Is eucalyptus oil effective in treating onychomycosis (fungal infection of the nail)?

From the Guidelines

Eucalyptus oil should not be used as a primary treatment for onychomycosis, but rather as a complementary therapy alongside conventional antifungal medications like terbinafine or itraconazole, as recommended by the British Association of Dermatologists' guidelines 1. When considering treatment for onychomycosis, it is essential to prioritize evidence-based options that have demonstrated efficacy in reducing morbidity, mortality, and improving quality of life.

Key Considerations

• The British Association of Dermatologists' guidelines recommend terbinafine as the first-line treatment for dermatophyte onychomycosis due to its higher efficacy and tolerability compared to itraconazole 1.
• Eucalyptus oil may have antifungal properties, but its clinical effectiveness against nail fungus is limited, and it should not replace conventional antifungal medications.
• To use eucalyptus oil as a complementary treatment, apply 1-2 drops of 100% pure eucalyptus oil directly to the affected nail twice daily after cleaning and drying the area thoroughly.

Important Safety Precautions

• Always perform a patch test before regular use of eucalyptus oil to avoid skin irritation.
• Discontinue use if redness, itching, or discomfort occurs.
• Avoid applying eucalyptus oil to broken skin.

Next Steps

• If your nail infection worsens or shows no improvement after several weeks, consult a healthcare provider for more effective treatment options.
• Consider using eucalyptus oil alongside prescribed antifungal medications like terbinafine or itraconazole for best results, as supported by the guidelines for treatment of onychomycosis 1.

From the Research

Onychomycosis Treatment Options

• Onychomycosis is a common fungal infection of the nail apparatus that is challenging to treat, even with identified causative agents, and often requires prolonged systemic antifungal therapy 2.
• Various antifungal medications, including fluconazole, itraconazole, and terbinafine, have been used to treat onychomycosis, with terbinafine producing the best results for dermatophyte infections 2.

Efficacy of Antifungal Medications

• Efinaconazole, a topical antifungal agent, has been shown to be effective in treating onychomycosis, with complete cure rates of 17.8% and 15.2% demonstrated in Phase III clinical trials 3.
• Efinaconazole has been found to have a good safety profile, with minimal localized adverse events that cease upon stopping treatment 3, 4.
• The efficacy of efinaconazole is comparable to that of oral antifungal medications, such as itraconazole, and exceeds the efficacy of topical ciclopirox 3, 4.

Treatment Recommendations

• Experts recommend efinaconazole 10% topical solution as the first line for mild-to-moderate onychomycosis, pediatric onychomycosis, those with liver or kidney disease, and as maintenance therapy to prevent relapse 4.
• Continuous terbinafine treatment for 24 weeks has been found to be the most effective treatment regimen for dermatophyte toenail onychomycosis, with a higher likelihood of mycological cure compared to other treatment regimens 5.

Safety and Adverse Events

• The side effects of topical efinaconazole are minimal, with the most common adverse events being ingrown toenails, dermatitis, vesicles, and pain at the application site 4.
• There were no significant differences in the likelihood of adverse events between continuous and pulse regimens of terbinafine, itraconazole, and fluconazole 5.

Eucalyptus Oil

• There is no mention of eucalyptus oil in the provided studies as a treatment for onychomycosis.