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Athletes foot

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Q) I've been suffering from athlete's foot on and off over the past few years

Q) I've been suffering from athlete's foot on and off over the past few years. Do you know of any effective natural remedies?-M.N., via e-mail

A) Athlete's foot, medically known as 'tinea pedis', is a contagious fungal infec-tion of the foot that typically causes scaling, flaking and itching between the toes. The fungi responsible for it are called 'dermato-phytes'. These mould-like organisms thrive in warm, moist environments and, when they invade the superficial layer of the skin, they cause the skin cells to overreproduce, resulting in a thickened, scaly skin. As the fungi spread, so does the infection.
Despite its name, athlete's foot can affect anyone. In fact, around 17 per cent of the UK population are suffering from athlete's foot at any given time (Drug Ther Bull, 2002; 40: 53-4).
Getting rid of the infection usually involves one of the many antifungal creams, powders or tablets that are available by prescription or over the counter. However, a number of these are linked to nasty side-effects such as contact dermatitis (clotrimazole), liver damage (terbinafine) and gastrointestinal effects (most oral antifungals) (Nippon Ika Daigaku Zasshi, 1996; 63: 356-64; Ann Hepatol, 2003; 2: 47-51; Ugeskr Laeger, 2003; 165: 1436-8).
Fortunately, the evidence shows that, in many cases, natural agents can be just as-or even more-effective as drugs are at fighting the fungi that cause athlete's foot.

Natural alternatives
- Essential oils. Several of these concentrated plant oils appear to be helpful against athlete's foot because of their antifungal activity.
In one study, 158 patients with tinea pedis were treated with either tea tree oil (25- or 50-per-cent solution) or a placebo twice daily for four weeks. Tea tree oil was significantly more effective than the placebo at curing the infection (Australas J Dermatol, 2002; 43: 175-8).
In another trial, a 10-per-cent tea tree oil cream reduced symptoms of athlete's foot (scal-ing, inflammation, itching and burning) more effectively than either the synthetic antifungal tolnaftate or placebo (Australas J Dermatol, 1992; 33: 145-9).
Other essential oils that may also work are bitter orange, oregano, thyme, cinnamon bark, lemongrass, clove, peppermint, lavender, basil and sage (Int J Dermatol, 1996; 35: 448-9; J Int Soc Sports Nutr, 2007; 4: 3). Try adding a few drops of one or more of these essential oils-with some ordin-ary salt to enhance fungicidal activity-to a foot spa or bowl of hot water, and soak your feet for 20 minutes (Nippon Ishinkin Gakkai Zasshi, 2007; 48: 27-36).
As some people are sensitive to certain essential oils, always do a skin-patch test before using an oil for the first time, and avoid their prolonged use.
- Herbs. A number of herbs have been traditionally used in Mexico to treat fungal skin infections such as athlete's foot. One of them, Solanum chrysotrichum (giant devil's fig), was found to be just as effective as the drug keto-conazole (in the form of a 2-per-cent cream) in a double-blind study of 101 patients. A standard-ized extract of the herb was regularly applied to the affected area for four weeks (Planta Med, 2003; 69: 390-5).
In a similar study, the herb Ageratina pichinchensis (snake-root) also showed powerful anti-fungal activity against athlete's foot (Planta Med, 2006; 72: 1257-61).
If you can't track down these herbal preparations, try garlic. A compound found in garlic known as 'ajoene' appears to have potent antifungal properties. In a study of 34 patients using a 0.4-per-cent ajoene cream daily, 79 per cent were completely free of athlete's foot after just one week; the rest were cured within two weeks. What's more, all participants were still free of infection three months later (Mycoses, 1996; 39: 393-5).
In another trial, 1-per-cent ajoene cream was more effective for treating athlete's foot than topically applied terbinafine (J Am Acad Dermatol, 2000; 43: 829-32).
As ajoene cream is not yet available commercially, you could try applying crushed raw garlic to the affected area once a day.
- Ozone therapy. Vegetable oils exposed to ozone gas are showing promise in the treatment of fungal infections. In a study of 200 patients with athlete's foot, twice-daily application of ozonized sunflower oil (Oleozon) proved to be just as effective as the topical antifungal ketoconazole. After six months, around 80 per cent of patients using either Oleozon or ketoconazole were completely cured-with no side-effects. The Oleozon-treated group remained fungus-free six months later (Mycoses, 2002; 45: 329-32).

Avoiding athlete's foot
Keep feet clean and dry. Dry your feet thoroughly after washing, especially between the toes, and change your socks frequently.
- Let your feet breathe. Wear well-ventilated shoes, such as sandals, to let air get to your feet.
- Alternate between different shoes. This allows each pair to dry out after being worn.
- Protect your feet. Wear flip-flops or shower shoes when using communal showers, pools, fitness centres and other public areas.
- Avoid sharing. Never share your shoes, socks or towels with others.
- Choose natural materials. Cotton socks and leather footwear are preferable to nylon socks and plastic footwear, both of which increase sweating.

Vol 20 03

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