The Role of Shoe and Sock Sanitization in the Management of Superficial Fungal Infections of the Feet

Abstract

Because of the ubiquitous nature of dermatophytes and a lack of an adaptive immune response in the nail plate, recurrence and relapse rates associated with superficial fungal infections are high (10%-53%). Cured or improved dermatophytosis patients could become reinfected if exposed to fungal reservoirs, such as an infected shoe, sock, or textile. To prevent this, footwear, sock, and textile sanitization methods can be used. To provide insight into effective sanitization options, the focus of this article is to review footwear, sock, and textile sanitization studies conducted throughout history (1920-2016). Thirty-three studies are covered in this review, encompassing techniques ranging from formaldehyde fumigation and foot powder application, to more modern approaches such as UV light and silver-light irradiation technologies. Older sanitization methods (eg, boiling, use of chlorine and salts) are quite limited in their practicality, as they can result in health complications and ruin shoe integrity. Newer approaches to shoe and sock sanitization, such as ozone application and UV irradiation, have shown very promising results. Further research is still needed with these modern techniques, as knowledge gaps and cost prevent the creation of standardized parameters for successful use. By combining sanitization methods with other preventative measures, protection against reinfection may be enhanced.

Onychomycosis in the 21st Century: An Update on Diagnosis, Epidemiology, and Treatment

“…138 Laundering socks at high temperatures (60°C for 45 minutes) and using ozone gas to sanitise footwear could also help limit exposure to fungal reservoirs. 138,139 In addition, to help prevent onychomycosis from spreading, immediate family members can also be treated. 138 Preventative methods can be incorporated by high-risk patients such as organ transplant recipients, diabetics, HIV-positive individuals, and dialysis patients as well as infection-free individuals.…”

A Paradigm Shift in the Treatment and Management of Onychomycosis

“…Continued or re-exposure to fungal reservoirs, such as infected shoes, socks, or textiles, can contribute to reinfection (Fig. 3) [72][73][74][75][76][77]. Dermatophytes are known to colonize and survive for a long duration in footwear worn by patients with onychomycosis and tinea pedis [78].…”

“…Dermatophytes are known to colonize and survive for a long duration in footwear worn by patients with onychomycosis and tinea pedis [78]. Fungi may use sweat and skin cells trapped in footwear as a source of nutrients to create and maintain fungal reser-voirs [72,79,80]. Textiles such as towels, sheets, and blankets are also potential fungal reservoirs [72,79].…”

“…Fungi may use sweat and skin cells trapped in footwear as a source of nutrients to create and maintain fungal reser-voirs [72,79,80]. Textiles such as towels, sheets, and blankets are also potential fungal reservoirs [72,79]. Contaminated socks and shoes can act as a source of reinfection when worn by patients after achieving cure with antifungal therapy [81].…”

Microemulsification of essential oils for the development of antimicrobial and mosquito repellent functional coatings for textiles

“…This article is protected by copyright. All rights reserved or prophylaxis for skin infections, such as tinea pedis, caused by the dermatophyte Trichophyton rubrum (Gupta and Versteeg 2019), and atopic dermatitis, which is associated with Staphylococcus aureus colonization (Srour et al 2019).…”