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Good Health and Bad Medicine:
 Care Of The Skin And Its Disorders - Part 1

 Care Of The Skin And Its Disorders - Part 2

 Care Of The Skin And Its Disorders - Part 3

 Care Of The Skin And Its Disorders - Part 4

 Care Of The Skin And Its Disorders - Part 5

 Care Of The Skin And Its Disorders - Part 6

 Care Of The Skin And Its Disorders - Part 7

 Care Of The Skin And Its Disorders - Part 8

 Care Of The Skin And Its Disorders - Part 9

 Feminine Hygiene

 Read More Articles About: Good Health and Bad Medicine

Care Of The Skin And Its Disorders - Part 9

( Originally Published 1940 )

Athlete's Foot

This is an infection caused by a microscopic fungus, and it is readily transmissible from one person to another. This fungus exists everywhere, and there are few adults in this country who have not at some time been exposed to infection and suffered from some slight discomfort as a result of the infection. Furthermore, numerous studies on school children, prisoners, college students and other large groups of individuals have shown that almost everyone constantly harbors colonies of living skin fungi. They can generally be found in the toenails and in dry or macerated scales between the toes.

Although the fungi are present in almost everyone's skin, not everybody suffers from the infection. A special sensitivity or loss of resistance to the fungus must exist before it can produce a disturbance of the skin—before the redness, scaling, blisters and itching can appear. Why some people be-tome sensitive and others remain resistant or immune is not yet clear. It is certain, however, that contact with sources of infection can disturb the delicate balance of immunity and permit the infection to spread and produce symptoms.

The most important sources of infection are places where people are likely to walk barefoot, such as the floors of showers, toilets, locker rooms and the approaches to the pool or beach. Disinfection of these places is almost impossible. In some schools and gymnasiums an attempt has been made to limit, if not prevent, additional infection by requiring people to step into a 1% solution of sodium hypochlorite (freshly prepared and changed every two or three days) on their way to and from the swimming pool or shower bath.

Although the fungus of "athlete's foot" is prevalent almost everywhere, and complete and permanent sterilization of the skin and nails of infected people (which means practically all adults) is beyond the present powers of science, there are, nevertheless, some measures that can be carried out which will tend to limit the infection or prevent the appearance of a troublesome eruption of the feet. The fungus grows in moisture, so that the first thing to do for prevention is to keep the skin as dry as possible. Perspiration can be combated by frequent change of stockings or socks and by use of dusting powders such as bismuth formic iodide, kaolin, zinc stearate or talcum. If the sweating is severe, a dusting powder of to% alum and 2% salicylic acid in talc or kaolin may be used. It should be dusted on freely in the morning and after bathing, on the feet, between the toes and in the shoes. After bathing, the feet should be dried as thoroughly as possible, especially between the toes. Lamb's wool or cigarette paper also may be kept between the toes during the day so as to absorb the moisture. The shoes should fit well and not cause pressure on the toes, as otherwise the skin is damaged and sweating is encouraged, thus permitting the fungus to grow.

Cotton—not silk—socks should be worn and changed daily.

Some specialists state that the insides of shoes and bedroom slippers usually contain the fungi and are frequently responsible for re-infection. Shoes can be disinfected by keeping a wad of gauze soaked in formaldehyde solution (i part of 40% formaldehyde to 5 parts of water) inside the shoes for one or two days. They should then be aired well for at least a day before use.

Besides these local measures suggested for prevention, there are certain general measures that are also helpful. People who are overweight usually tend to perspire freely. Free perspiration predisposes to skin infection by fungi. An important prophylactic measure, therefore, for those who are overweight is to reduce. Diabetes also favors infection and should be controlled as strictly as possible by competent medical advice.

In many people, despite all that they may do to avoid the disease, an eruption will appear and they will be plagued by the intense itching of the toes and feet characteristic of the disease. In the acute stage, when there is blistering, weeping and redness, the best treatment is wet dressings or soaking of the feet in Potassium Permanganate Solution (one 5-grain tablet to a quart of water). The soaking should be performed twice daily. The solution should be changed each day. If the disease is mild, and the itching is only slight, it may be sufficient to swab the toes twice daily with cotton soaked in Lugol's Solution (U.S.P.) or tincture of merphenyl borate. The swabbing should be done in the morning on arising and before retiring. Following soaking or swabbing in the morning, the toes should be freely dusted with powder, and lamb's wool or cigarette paper inserted between the toes.

Salves and ointment should not be used during the acute stage, as they can cause an aggravation of the disease. Whitfield's Ointment, a popular remedy with many people, should not be used except upon the advice of a physician, since a severe irritation of the skin can occur. Dr. Marion B. Sulzberger warns that remedies must be used with great caution. He and other dermatologists have seen severe eczemas developing from mild cases of athlete's foot because of use of proprietary preparations. He warns that in "so many cases .. . injudicious self-medication is aggravating and prolongs mild and perhaps otherwise self-limited fungous eruptions."

Almost all proprietary remedies, liquids and salves, contain salicylic acid. This drug is employed as a sovereign remedy for fungus infections. It causes peeling of the skin, thereby causing the throwing off of the germs. Since proprietary remedies are not compounded to fit individual requirements, and since many people are sensitive to salicylic acid, it is wise to avoid such remedies and to rely upon soaks of potassium permanganate, or swabbing with Lugol's Solution or tincture of merphenyl borate. If none of these remedies helps, or if the disease becomes worse, a physician should be consulted. Chronic and severe cases in which the skin is much thickened or inflamed and those in which the nails are involved also require medical care.

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