Researchers have found that hydrogen sulfide (H₂S) can be used to treat complex nail infections, which is a faster-acting treatment with fewer side effects than currently available treatments.
Hydrogen sulfide is known for its pungent smell, similar to that of rotten eggs, and has some toxicity, but researchers believe that the quantities required are much less than the levels that might cause toxicity, and that the correct composition will limit any unpleasant odors.
The study was conducted by researchers from the University of Bath and King’s College London in the United Kingdom, and its results were published in Scientific Reports magazine on October 31, and the Eurick Alert website wrote about it.
Fungi often cause nail infections, and they are very common, infecting between 4% and 10% of the world’s population, and rising to nearly half of those aged 70 years and over.
This infection may cause complications, especially in groups most vulnerable to infection, such as diabetics and the elderly, but it is very difficult to treat.
Oral antifungals or gas?
Current treatments include oral antifungals in tablet form, and topical treatments applied directly to the nail.
Oral antifungals take about 2 to 4 months to work and are reasonably effective, but they carry a risk of side effects, especially in patients with other medical conditions.
Treatments applied directly to the nail are safer, but they often take much longer to work, sometimes taking years, and they often recur or fail, largely because it is difficult for the medication to penetrate the nail and reach the site of infection.
Even the most effective topical treatments have relatively low cure rates, so there is a clear need for new treatment approaches that are safe, effective and able to reach microbes deep within the nail.
Previous research has shown that hydrogen sulfide penetrates the nail plate much more efficiently than current topical medications, and the team has now demonstrated that it has strong antimicrobial activity against a wide range of nail pathogens, including fungi resistant to common treatments.
Hopes for developing an effective treatment
In laboratory tests, the team used a chemical that decomposes to release hydrogen sulfide gas, and found that it worked in a unique way, disrupting and damaging microbial energy production, ultimately killing the fungus.
Dr Albert Paulhus, from the Department of Life Sciences at the University of Bath, said: “Thanks to its ability to efficiently reach the site of infection and its innovative mode of action, we believe that a topical drug containing hydrogen sulphide could become a new and highly effective treatment for nail infections, surpassing the limitations of currently available treatments.”
The research so far has been conducted only in the laboratory, but the team hopes to develop a treatment that can be used in patients within the next five years.
Professor Stuart Jones, Director of the Center for Pharmaceutical Medicine Research at King’s College London, said: “We look forward to translating these findings into an innovative topical product for the treatment of nail inflammation.”