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Indian Journal of Dermatology, Venereology and Leprology
Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL)
ISSN: 0378-6323 EISSN: 0973-3922
Vol. 70, Num. 2, 2004, pp. 129-130

Indian Journal of Dermatology, Venereology, Leprology, Vol. 70, No. 2, March-April, 2004, pp. 129-130

Dispensing Pearl

Thymol in chloroform

Hon. Dermatologist, Bhatia General Hospital, Mumbai
Correspondence Address:402, Sugan, 13, Cumballa Hill Lane, August Kranti Marg, Mumbai - 400036

Code Number: dv04042

Chronic paronychia is characterized by erythema and edema of the proximal nail fold and absence of the cuticle generally in the fingernails of adult women. In the majority of cases, Candida species can be isolated,[1] but it appears that chronic paronychia represents a contact reaction to irritants or allergens.[2] Thymol (4%) in chloroform (or absolute alcohol) is a very good adjunct in the treatment of chronic paronychia.

Thymol in chloroform

Thymol 1 ml
Chloroform to make 25 ml

Sig: Apply 2-3 times daily to the affected nail folds

Role of the ingredients

Thymol is an alkyl derivative of phenol with bactericidal and fungicidal properties.[3] Although it is a more potent antiseptic than phenol, its low water solubility and irritancy tend to limit its use.[4]

Chloroform is a volatile fluid used as a solvent and for the preservation of mixtures and extracts.

Thymol in chloroform in contemporary practice
Patients with chronic paronychia should protect their cuticles from moisture for at least 3 months. Oral fluconazole 150 mg once a week for a period of 12 weeks is useful in eradicating the candidal infection. If edema or pain is associated, a topical corticosteroid cream for the first few days is helpful.[3] Signs of acute inflammation are an indication for a course of an oral anti-staphylococcal antibiotic.

Along with these measures, 4% thymol in chloroform topically works very well. It is a non-aqueous preparation that reaches the paronychial area by capillary action. It appears more logical to apply this formulation since otherwise one asks the patient to restrict wet work, but apply antifungal preparations having an aqueous base.[3] Absolute alcohol can be substituted for chloroform as a solvent. Some patients experience irritation and dryness, in which case the concentration of thymol can be reduced to 2%.


1.Stone OJ, Mullins JF. Chronic paronychia: microbiology and histopathology. Arch Dermatol 1962;86:324-7.  Back to cited text no. 1  [PUBMED]  
2.Daniel CR III, Daniel MP, Daniel CM, Sullivan S, Ellis G. Chronic paronychia and onycholysis: a thirteen-year experience. Cutis 1996;58:397-401.  Back to cited text no. 2    
3.Arndt KA, Bowers KE. Manual of dermatologic therapeutics. Philadelphia: Lippincott, Williams and Wilkins; 2002.  Back to cited text no. 3    
4.Griffiths WAD, Wilkinson JD. Topical therapy. In: Champion RH, Burton JL, Burns DA, Breathnach SM, editors. Rook/Wilkinson/Ebling Textbook of dermatology. Oxford: Blackwell Science; 1998.  Back to cited text no. 4    
5.Polano MK. Topical skin therapeutics. Edinburgh: Churchill Livingstone; 1984.  Back to cited text no. 5    

Copyright 2004 - Indian Journal of Dermatology, Venereology, Leprology

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