Effectiveness and safety of zinc oxide nanoparticle‐coated socks compared to uncoated socks for the prevention of pitted keratolysis: a double‐blinded, randomized, controlled trial study

Abstract

Background Pitted keratolysis (PK) and bromodosis have negative impacts on the quality of life especially for military personnel. The antibacterial efficacy and safety of zinc oxide nanoparticles (ZnO-NPs) make them a suitable additive for textiles. We aim to establish the ability of ZnO-NP-coated socks to prevent PK and bromodosis in a real-life setting.Materials and methods A double-blinded, randomized, controlled trial was conducted in January 2019. Naval cadets assigned to a 14-day field training course were randomly allocated to either a ZnO-NP-coated or an uncoated-sock group. They completed questionnaires evaluating behavioral risk factors and self-assessed foot odor levels using a visual analogue scale (VAS); intervention-blinded dermatologists also performed foot examinations. They reassessed their odor levels and had their feet re-examined upon completion of the training course. ResultsThe 148 cadets enrolled for the study were allocated to two groups of 74 each.The ZnO-NP-coated sock participants demonstrated significantly less PK development than uncoated socks (P = 0.05). There was a reduction of the foot odor levels in both groups, as measured by the VAS, without statistical difference. However, the uncoated sock group experienced more foot odor with a significantly greater negative effect on their daily lives (P = 0.04) than the ZnO-NP-coated sock group.Conclusions ZnO-NP-coated socks proved their efficacy in inhibiting the development of PK for military personnel.

Randomized controlled trial and cost‐effectiveness analysis: Comparing chlorhexidine scrub, ZnO‐nanoparticle socks, and their combination in pitted keratolysis treatment

“…21 Previous research has shown that ZnO-NP-coated socks can prevent PK among naval rating cadets after a 14-day training course. 16 However, the effectiveness of ZnO-NP-coated socks as a treatment for PK has not previously been reported. Our study is the first to demonstrate the ability of these socks to treat PK.…”

“…ZnO nanoparticles are known for their antibacterial properties, which mainly target the cytoplasmic membrane of bacteria 21 . Previous research has shown that ZnO‐NP‐coated socks can prevent PK among naval rating cadets after a 14‐day training course 16 . However, the effectiveness of ZnO‐NP‐coated socks as a treatment for PK has not previously been reported.…”

“…A previous study by Choopong and Sarayut developed antimicrobial socks by incorporating zinc oxide nanoparticles (ZnO‐NPs) into the textile material used to make the socks 15 . Another study confirmed the efficacy of ZnO‐NP‐coated socks in preventing PK among naval rating cadets 16 . However, ZnO‐NP‐coated socks are nearly twice as expensive as regular socks, and their cost‐effectiveness has yet to be reported.…”

“…15 Another study confirmed the efficacy of ZnO-NP-coated socks in preventing PK among naval rating cadets. 16 However, ZnO-NP-coated socks are nearly twice as expensive as regular socks, and their cost-effectiveness has yet to be reported.…”