TINEA

(Tinea Pedis, Athlete’s foot)

DEFINITON

Tinea is a group of fungal infections caused by different fungi families.

DESCRIPTION

Tinea Pedis is caused by an organism called Trichophyton mentagrophytes. Initially it attacks the web of skin between the 3^rd, 4^th and 5^th toes and may progress to other areas of the feet including the soles and heels. The skin between the toes can become dry, scaly, cracked, bleeding and very tender. When the infection is between the toes, the skin usually peels first and then itches in some cases to the point of bleeding. Sometimes the infected area becomes cracked and soggy, particularly if the patient keeps the toes away from fresh air by wearing socks and shoes continually.

If not treated, the infection may spread to cover the foot and eventually the nail. Various bacteria (e.g. streptococci) may establish in these areas, causing weeping with a bad smell.

Men suffer from tinea more commonly than women.

Tinea Pedis is transferred very easily from person to person via skin scales which are shed from the infection. They cling to items of clothing such as socks. Other items which may be carriers of the fungus include towels, shoes and areas of flooring which are constantly moist such as common showers and public toilets. Wear sandals or shoes in these areas if possible.

MANAGING TINEA

PREVENTION:

Flare-ups in tinea are often associated with hot, humid weather, excessive sweating and tight fitting or closed-in footwear. The following tips can help prevent tinea coming back:

1.      Wash your feet with a soap alternative (Pinetarsol) and warm water every day.

2.      Dry your feet promptly and thoroughly after cleaning – especially the areas between the toes.

3.      Avoid wearing socks made from wool or synthetic materials (eg. Rayon or nylon). Instead wear clean cotton socks and change them daily or more often if the feet sweat a lot.

4.      Use an absorbent powder between the toes and on your feet, socks and shoes. Use the powder between the times you use an anti-fungal cream.

5.      Wear sandals or well ventilated shoes to avoid build-up of moisture on the feet. Avoid wearing closed-in shoes as much as possible.

6.      Do not walk barefoot near swimming pools, locker rooms, public showers or bathrooms at home - wear sandals or thongs.

7.      Discard footwear that is unsanitary and change them regularly.

8.      Do not share towels, bathmats, socks or shoes.

9.      Wash socks, towels, bathmats and linen in hot water.

10.  Always trim toe nails straight across, so that their corners stay clear of the toes.  This prevents the tinea spreading to the nail.

TREATMENT:

Use the preventative measures whilst treating and after treatment has finished.

The best treatment is using a combination of a cream, powder and a soap alternative.

Creams:

·         Lamisil (terbinafine): - the only treatment that kills not just suppresses tinea (fungicide).                                          Therefore existing tinea should not return if effectively treated

                                          with Lamisil.

-          fast, effective treatment

-          itchiness should go away after a couple of days.

-          Apply once daily for 7 days.

-          Must cover entire affected area.

·     Daktarin (miconazole) Canesten (Clotrimazole)

-     only suppresses tinea, does not kill the infection (fungostat).

-          apply morning and night for 3 weeks (approximately one week to clear the symptoms and a further two weeks to clear the infection).

-          If treatment is stopped too soon it may recur

-          Must cover entire affected area.

·     Resolve Soothing Balm    -  Fungostat and antiinflammatory.

(miconazole, bufexamac) - apply morning and night for approximately 3 weeks (as above)

-          Same as Daktarin, however also contains Bufexamac which is a topical anti-inflammatory agent. It reduces itching and redness associated with the infection.

Powders:

·   Prantal Powder       -    Reduces sweat production by affecting the para-sympathetic 

                                          nervous system.

-          dust onto feet and in shoes and socks, every morning after applying cream. Apply to feet after cream has been absorbed and foot is dry.

·   Resolve Powder     -     excellent at absorbing moisture and also contains an anti-fungal .

(miconazole)                -     use as with Prantal Powder.

-          may aid in treatment because is also anti – fungal.

·   Lamisil OdorEze Powder   -    This contains talc, cornstarch, aluminum (as a salt) silicon                                       

                                          and aloe vera powder.

-          These ingredients absorb excess moisture, so that the fungal 

      infection has less chance of surviving.

 Soap Alternative:

Ego Pinetarsol             -      a coal tar soap that is ph 6. The same acid level as normal skin,                    therefore does not disrupt the natural acid barrier of the skin, but                        maintains this barrier that aids in treatment.

-            will reduce inflammation, redness and itchiness of tinea.

Using the treatment combination:

MORNING AND EVENING (miconazole/clotrimazole) or ONCE DAILY (Lamisil):

1. Clean feet using Pinetarsol.

            2. Dry the feet thoroughly, especially between the toes.

            3. Apply Cream to feet thinly, ensuring all affected area(s) are covered.

                4. Allow feet to air dry, then dust Powder freely onto feet and into shoes and socks.

SOLUTION KIT

The solution to treat and kill tinea is:

1. Lamisil, Resolve or Canesten PLUS
2. Prantal, Lamisil Odoreze or Resolve powder PLUS
3. Ego Pinetarsol or another soap substitute.