Prevention of mycoses of the feet

Authors:

Alexander Litus, Doctor of Medical Sciences, Professor of the Department of Dermatovenereology of Uzhgorod National Medical University (Kiev)

Roman Kachan, Ph.D., head of the chemical and microbiological laboratory of PJSC "UNVC for Disinfection Problems" (Kiev)

Kuzma Khobzey, dermatovenerologist, MC “Institute of Psoriasis and Chronic Dermatoses” (Kiev)

Ubiquitous fungus

Mycoses are a disease caused by fungal infections of the skin. The skin of the feet is predominantly affected by Trichophyton rubrum, Trichophyton mentagrophytes, and less commonly by Epidermophyton floccosum. Most often, infection occurs through fungal-contaminated shoes, rugs, towels, as well as through contact surfaces of baths, showers, gyms, and saunas. Spores or mycelium of mold fungi, once on the feet, best adapt to areas with microtraumas and abrasions. Favorable factors for the infectious process are hyperhidrosis, diaper rash, tight shoes, and insufficient hygienic care of the feet.

Symptoms

The disease can be asymptomatic for a long time or manifest itself with minor symptoms in the form of mild peeling, maceration of the epidermis, and mild itching. This condition can last for many months without causing significant problems, as a result of which the patient often concludes that the disease cannot be treated. However, this opinion is erroneous because the infection spreads to the nails and smooth skin. The appearance of the disease on the hands is explained mainly not by direct infection, but by the action of fungal toxins circulating in the bloodstream. On the other hand, when scratching the soles, microorganisms end up under the fingernails, from where they can be transferred to other parts of the body, including the scalp.

Under the influence of various factors, exacerbation of mycoses may occur, manifested in the form of redness, cracking and pain. More often, exacerbations are observed during the warm season. This is explained by the fact that at high temperatures more moisture is released, and excess moisture in the feet creates favorable conditions for the development of fungi.

Due to chronic allergolysis of the body by fungal antigens, mycosis of the feet is one of the serious causes of allergic dermatitis and even eczema. If these conditions are detected, the doctor prescribes complex treatment: in addition to external therapy, it may be necessary to take systemic antifungal drugs, and in case of severe allergic reactions, corticosteroids. However, long-term treatment often does not provide complete recovery from this disease - after some time, the disease returns and may even appear in family members of the patient.

Shoe hygiene and fungus

There is an opinion that it is impossible to cure foot mycoses without maintaining shoe hygiene at a high level. Shoes help retain heat and sweat, and the leather from which the shoes are made is a favorable environment for mold fungi. All of the above factors create optimal conditions for the development of fungi and infection of human feet.

We carried out microbiological analyzes from the patient's shoes. When studying their results, three types of molds were identified: Trichophyton rubrum, Trichophyton mentagrophytes, Aspergillus niger. This means that even after successful treatment, the patient becomes infected again after a short period of time in almost 100% of cases.

As we mentioned at the beginning of the article, Trichophyton rubrum and Trichophyton mentagrophytes cause athlete's foot, and Aspergillus niger is a known destructor of leather shoes. In addition, Aspergillus niger, as a result of its destructive action, produces enzymes and organic acids, which also enhance the infectious process.

Antifungal treatment of shoes

Thus, treatment and prevention of foot mycoses is impossible without antifungal treatment (disinfection) of shoes. It is generally accepted that long-term treatment of foot mycoses is due to the fact that shoes contaminated with fungi are a source of re-infection of patients. Therefore, in addition to treating fungal infections of human skin, it is necessary to periodically treat shoes in order to destroy mold fungi located inside the shoes. Also, shoes should be disinfected for people suffering from fungal infections or foot hyperhidrosis.

Currently in Ukraine, antimicrobial treatment of shoes is performed using formaldehyde (34–40% aqueous solution of formaldehyde) and acetic acid solution for 48 hours. However, these processing methods have a significant drawback - high toxicity.

Thus, formalin is a generally toxic substance included in the GN 1.1 list of carcinogenic substances. 725-98. Formalin negatively affects the reproductive organs, respiratory system, eyes, skin, central nervous system, and has allergenic and mutagenic properties. Formalin is very dangerous if it comes into contact with the skin, mucous membranes and the respiratory system. Substance safety class – 2.

Inhalation of acetic acid vapor causes a typical irritant effect on the mucous membrane of the nasopharynx and bronchial tree, and in rare cases causes bronchopneumonia. Acetic acid also attacks the skin, causing chemical burns. In addition to the toxic effect of acetic acid on humans, it and its aqueous solutions have a destructive effect on shoe leather due to its low pH value.

So, as we see, there is currently no modern, effective, safe product for humans that does not have a negative effect on shoes on the Ukrainian market.

We have investigated a number of antiseptic and disinfectants for fungicidal treatment of leather shoes of various manufacturers - both domestic and foreign. Among them, products containing: ethyl alcohol, isopropyl alcohol, and other components that enhance and prolong the antimicrobial effect were singled out for their effectiveness, safety and positive effect on leather shoes. In addition, these products should contain a fragrance to eliminate the unpleasant odor of shoes and components that care for the leather of shoes.

Synthetic shoes are an additional risk factor

Another reason that contributes to the occurrence of foot mycoses is shoes made of synthetic materials, popular among young people (sneakers, sneakers, etc.), as well as among people with low incomes.

The foot, which is dressed in shoes made of synthetic materials, does not breathe. As a result, a large amount of sweat is produced, which cannot evaporate and be absorbed into the shoes. As a result, a favorable environment is created for the development and reproduction of mold fungi and, as a result, the occurrence of mycoses of the feet.

Disinfection as a method of prevention

Microbiological analysis of the socks of a patient with mycosis of the feet confirms the presence of the mold Trichophyton rubrum. This means that not only the patient’s shoes, but also socks can serve as a source of re-infection. As you know, washing socks with household detergents at low temperatures does not disinfect fungal microflora. The way out of this situation is to use disinfectants when washing.

Many people have a natural question: won’t disinfectants be more harmful to the body than pathogenic fungi? The answer is no. Not all disinfectants are toxic. For example, disinfectants based on quaternary ammonium salts do not have a toxic effect on humans and have strong fungicidal (disinfects fungi) and bactericidal (disinfects bacteria) properties. In addition, these substances have a strong cleaning effect, which makes it possible to use them instead of classic laundry detergents.

Also, patients with mycosis of the feet and people with hyperhidrosis are recommended to wear socks with a fungicidal effect , which are used to prevent fungal infections of the feet. Basically, socks with fungicidal properties include silver thread. As you know, silver has long been used to treat bacterial and fungal infections. This is explained by the fact that silver ions have strong bactericidal and fungicidal properties, while silver is safe for humans. Socks that contain silver can serve not only to prevent mycosis, but also to prevent the formation of unpleasant foot odor, since the unpleasant odor is caused by microorganisms.

In addition, in order to prevent mycoses of the feet, it is necessary to thoroughly disinfect baths, showers, and other surfaces with which the unprotected foot will come into contact.

It is recommended to use products that meet the following criteria as disinfectants:

• have strong fungicidal properties;
• do not cause metal corrosion;
• safe for humans;
• have cleaning ability.

When visiting saunas and swimming pools, you must use rubber slippers. And after visiting baths, saunas, showers, swimming pools, beaches, you should treat the skin between the toe folds and soles with a 1-2% iodine solution or antifungal agents.

To prevent mycosis, attention should be paid to the active identification and treatment of patients with mycosis of the feet. These measures are most rationally carried out in large and organized groups (athletes, military personnel, etc.). Workers of baths, saunas, swimming pools, and laundries should be subject to systematic inspection. And those who have been diagnosed with a fungal infection must be registered and actively treated.

You should also pay special attention to reducing sweating by choosing comfortable shoes and socks made from natural materials, and carrying out daily hygiene measures.

Source: Les Nouvelles Esthetiques Ukraine, No. 3 (67), 2011, pp. 76-77