail fungus can be caused by dermatophytes, yeasts, and non-dermatophyte molds.

However, the most common culprit of toenail fungus is the dermatophyte trichophyton rubrum, also known as T. rubrum.  

In this study, researchers studied the following toenail fungus:

  • T. mentagrophytes (dermatophyte)
  • T. rubrum (dermatophyte)
  • Candida parapsilosis (yeast)

After 48 weeks, all patients with T. mentagrophytes or Candida parapsilosis toenail fungus went on to a “total cure”.  

While those with the common T. rubrum seemed to fare the worst. Of the 6 with positive T. rubrum cultures, 5 saw a particle cure and 1 saw no change.

Remember, T. rubrum is commonly the fungi culprit behind most toenail fungus infections… 


So, can Vicks VapoRub kill toenail fungus?

While the study concluded positively, stating “Vicks VapoRub seems to have a positive clinical effect in the treatment onychomycosis” — it’s clear it only works for some. 

(T. rubrum party excluded.)

Since most toenail infections are caused by T. rubrum, it’s not likely Vicks VapoRub can help kill your infection. However, if your infection is yeast-based or due to T. mentagrophytes — it might help.

One clear limitation to this study is the lack of patient follow-up after product use stops. Considering nail fungus infections easily and quickly reoccur after treatment, it’s quite difficult to consider it a “cure” if it reoccurs.   


Summary

Can Vicks VapoRub treat toenail fungus? 

Yes and no. 

Vicks VapoRub can’t treat the most common fungus culprit. Which, might suggest for the large majority — it’s just not useful. 

If your infection is primary yeast-based or due to T. mentagrophytes — Vicks VapoRub might help. 

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For the rest of us, trusty and tested azole antifungal drugs such as ketoconazole might be the best way forward.

If you want to see if our prescription medicated nail fungus cream may be a good fit for your toenail fungus, you can have a free online consultation with our U.S. licensed doctors. If you are a good candidate for treatment, your medication can be shipped to you with our free shipping.



— Update: 30-12-2022 — cohaitungchi.com found an additional article Home remedies that may be worth a try from the website www.health.harvard.edu for the keyword does vaporub help with nail fungus.

Harvard Medical School embraces evidence-based medicine — treatments that have been shown to be effective through high-quality studies called randomized controlled clinical trials. So it’s always a little surprising when a Harvard doctor proposes a home remedy, as Dr. James P. Ioli did in an interview about toenail fungus. Dr. Ioli, who is chief of the podiatry service at Harvard-affiliated Brigham and Women’s Hospital, suggested that daily applications of Vicks VapoRub might be at least as effective as most of the topical treatments for toenail fungus that are available by prescription or over the counter.

Toenail fungus is representative of the type of condition that may benefit from home remedies. It isn’t usually serious and there are no sure cures for it that don’t have significant side effects. Vicks is also representative of the type of home remedy that isn’t likely to be harmful — a product we know well and have used safely for other purposes.

Why try home remedies?

Home remedies are inexpensive. Even though prescription drugs and over-the-counter products may be available for some conditions, home remedies may also be effective at a fraction of the cost. For example, the retail price of a year’s supply of the medication for toenail fungus called efinaconazole (Jublia) is several thousand dollars, compared with $24 for Vicks VapoRub.

Home remedies are also readily available when you need them. You may already have them in your kitchen cabinet or on your bathroom shelves. If not, they’re likely to be as close as the nearest supermarket.

The evidence supporting some home remedies

Hundreds of testimonials for a home remedy on the Internet may provide some assurance that it may help and probably won’t hurt you, but evidence from a well-conducted scientific study is far preferable. For example, a small study published in the Journal of the American Board of Family Physicians in 2011 demonstrated that Vicks can help eliminate toenail fungus. In that report, 15 of 18 volunteers with fungus-infected toenails had significant improvements, and five had complete eradications of the fungus, after daily applications of Vicks for a year. Even the venerable cold therapy chicken soup has undergone scientific scrutiny. A clinical study published in Chest in 1978 demonstrated that drinking chicken soup increased the flow of nasal mucus significantly more than drinking either hot or cold water.

The remedies listed below have been tested in clinical studies that have been published in peer-reviewed medical journals.

What it is
What it can be used to treat
How used
Comparable medical treatment
Cost per use
Cautions
Chicken soupNasal congestionDrink steaming hot soupVaporizers, oral decongestants$.50 to $1.50 per servingHigh sodium content
Duct tapeWartsCover wart with tape. Every few days, remove tape, soak foot, sand wart with emery board, and replace tape.Lasers, cauterization, acid therapyLess than $.01Skin irritation
Pickle juiceMuscle crampsDrink one ounceCalcium channel blockersAbout $.19High sodium content
Vicks VapoRubToenail fungusCover surface of affected nailOral and topical fungicides$.06 per dayNone identified

A few cautions

Seemingly benign home remedies can have dangerous side effects. For example, baking soda dissolved in water, once recommended for relieving indigestion, has sent hundreds of people to the emergency room with electrolyte imbalances. If you’re taking any home remedy for an extended period, you may want to check with your doctor to see if there are any risks involved.

References

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About the Author: Tung Chi