Innovative herbal formulation as monotherapy to treat topically onychomycosis: An observational retrospective study

Onychomycosis is a fungal infection of the nail that affects approximately 5% of the population worldwide. The causative agents are usually dermatophytes and less often yeasts and non-dermatophyte molds (NDMs). The main problems of onychomycosis treatment are the long time needed to obtain a complete cure, the resistance to drugs, occurrence of adverse effects and the high relapse rates [ 1 ] [ 2 ]. The aim of this study was to investigate the effect of an innovative herbal product on onychomycosis. From 2017 to 2024, 28 patients (7 males, 21 females, age range: 14-83 years), with onychomycosis caused by dermatophytes [ Trichophyton rubrum (17)], yeasts [ Candida albicans (3), C. parapsilosis (1), C. krusei (1)] and NDMs [ Aspergillus fumigatus (2), A. niger (1), A. flavus (1), Scopulariopsis brevicaulis (1)], were treated topically twice a day with an oleolite containing Salvia r osmarinus Spenn. extract, cinnamaldehyde, carvacrol, thymol and eugenol [ 3 ]. Except 2 subjects [ A. fumigatus (1) and A. niger (1)] everyone else achieved a complete cure, namely elimination of the infective fungal organism (mycological cure) and restoration of the normal appearance of the nail (clinical cure). The mean time in months to complete therapy was 5.4 for dermatophytes, 8.7 for yeasts and 5 for NDMs. No adverse effects were noticed. The disease-free patients were very satisfied by the treatment. No relapses were observed during the follow-up. The described natural remedy showed an excellent efficiency and safety without problems of resistance development, therefore might provide an alternative as monotherapy or addition to current options for treating onychomycosis. Publication History Article published online: 05 March 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany