Onychomycosis

Toefungus.jpg
A toenail affected by onychomycosis



Background

We can say that treatment will take 12 months and even with the most thorough and systematic bombardment of the fungus recurrance is very common.  The article referred to Westerberg, DP; Voyack, MJ (2013 Dec 1) may give some hope to those wanting to free themselves completely of this ailment as research indicates the fungi are heat sensitive so may be susceptible to laser treatment at 40-60 degrees. 

Certainly first and most important stop is the GP who will send the clippings away to the laboratory to see what we are dealing with. Diagnosis precedes any kind of treatment and aromatherapists often lack a medical qualification as a doctor or a nurse to make a diagnosis. The GP has seen plenty of yellowing toenails a condition which affects 10% of the population. 

Onychomycosis is a good example of how medicine and natural personal care work hand in hand to contain and sometimes defeat a problem. The initial emphasis following diagnosis is on containment so there is no reason not to use the essential oils indicated but a visit to the surgery should not be postponed to see if essential oils “work” first. 

If you have Onychomycosis you are “ill” and should see your doctor who assesses the seriousness of the condition and your view of its seriousness. Anyone can become depressed about their appearance. Often the condition is a consequence of other conditions or simply aging. 


The duration of the treatment following diagnosis is a strong argument in favour of essential oil use which apart from the dermal sensitisation sometimes associated with them are well tolerated by the body. This is why essential oils are favoured by manufacturers of over the counter treatments like Vicks for common ailments (who have a natural concern for their customers wellbeing!). Essential oils can be used for such an extensive period to minimise the “collateral damage” of an extensive period of use of non naturally derived chemicals and minimise recurrance. 

Recommended essential oils with antifungal properties

Tea tree (Melaleuca alternifolia), Thyme (Thymus vulgaris), Oregano (Oreganum vulgare)

Carriers: Tamanu

Over the counter: Vicks vapour rub

Vicks vapour rub contains Thymol, Nutmeg Oil, Cedarwood Oil.  Levomenthol2.75% wl w, camphor 5.00% wl w, eucalyptus oil 1.50% wl w. turpentine oil 5.00% wl w. 

alpha pinene is highly reactive


Vicks vapour rub is a noted respiratory aid. Interesting to see its use in practice for foot fungal infection too. The petrolatum will certainly aid in easing the foot itch and retain the oils. Vicks reportedly contains Thymol, Nutmeg Oil, Cedarwood Oil. However I observe the active ingredients are said to be “Levomenthol2.75% wl w, camphor 5.00% wl w, eucalyptus oil 1.50% wl w. turpentine oil 5.00% wl w.” This is interesting. The often unheralded turpentine oil contains about 70% alpha pinene. 

Alpha pinene contains a highly reactive 4 carbon ring. We also see camphor, menthol and eucalyptus oil. If I were blending for a client I would be reaching for the Cornmint (70% menthol) to give this a try as part of the blend and sources of camphor, cineole and alpha pinene which minimised any possibility of dermal sensitisation. And yes I would include the Tea tree and Thyme for their alcohols too. I would probably use a heavy cleansing cream/reflex cream as a carrier rather than an oil like Tamanu but the Tamanu is a good choice as is Neem oil.


As to the philosophy the choice of oils is of importance but of equal importance is sending a consistent and harmless chemical message to the fungus over 12 months at least that the organism is not compromised and it is not needed or welcome. As the infection can be spread to the anus and ears and will be infectious to others using showers and swimming treatment with essential oil is certainly justified.

Treatment with essential oils may contain onychomycosis but will not remove it or prevent recurrence as the fungus often takes deep root in the nail bed under the toenail requiring systematic medical treatment but even then recurrance is common.

References
1.  Wikipedia http://en.wikipedia.org/wiki/Onychomycosis
2.  Westerberg, DP; Voyack, MJ (2013 Dec 1). “Onychomycosis: current trends in diagnosis and treatment.”. American family physician 88 (11): 762–70. PMID 24364524
3.  Podiatry
4. Tea Tree oil research  http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=6654
 Latest reference: http://www.ncbi.nlm.nih.gov/pubmed/23392821 while this 1994 study (http://www.ncbi.nlm.nih.gov/pubmed/8195735) is a comparative trial between TTO and clotrimazole in the treatment of Trichophyton rubrum which is the fungus commonly associated with the problem.

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