Abstract
Onychomycosis is a chronic disease ofa nail infection by the fungi. Based on the mode of nail invasion and morphologic patterns, it can be divided into 5subtypes: distal and lateral subungualonychomycosis, proximal subungualonychomycosis, superficial onychomycosis, total dystrophic onychomycosis, and endonyxsubungualonychomycosis.Common pathogens are dermatophytes, non-dermatophyte molds, and yeasts. In recent years, the development of new antifungal agents, such as allylamines and azoles, has provided good treatment options for onychomycosistherapy. There is a growing interest in the use of plant-derived compounds or alternatives to treat dermatophyte infection. Recently, a Chinese web page describing an alternative method for onychomycosis by using garlic and pepper extractswas very popular [Figure 1] [1]. They described 200 cases of onychomycosis patients treated once daily with a mixture of 100g garlic and 20g pepper extracted with 500ml acetic acid for 30 days. They claimed the cure rate was 94.05% and the effective rate was 99.88%. Although it may seem effective, the detailed exact preparation methods, the culture results, and the subtypes of the onychomycosis were not described. The treatment responses also seemed too good to be true. Martin et al. reviewed 7 controlled clinical trials performed to determine the effectiveness of plant extracts against fungal infection [2]. Among them, tea tree oil was the most thoroughly clinically tested. Solanum species and oil of bitter orange preparations were also reviewed. However, there were no researches on garlic or pepper preparation. Till now, there are still no peer-reviewed, double-blind, placebo-controlledclinical trials of garlic or pepper-based preparations used as an alternative treatment method for onychomycosis.
Highlights
There is a growing interest in the use of plant-derived compounds or alternatives to treat dermatophyte infection
The antioxidant activityof A. sativum extract may be effective as a local or systemic anti-inflammatory therapy and target the oxidative stress from the inflammation associated with onychomycosis
The A.sativum extract is effective against Meyerozymaguilliermondii and Rhodotorulamucilaginosa cultured from the toenails of a patient with onychomycosis[5]
Summary
There is a growing interest in the use of plant-derived compounds or alternatives to treat dermatophyte infection. Garlic (Allium sativum) is one of the most cultivated plants used as a spice. It is widely used for its therapeutic properties, including antifungal effects. Allium plants contain active compounds such as alliin, allicin, ajoene, sterols, flavonoids, and phenolic acids [3].
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