Background: Resistance and side effects encountered with use of common topical and systemic antifungal drugs for dermatophyte infections highlights the need for novel therapies. Medicinal plants, which have been traditionally utilised for their antimicrobial properties to treat superficial skin infections, serve as an abundant source for the identification of new antifungal compounds.
Aim: To summarise the current evidence for plant-based natural therapies for dermatophytic infections.
Methods: A comprehensive literature search was performed across databases PubMed, Embase and ScienceDirect using keywords ‘dermatophyte’ or ‘anti-dermatophytic’ or ‘antifungal’, combined with ‘natural, ‘ethnomedical’, ‘plant’, ‘botanical’, ‘treatment’ or ‘remedy’. Additional studies specific to the plant extract were searched using genus and species.
Results/ Discussion: Seventy plant extracts demonstrating in vitro anti-dermatophytic properties are summarised in this review. Among these, common antifungal phytochemicals found include phenolic compounds, terpenoids, terpenes, alkaloids, xanthones and glycosides including saponins. Only 21 plant extracts or their active components have been evaluated in in vivo bioassays in clinical trials and animal studies. Multiple mechanisms of action have been elucidated, including disruption to cell wall and cell membranes, inhibition of cell wall synthesis, hyphal growth, and spore germination, as well as possible in vivo anti-inflammatory and immunomodulatory effects.
Conclusion: Based on in vitro studies, numerous plant extracts show significant therapeutic potential for the treatment of dermatophyte infections. However, more in vivo studies are required to assess the clinical effectiveness of plant extracts.
Tasman Med J 2022: 3; 21-37
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