Can Ciclopirox Shampoo Help Combat Fungal Infections Of The Feet?

Author(s): 
By Gary L. Dockery, DPM, FACFAS

Anecdotally, I have found that foot infections resulting from fungal and bacterial pathogens can be effectively controlled with ciclopirox shampoo. The process involves having the patient put a small amount of the shampoo on both feet and washing the lower leg and foot completely. Patients may do this at the beginning of a shower or at the end. They should rub in the shampoo with a small amount of water, leave the shampoo lather on for a few minutes and then rinse it off.
There are alternatives for patients who may have difficulty reaching their feet in the shower. One option is to use a soft-bristled back brush with a small amount of shampoo to wash both feet. Another option is to telling the patient to sit in an empty tub, wet his or her feet and then wash them with the shampoo as described. After a few minutes, the patient can rinse off the shampoo and dry his or her feet before leaving the tub. Patients should repeat this process daily in order to prevent the recurrence of bacterial and fungal foot infections.
Recommendations for reducing the incidence of reinfection by fungal or bacterial pathogens include: bathing daily and drying feet well between the toes; wearing socks that absorb moisture and wick it away from the skin; changing shoes daily; wearing sandals or shoes that allow air to circulate; and using antifungal and antibacterial agents to prevent recurrence.15,16
According to Gupta, et. al., ciclopirox offers advantages in treating tinea pedis with its antifungal, antibacterial, and antiinflammatory properties.10,11 In a double-blind, randomized, vehicle controlled study by Aly et. al., they found daily use of ciclopirox gel for four weeks effective and safe for treating moderate to severe tinea pedis interdigitalis.17 Ciclopirox in gel formula is indicated for the treatment of interdigital tinea pedis as well as seborrheic dermatitis of the scalp and tinea corporis.18
In addition to addressing issues of chronic nail trauma and avoiding irritants associated with paronychia and onycholysis, eliminating possible exacerbating pathogenic fungi with a broad-spectrum antifungal agent has been associated with positive treatment outcomes.19

Taking A Closer Look At Ciclopirox And Its Mechanism Of Action
Ciclopirox (Loprox) is currently indicated for topical treatment of a broad range of dermal fungal infections including: tinea pedis, tinea cruris, and tinea corporis due to Trichophyton rubrum, T. mentagrophytes, Epidermophyton floccosum, and Microsporum canis. It is also indicated for candidiasis due to Candida albicans and tinea versicolor due to Malassezia furfur.18 Ciclopirox also has in vitro activity against many gram positive and gram negative bacteria including Proteus species, Pseudomonas species, Proprionibacteria acnes, and Cornybacterium minutissimum.20 Researchers have also shown that ciclopirox may exhibit better antiinflammatory activity than 2.5% hydrocortisone.21

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