title: Novel treatment of onychomycosis using over-the-counter mentholated ointment: a clinical case series.
abstract: BACKGROUND
  current medication treatments for onychomycosis have less than full cure-rate efficacy and have the potential for adverse side effects. Vicks VapoRub (The Proctor & Gamble Company, Cincinnati, OH) has been advocated in the lay literature as an effective treatment for onychomycosis. This pilot study tested Vicks VapoRub as a safe, cost-effective alternative for treating toenail onychomycosis.
  
  
  METHODS
  eighteen participants were recruited to use Vicks VapoRub as treatment for onychomycosis. Participants were followed at intervals of 4, 8, 12, 24, 36, and 48 weeks; digital photographs were obtained during initial and follow-up visits. Primary outcome measures were mycological cure at 48 weeks and clinical cure through subjective assessment of appearance and quantifiable change in the area of affected nail by digital photography analysis. Patient satisfaction was a secondary outcome, measured using a single-item questionnaire scored by a 5-point Likert scale.
  
  
  RESULTS
  fifteen of the 18 participants (83%) showed a positive treatment effect; 5 (27.8%) had a mycological and clinical cure at 48 weeks; 10 (55.6%) had partial clearance, and 3 (16.7%) showed no change. All 18 participants rated their satisfaction with the nail appearance at the end of the study as "satisfied" (n = 9) or "very satisfied" (n = 9).
  
  
  CONCLUSIONS
  Vicks VapoRub seems to have a positive clinical effect in the treatment onychomycosis.
authors.affiliation: US Air Force 375th Medical Group, Family Medicine Residency Program, Belleville, IL, USA. Richard.derby-02@scott.af.mil
authors.forename: Richard
authors.initials: R
authors.lastname: Derby
authors.forename: Patrick
authors.initials: P
authors.lastname: Rohal
authors.forename: Constance
authors.initials: C
authors.lastname: Jackson
authors.forename: Anthony
authors.initials: A
authors.lastname: Beutler
authors.forename: Cara
authors.initials: C
authors.lastname: Olsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002164:Camphor / Q000008:administration & dosage / Q000627:therapeutic use; D002175:Candida / Q000187:drug effects; D004338:Drug Combinations; D005052:Eucalyptus; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000382:microbiology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008610:Menthol / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D009824:Ointments / Q000008:administration & dosage / Q000627:therapeutic use; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology; D017060:Patient Satisfaction; D010865:Pilot Projects; D010936:Plant Extracts / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013729:Terpenes / Q000008:administration & dosage / Q000627:therapeutic use*; D013943:Thymol / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; D004366:Nonprescription Drugs; D009824:Ointments; D010936:Plant Extracts; D013729:Terpenes; C009952:camphor, cedar leaf oil, eucalyptus oil, menthol, myristica oil, terebinth oil, thymol drug combination; D008610:Menthol; D013943:Thymol; D002164:Camphor