Athlete’s Foot
Definition
Western
Athlete’s Foot, also known as tinea pedis or “Hong Kong foot”, is a type of fungal infections caused by superficial or cutaneous mycosis, usually occur between the toes and/or on the sole of the feet which causes itchiness and scaling. Warm and moist conditions provide a welcoming environment for the fungal growth and infections such as the warmth and dampness of areas around swimming pools, showers and locker rooms are good breeding grounds for the reproduction of the microorganisms [13, 18-21]. It can also be transmitted through direct contact of the person, objects or even household pets containing the fungi [11].
Traditional Chinese Medicine (TCM)
Causes of athlete’s foot are often related to the pathogenic agents existing in the environment as well as the dysfunctioning of the Spleen System. Spleen plays an important role in the digestive system and governs the fluid circulation in the body. Regular intakes of oily spicy foods, consumption of alcohol or being in warm humid environment for prolonged period of time will impair the Spleen System and often account for symptoms such as constipation, tightness in chest, vomiting, lack of appetite and sore or numbness in lower limbs. It is also known as “Jiao Shi Qi” or “Jiao Qi” which literally translates to as “dampness in the feet”.
Symptoms Displayed / Classifications / Types
Acute Type
Various degrees of itchiness with burning sensation accompanied by redness or even painful blistery lesions. May develop strong odour. Lesions may contain either clear or pus-like fluid. After they rupture, scaling may persist.
Dormant Type
Cracking, peeling of the dry and scaly skin, usually on the soles or sides of the feet. This type often affects both feet. In extreme cases, toenails may thicken or even fall off. Some elderly patients may attribute their scaling feet to dry skin [17].
Risk Factors
· Poor foot hygiene
· Wet feet for prolonged period of time [12] e.g.: sweaty feet, damp socks
· Enclosed shoes, worse if they are plastic-lined shoes also tend to create a warm and humid environment, which encourages the fungus growth.
· Individuals with weak immune systems such as diabetes [14] or HIV/AIDS [15]
· Crowded public areas such as locker rooms, saunas, swimming pools, fitness centres and public showers [18]
· Clinical studies showed that men are more likely to develop athlete’s foot as compared to women [12, 16] due to their life habits and occupations.
Treatments
Herbs commonly used in prescriptions:
1. Ku Shen – 苦参
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English/ Common name
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Bitter root
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Latin species
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Sophora flavescens
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Park of plant used
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Roots
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Action/s
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Commonly used in the treatment of skin inflammations [1-2] and related skin diseases [3]
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Precaution/s
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Individuals with poor digestive system should use with caution. Prohibited to be used together with Veratrum nigrum L.
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2. Bai Xian Pi – 白鮮皮
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English/ Common name
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Latin species
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Dictammnus dasycarpus Turcz
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Park of plant used
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Root tubers
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Action/s
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Helps to provide relieve for skin allergies [4] and helps to treat certain cases of hepatitis[5]
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Precaution/s
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Individuals with poor digestive system should use with caution.
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3. Bai Bu – 百部
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English/ Common name
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Stemona Root
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Latin species
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Stemona sessilifolia (Miq.) Franch. Et Sav.,Stemona japonica (Bl.) Miq.or Stemona tuberosa Lour
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Park of plant used
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Root tubers
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Action/s
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Contains anti-fungal [7] anti-microbial and anti-inflammatory activities [8].Helps to relieve acute or chronic coughs [6].
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Precaution/s
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No significant side effects within proper dosage
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4. She Chuang Zi – 蛇床子
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English/ Common name
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Cnidium Seed
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Latin species
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Cnidium monnieri（L.）Cuss.
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Park of plant used
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Dried ripe fruit
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Action/s
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Primarily used externally to treat various skin conditions and helps to alleviate itchiness [22-23].
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Precaution/s
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Do not apply on hot, dry and sore skin.
Not suitable to be taken internally for individuals having hot flushes, lack of sleep, breathlessness. Individuals with kidney or liver problems should also use with caution.
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Tests & Diagnosis
KOH Test
Direct microscopic analysis of potassium hydroxide preparations performed on skin scrapings from the affected areas.Lung
Skin lesion biopsy
Histological examination of skin scrapings or fluid samples from the suspected foot is performed.
Prevention Practice
· Practice good foot hygiene is the best prevention.
· Keep your feet dry, especially between toes.
· Avoid tight footwear. Wear well-ventilated shoes.
· Change socks and stockings regularly.
· Daily use of foot powder in the shoes, if necessary.
Home Remedies
Tea Tree Oil Foot Soak
a) Put a few drops of tea tree oil into a pail of warm water.
b) Soak both legs for 15-30 minutes.
c) Dry legs thoroughly. Sprinkle talcum powder, if necessary to keep dry
Bitter root, Stemona root and Cnidium Seed Soak
a) Put bitter root, stemona root and cnidium seeds into a pot.
b) Add water and boil for 30 minutes. Soak both legs for 20-30 minutes.
c) Dry legs thoroughly.
References
1. Ping Zheng, Feng-Li Niu, Wen-Zhong Liu, Yao Shi, Lun-Gen Lu. Anti-inflammatory mechanism of oxymatrine in dextran sulfate sodium-induced colitis of rats. World J Gastroenterol 2005;11(31):4912-4915
2. Jin JH, Kim JS, Kang SS, Son KH, Chang HW, Kim HP. Anti-inflammatory and anti-arthritic activity of total flavonoids of the roots of Sophora flavescens. J Ethnopharmacol. 2010 Feb 17;127(3):589-95. Epub 2009 Dec 23.
4. Jiang S, Nakano Y, Rahman MA, Yatsuzuka R, Kamei C.: Effects of a Dictamnus dasycarpus T. extract on allergic models in mice. Biosci Biotechnol Biochem. 2008 Mar;72(3):660-5. Epub 2008 Mar 7.
5. Sun Y, Qin Y, Gong FY, Wu XF, Hua ZC, Chen T, Xu Q. Selective triggering of apoptosis of concanavalin A-activated T cells by fraxinellone for the treatment of T-cell-dependent hepatitis in mice.Biochem Pharmacol. 2009 Jun 1;77(11):1717-24. Epub 2009 Mar 14.
7. Tierra, Michael: The Way of Chinese Herbs – the most complete guide to natural healing and health with tranditional Chinese herbalism. Pocket Books, London. 1998. ISBN No. 0-671-89869-8
11. Andrews MD, Burns M.: Common tinea infections in children. Am Fam Physician. 2008 May 15;77(10):1415-20
12. Cohen AD, Wolak A, Alkan M, Shalev R, Vardy DA.: Prevalence and risk factors for tinea pedis in Israeli soldiers. Int J Dermatol. 2005 Dec;44(12):1002-5.
13. Carlos Nicolas Prieto-Granada, Alice Z.C. Lobo and Martin C. Mihm Jr.: Skin Infections. Diagnostic Pathology of Infectious Disease, 2010, Pages 519-616
14. Bristow IR, Spruce MC.: Fungal foot infection, cellulitis and diabetes: a review. Diabet Med. 2009 May;26(5):548-51.
15. Tosti A, Hay R, Arenas-Guzmán R.: Patients at risk of onychomycosis--risk factor identification and active prevention. J Eur Acad Dermatol Venereol. 2005 Sep;19 Suppl 1:13-6.
16. Demetrius J. Porche: Tinea Pedis: A Common Male Foot Problem. The Journal for Nurse Practitioners, Volume 2, Issue 3, March 2006, Pages 152-153
17. Daniel S. Loo: Cutaneous fungal infections in the elderly. Dermatologic Clinics, Volume 22, Issue 1, January 2004, Pages 33-50
18. T Kamihama, T Kimura, J-I Hosokawa, M Ueji, T Takase, K Tagami.: Tinea pedis outbreak in swimming pools in Japan. Public Health, Volume 111, Issue 4, July 1997, Pages 249-253
19. Gentles JC. The isolation of dermatophytes from the floors of communal bathing places. J Clin Pathol. Nov 1956;9(4):374-7
20. Rosenthal SA.: Tinea pedis isolates. Cutis. 2001 May;67(5 Suppl):20-1.
21. Pau M, Atzori L, Aste N, Tamponi R, Aste N.: Epidemiology of Tinea pedis in Cagliari, Italy. G Ital Dermatol Venereol. 2010 Feb;145(1):1-5.
22. Tohda C, Kakihara Y, Komatsu K, Kuraishi Y.: Inhibitory effects of methanol extracts of herbal medicines on substance P-induced itch-scratch response. Biol Pharm Bull. 2000 May;23(5):599-601.
23. Yamaguchi-Miyamoto T, Kawasuji T, Kuraishi Y, Suzuki H.: Antipruritic effects of Sophora flavescens on acute and chronic itch-related responses in mice. Biol Pharm Bull. 2003 May;26(5):722-4.
24. 高学敏主編《中藥學》中国中医药出版社, 2002年9月。
Gao Xue Min, ed. Chinese Medicine, China Chinese Medicine Publication. 2002. ISBN 7-80156-318-2/R.318