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Abstract

Background: Feet odor is a common sociomedical problem that affects the feet of human beings of different etiological factors. Multiple modalities of therapy have been used in the treatment of feet odor. Objective: To evaluate the efficacy and safety of topical 15% zinc sulfate solution in the treatment of feet odor. Patients and Methods: This single blind, placebo, controlled therapeutic study was conducted at the Department of Dermatology-Baghdad Teaching Hospital, from March 2010 to July 2011. A total of 108 (88 males and 20 females) patients with feet odor were enrolled and were divided into 2 groups: Group A: treated with 15% zinc sulfate solution. Group B: treated with distilled water as placebo control group. Full history and examination were carried out including all relevant points. Four scoring had been used to assess the severity of odor in patients with bared feet Score 0: no odor, Score 1: mild odor, Score 2: moderate odor and Score 3: severe odor. Zinc sulfate solution 15% was applied to sole and toe webs once daily for two weeks, three times per week for next two weeks and followed by single application weekly as maintenance after clearance of odor for two months. Patients were seen every two weeks to be examined and to score the odor again and to record side effects. Results: Group A: Fifty patients completed the study, their ages ranged from 8 - 68 (33 + 14.5) years, while the duration of the disease ranged from 1 - 180 (7.22 + 38.24) months. The complete clearance of feet odor after two weeks of therapy was 35 (70%) patients which was similar to two months maintenance therapy 35 (70%) and was highly statistically significant (p value = 0.0000001). Group B: Fifty patients received the placebo solution, their ages ranged from 16 - 75 (32.6 + 13.4) years, while the duration of the disease ranged from 1 - 180 (43.7 + 47.65) months. The complete clearance of feet odor was in 1 (2%) patient after two weeks therapy and after two months maintenance therapy. No side effects were recorded. Conclusions: Topical 15% zinc sulfate solution had an effective therapeutic and prophylactic action against feet odor.
Journal of Cosmetics, Dermatological Sciences and Applications, 2013, 3, 203-208
http://dx.doi.org/10.4236/jcdsa.2013.33031 Published Online September 2013 (http://www.scirp.org/journal/jcdsa) 203
Topical 15% Zinc Sulfate Solution Is an Effective
Therapy for Feet Odor*
Khalifa E. Sharquie1#, Adil A. Noaimi2, Saad D. Hameed3
1Scientific Council of Dermatology & Venereology-Iraqi Board for Medical Specializations, Department of Dermatology & Vene-
reology, College of Medicine, University of Baghdad, Baghdad, Iraq; 2Head of Department of Dermatology & Venereology, College
of Medicine, University of Baghdad, Baghdad, Iraq; 3Department of Dermatology and Venereology, Baghdad Teaching Hospital,
Medical City, Baghdad, Iraq.
Email: #ksharquie@ymail.com, adilnoaimi@yahoo.com, saadhameed9@yahoo.com
Received May 12th, 2013; revised June 15th, 2013; accepted June 23rd, 2013
Copyright © 2013 Khalifa E. Sharquie et al. This is an open access article distributed under the Creative Commons Attribution Li-
cense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Feet odor is a common sociomedical problem that affects the feet of human beings of different etiological
factors. Multiple modalities of therapy have been used in the treatment of feet odor. Objective: To evaluate the efficacy
and safety of topical 15% zinc sulfate solution in the treatment of feet odor. Patients and Methods: This single blind,
placebo, controlled therapeutic study was conducted at the Department of Dermatology-Baghdad Teaching Hospital,
from March 2010 to July 2011. A total of 108 (88 males and 20 females) patients with feet odor were enrolled and were
divided into 2 groups: Group A: treated with 15% zinc sulfate solution. Group B: treated with distilled water as placebo
control group. Full history and examination were carried out including all relevant points. Four scoring had been used to
assess the severity of odor in patients with bared feet Score 0: no odor, Score 1: mild odor, Score 2: moderate odor and
Score 3: severe odor. Zinc sulfate solution 15% was applied to sole and toe webs once daily for two weeks, three times
per week for next two weeks and followed by single application weekly as maintenance after clearance of odor for two
months. Patients were seen every two weeks to be examined and to score the odor again and to record side effects.
Results: Group A: Fifty patients completed the study, their ages ranged from 8 - 68 (33 + 14.5) years, while the duration
of the disease ranged from 1 - 180 (7.22 + 38.24) months. The complete clearance of feet odor after two weeks of ther-
apy was 35 (70%) patients which was similar to two months maintenance therapy 35 (70%) and was highly statistically
significant (p value = 0.0000001). Group B: Fifty patients received the placebo solution, their ages ranged from 16 - 75
(32.6 + 13.4) years, while the duration of the disease ranged from 1 - 180 (43.7 + 47.65) months. The complete
clearance of feet odor was in 1 (2%) patient after two weeks therapy and after two months maintenance therapy. No side
effects were recorded. Conclusions: Topical 15% zinc sulfate solution had an effective therapeutic and prophylactic
action against feet odor.
Keywords: Feet Odor; Topical; Zinc Sulfate
1. Introduction
Feet odor is a common socio-medical problem, its etio-
pathogenesis is not well elucidated but there are multi-
factorial agents like sweating, bacterial, fungal infections,
shoes and socks [1].
The most common type of bacteria of feet is Brevibac-
teria which is considered a major cause of feet odor be-
cause they ingest dead skin on the feet and, in the process,
convert amino acid methionine into methanethiol, which
has a sulfuric aroma and cheesy odor. Also Propioni-
bacteria which thrive in the ducts of adolescent and adult
sebaceous glands produce propionic acid as result of a
breakdown product of amino acids, it has vinegar-like
odor. Staphylococcus epidermidis also play a role in feet
odor by degradation of leucine present in sweat and
changed it to isovaleric acid, which give strong cheesy
odor [2].
There are many systemic drugs like anticholinergic
(glycopyrrolate) [3] and topical antibacterial drugs like
erythromycin, clindamycin and benzoyl peroxide have
been used in the treatment of feet odor [4]. Also, topical
anti-perspiration agents like aluminum salts and ionto-
*Disclosure: This study is an independent study and not funded by any
drug company.
#Corresponding author.
Copyright © 2013 SciRes. JCDSA
Topical 15% Zinc Sulfate Solution Is an Effective Therapy for Feet Odor
204
phoresis have been used as therapeutic measures [5,6].
Zinc is an essential trace element that involved in more
than 300 metalloenzymes, including the antioxidant en-
zyme, superoxide dismutase, and it affects their conformi-
ty, stability and activity. [7] Zinc sulfate either topical, in-
tralesional or systemic has been used successfully in an
effective agent for the treatment of many dermatological
problems like acne [8], recurrent aphthous stomatitis [9],
cutanous leishmaniasis [10,11], plane warts [12], viral
warts [13,14], pityriasis versicolor [15], superficial fun-
gal infections [16]. It works through its different modes
of action which are antioxidant, antiviral, antidermato-
phyte, astringent, immunomodulator and cytotoxic in
high concentration [17].
For this reasons the present study was designed to
evaluate the efficacy and safety of topical 15% zinc sul-
fate solution in the treatment of feet odor.
2. Patients and Methods
This single blind placebo controlled therapeutic trial us-
ing topical 15% zinc sulfate solution in the treatment of
feet odor was carried out in Department of Dermatology
and Venereology, Baghdad Teaching Hospital from
March 2010 to July 2011. One hundred eight (88 males
and 20 females) patients with feet odor were included in
this work. All patients attending the Department of Der-
matology and Venereology complained from feet odor
were included regardless the age and sex.
2.1. Exclusion Criteria
Patients with feet odor with associated tinea pedis, pa-
tients had received any therapy for feet odor for last two
months, patients with feet complication of diabetes mel-
litus or atherosclerosis, feet deformity, malformation and
patients on immunosuppressive drugs were excluded.
Full history and examination was performed including:
age, sex, marital status, residence, social status, job, his-
tory of feet odor and family history, duration, type, site,
associated with axillary odor, palmoplanter hyperhidrosis,
seasonal variations and aggravating factors. Also, history
of type of socks, daily change and type of shoes were
taken from all cases.
Formal consent was taken from each patient after and
full explanation about the nature, course of treatment.
The ethical approval was obtained from the Scientific
Council of Dermatology and Venereology-Arab Board
for Medical Specializations,
Patients were instructed for cleaning and drying the
feet and apply the solution to the sole and toe webs as
follow: single daily for two weeks, three times per week
for other two weeks then single application weekly as
maintenance therapy for two months and at each visit the
following scoring was done:
Scoring of feet odor (Sharquie
s scoring):
Four scoring had been used to assess the severity of
odor in patient with bared feet:
Score 0: No odor.
Score 1: Mild odor as it is smelt by patient only when
he puts his finger in between toe webs and on his sole.
Score 2: Moderate odor as it is smelt by examining
doctor in close contact with patient.
Score 3: Severe odor as the odor is smelt by surround-
ding people.
This score has been used for first time for such studies.
Follow up of the patients was done every two weeks to
assess the response to therapy, to do scoring of odor
again and to record any side effects.
2.2. Preparation and Treatment Plan
Fifteen percent (W/V) zinc sulfate solution is prepared
by dissolving 15 grams of zinc sulfate crystals (ZnSO4
7H2O = 287.54, by Thomas Bekar India) in 100 ml of
distilled water, and kept in clean container at the room
temperature of hospital. Patients were asked to apply this
preparation on their sole and toe webs using cotton appli-
cator.
Statistical analysis was used in all parameters. Stu-
dent’s t test used for comparison of means by analysis of
variance scoring and Chi Square used to compare the
changes that result from the treatment.
P value of less than 0.05 is considered to be signifi-
cant.
3. Results
Hundred patients completed the therapy, while 8 patients
defaulted for unknown reasons.
Group A: Fifty patients 8 (16%) females and 42 (84%)
males included in this group. Their ages ranged from 8 -
68 years with a mean ± SD of 33 ± 14.5 years; while the
duration of the disease ranged from 1 - 180 months with
a mean ± SD of 7.22 ± 38.24 months.
Seven (14%) patients had axillary odor in addition to
feet odor while 8 (16%) patients had positive family his-
tory of feet odor. History of palmoplanter hyperhydrosis
was found in 6 (12%) patients, while 44 (88%) patients
had associated plantar hyperhydrosis. The quality of odor
was cheesy in 33 (66%) patients and vinegar odor in 17
(34%) cases. Twenty one (42%) of patients had seasonal
variation and was worse odor during summer time, while
15 (30%) cases had habit of drying of their feet after
washing.
The types of socks were nylon in 20 (40%), cotton 17
(34%) and wool 8 (16%) patients. History of daily
change of socks was present in 28 (56%) patients. The
types of shoes were leather 33 (66%), sandal 12 (24%),
and rubber 5 (10%) patients.
Copyright © 2013 SciRes. JCDSA
Topical 15% Zinc Sulfate Solution Is an Effective Therapy for Feet Odor
Copyright © 2013 SciRes. JCDSA
205
The aggravating factors of feet odor were: hyperhy-
drosis in 31 (62%), occlusive feet wear in 9 (18%) and
nylon socks 9 (18%) patients (Table 1).
The localization of feet odor in patients as follow: toe
webs in 22 (44%), toe webs and sole in 27 (54%), sole
alone in 1 (2%) patient.
Scoring of feet odor before therapy was Score 1 in 21
Table 1. Description of study groups with feet odor.
Group (A) Group (B)
Number (%) Number (%)
1 Family history 8 16 10 20
2 Axillary odor 7 14 12 24
3 Palmoplantar hyperhydrosis 6 12 5 10
4 Type of odor
Cheesy odor 33 66 39 78
Vinegar odor 17 34 11 22
5 Plantar hyperhydrosis 44 88 39 78
6 Season variation 21 42 20 40
7 Drying of feet 15 30 20 40
8 Types of socks
Nylon 21 44 24 48
Cotton 17 34 17 34
Wool 8 16 5 10
Daily changing 28 56 26 52
9 Types of shoes
Leather 33 66 36 72
Sandal 12 24 11 22
Rubber 5 10 3 6
10 Aggravating factors
Hyperhydrosis 31 62 20 40
Occlusive footwear 9 18 13 26
Nylon socks 9 18 15 30
(42%) patients, Score 2 11 (22%) patients and Score 3 18
(36%) patients (Table 2).
Group B: Fifty-three patients with feet odors were in-
cluded in this study. Fifty patients of feet odor had re-
ceived the placebo solution (distilled water), consisted
from 10 (20%) females and 40 (80%) males. Their ages
ranged from 16 - 75 years with a mean ± SD of 32.6 ±
13.4 years while the duration of the disease ranged from
1 - 180 months with a mean ± SD of 43.7 ± 47.65
months.
Twelve (24%) of patients had axillary odor while 10
(20%) patients had positive family history of feet odor.
History of palmoplanter hyperhydrosis was found in 5
(10%) patients and 39 (78%) of patients had plantar hy-
perhydrosis.
The quality of odor was cheesy odor in 39 (78%) pa-
tients and vinegar odor in 11 (22%) patients. Twenty
(40%) of patients had seasonal variation with worse odor
during summer time. Twenty (40%) cases had habit dry-
ing of feet after washing.
The types of socks were nylon in 24 (48%) patients,
cotton 17 (34%) and wool 5 (10%) patients. History of
daily change of socks was present in 26 (52%) patients.
The types of shoes were leather in 36 (72%), sandal 11
(22%) and rubber 3 (6%) patients.
The aggravating factors of feet odor were hyperhy-
drosis in 20 (40%) patients, occlusive feet wear 13 (26%)
and nylon socks 15 (30%) patients (Table 1).
Site distribution of feet odor patients was mainly on
toe webs 21 (44%) and sole alone in 3 (6%) patients, toe
webs and sole 26 (52%) patients.
Scoring of feet odor before therapy was Score 1 in 22
(44%) patients, Score 2 in 9 (18%) patients and Score 3
in 19 (38%) patients (Table 3).
The Clinical Response
Group A: Scoring of feet odor after 2 weeks of therapy
was score 0 in 35 (70%) patients, score 1 in 12 (24%) pa-
tients, score 2 in 2 (4%) and score 3: 1 (2%) patient (Ta-
ble 2) (t test = 121.22) (p value = 0.0000001).
While scoring of two months maintenance therapy as
follow:
Score 1 (21) patients changed into score 0 in 18 (86%)
Table 2. Scoring of feet odor (Group A) before and after 2 weeks of therapy with topical 15% zinc sulfate solution.
% total % Score 3 (18)% Score 2 (11)% Score 1 (21) Scoring Scoring before therapy
70 35 39 7 91 10 86 18 Score 0
24 12 44 8 9 1 14 3 Score 1
4 2 11 2 0 0 0 0 Score 2
2 1 6 1 0 0 0 0 Score 3
Scoring after
therapy
p value = 0.0000001.
Topical 15% Zinc Sulfate Solution Is an Effective Therapy for Feet Odor
206
patients and no change in 3 (14%) patients.
Score 2 (11) patients changed into score 0 in 10 (91%)
patients and score 1 in 1 (9%) patient. Score 3 (18) pa-
tients changed into score 0 in 7 (39%) patients, score 1 in
8 (44%) patients; score 2 in 2 (11%) patients and no
change in 1 (6%) patient.
So the response to two months maintenance therapy
could be summarized as follow: 35 (70%) patients had
complete clearance which was similar to that after 2
weeks therapy, 11 (22%) patients with partial clearance
and 8 (16%) patients no change in odor (Table 4 & Fig-
ure 1) (Chi square = 74.60, degree of freedom = 2, p
value = 0.0000001).
No side effects were recorded apart from slight irrita-
tion in the early course of treatment which did not re-
quire discontinuing the treatment
Group B: Scoring of feet odor after 2 weeks of therapy
with distilled water was: score 0 in 1 (2%) patient, score
1 in 22 (44%) patients, score 2 in 9 (18%) patients and
score 3 in 18 (36%) patients (Table 3) (t test = 0.18) (p
value = 0.67).
While scoring of therapy after two months as follow:
Score 1 (22) patients changed into score 0 in 1 (4.5%)
patient and no change in 21 (95.5%) patients. Score 2 (9)
changed into Score 1 in 1 (11%) patient and no change in
8 (89%) patients. Score 3 (19) changed into Score 2 in 1
(5%) patient but no change in 18 (95%) patients.
So the response to therapy after two months could be
summarized as follow: 1 (2%) patient had complete clea-
rance, 2 (4%) patients with partial clearance and 47 (94%)
patients showed no change in odor (Tables 4-6 & Figure
1).
4. Discussion
There are many etiological factors involved in feet odor
like wearing shoes, hyperhydrosis, maceration of skin,
proliferation of bacteria and fungal infections. All these
factors encourage bacteria species like Staphylococcus
epidermidis, Propionibacteria and Brevibacteria to pro-
duce volatile short chain free fatty acid which gives
characteristic odor like cheesy and vinegar [2].
Table 3. Scoring of feet odor (Group A) after 2 months maintenance therapy with topical 15% zinc sulfate solution.
% total % Score 3 (18)% Score 2 (11) % Score 1 (21) Scoring Scoring before therapy
70 35 39 7 91 10 86 18 Score 0
28 14 55.5 10 9 1 3 14 Score 1
2 1 5.5 1 0 0 0 0 Score 2
0 0 0 0 0 0 0 Score 3
Scoring after
therapy
0
p value = 0.0000001.
Table 4. Scoring of feet odor (Group B) before and after 2 weeks of therapy with placebo.
% total % Score 3 (19) % Score 2 (9) % Score 1 (22) Scoring Scoring before therapy
2 1 0 0 0 0 4.5 1 Score 0
42 21 0 0 0 0 21 95.5 Score 1
18 9 0 0 100 9 0 0 Score 2
38 19 100 19 0 0 0 Score 3
Scoring after
therapy
0
p value = 0.99.
0
10
20
30
40
50
Complete
clearance Partial clearance Nochange in
odor
Group A
Group B
No.
of patients
Figure 1. Clinical responses among patients with feet odor following 2 months after therapy in group A and group B.
Copyright © 2013 SciRes. JCDSA
Topical 15% Zinc Sulfate Solution Is an Effective Therapy for Feet Odor 207
Table 5. Scoring of feet odor (Group B) after 2 months maintenance therapy with placebo.
% total % Score 3 (19) % Score 2 (9)% Score 1 (22) Scoring Scoring before therapy
2 1 0 0 0 0 4.5 1 Score 0
44 22 0 0 11 1 21 95.5Score 1
18 9 5 1 89 8 0 0 Score 2
36 18 95 18 0 0 0 Score 3
Scoring after
therapy
0
P value = 0.992.
Table 6. Showing clinical responses among patients with
feet odor following 2 months maintenance therapy.
Feet odor Complete clearance
No. (%) Partial clearance
No. (%) No change in
odor No. (%)
Group (A) 35 (70%) 11 (22%) 4 (8%)
Group (B) 1 (2%) 2 (4%) 47 (94%)
P value = 0.0000001.
Feet odor is common problem among Iraqi population
especially in summer time. This problem practically is
seen among people wearing close shoes and specifically
among army people. From our daily practice we noticed
that feet odor has personal diathesis as some people pro-
duce odor while the others not and both of them wear
closed shoes and this was confirmed by the present work
as family history was positive in 20% of patients.
There are many therapies which had been used in con-
trolling feet odor, but according to our practice none of
these are satisfactory topical antibacterial like erythro-
mycin, clindamycin and benzyl peroxide [4] and topical
antiperspirant agents (aluminum salts and iontophoresis)
[5,6].
The present work showed that zinc sulfate is an effect-
tive mode of therapy in treatment of feet odor as 70% of
patients had complete clearance after two weeks. This
70% clearance continued after two months of mainte-
nance therapy and this was related to once week applica-
tion of zinc sulfate. This was in comparison with 2%
complete clearance treated by placebo.
The mechanism of action of topical zinc sulfate is not
well elucidated but most probably related to its multiple
effects like antibacterial, antifungal and anti-perspirant
actions.
To the best of our knowledge, this is first study carried
out and showed that topical 15% zinc sulfate solution is
an effective clearance of feet odor.
To keep the clearance of feet odor, we strongly advise
patients to keep maintenance therapy through once ap-
plication every week as shown in the present study.
Scoring of feet odor is difficult to be carried out but
fortunately we invented a new scoring system that pro-
ved its practicality by the present work.
In conclusion, topical 15% zinc sulfate solution proved
it’s effectiveness in clearance of feet odor in 70% of pa-
tients and it had both therapeutic and prophylactic ac-
tions.
REFERENCES
[1] F. Kanda, E. Yagi, M. Fukuda, K. Nakajima, T. Ohta and
O. Nakata, “Elucidation of Chemical Compounds Re-
sponsible for Foot Malodor,” British Journal of Derma-
tology, Vol. 122, No. 6, 1990, pp. 771-776.
doi:10.1111/j.1365-2133.1990.tb06265.x
[2] K. Ara, M. Hama, S. Akiba, K. Koike, K. Okisaka, T.
Hagura, T. Kamiya and F. Tomita, “Foot Odor Due to
Microbial Metabolism and Its Control,” Canadian Jour-
nal of Microbiology, Vol. 52, No. 4, 2006, pp. 357-364.
doi:10.1139/w05-130
[3] M. Connolly and D. de Berker, “Management of Primary
Hyperhidrosis,” American Journal of Clinical Dermatol-
ogy, Vol. 4, No. 10, 2003, pp. 681-697.
doi:10.2165/00128071-200304100-00003
[4] P. K. Lee, M. T. Zipoli, A. N. Weinberg, M. N. Swartz
and R. A. Johnson, “Fitzpatrick’s Dermatology in Gen-
eral Medicine,” 6th Edition, McGraw-Hill, New York,
2003.
[5] S. A. McWilliams, I. Montgomery, D. McEwan Jenkin-
son, H. Y. Elder, S. M. Wilson and A. M. Sutton, “Effects
of Topically Applied Antiperspirant on Sweat Gland
Function,” British Journal of Dermatology, Vol. 117, No.
5, 1987, pp. 617-626.
doi:10.1111/j.1365-2133.1987.tb07494.x
[6] Y. Karakoc, E. H. Aydemir, M. T. Kalkan and G. Unal,
“Safe Control of Palmoplantar Hyperhidrosis with Direct
Electrical Current,” International Journal of Dermatology,
Vo. 41, No. 9, 2002, pp. 602-605.
doi:10.1046/j.1365-4362.2002.01473.x
[7] A. S. Prasad, “Zinc: The Biology and Therapeutic of an
Ion,” Annals of Internal Medicine, Vo. 125, No. 2, 1996,
pp. 142-143.
doi:10.7326/0003-4819-125-2-199607150-00012
[8] K. E. Sharquie, A. A. Noaimi and M. M. Al-Salih,
“Topical Therapy of Acne Vulgaris Using 2% Tea Lotion
in Comparison with 5% Zinc Sulphate Solution,” Saudi
Medical Journal, Vol. 29, 2008, pp. 1757-1761.
[9] K. E. Sharquie, R. A. Najim, R. K. Al-Hayani, A. A.
Al-Nuaimy and D. M. Maroof, “The Therapeutic and
Prophylactic Role of Oral Zinc Sulphate in Management
of Recurrent Aphthous Stomatitis (RAS) in Comparison
Copyright © 2013 SciRes. JCDSA
Topical 15% Zinc Sulfate Solution Is an Effective Therapy for Feet Odor
208
with Dapsone,” Saudi Medical Journal, Vol. 29, No. 5,
2008, pp. 734-738.
[10] K. E. Sharquie and K. Al-Azzawi, “Intralesional Therapy
of Cutaneous Leishmaniasis with 2% Zinc Sulphate Solu-
tion,” Pan-Arab League of Dermatologists, Vol. 7, 1996,
pp. 41-46.
[11] K. E. Sharquie, R. A. Najim, D. J. Al-Timimi, I. B. Far-
jou, “Oral Zinc Sulphate in the Treatment of Acute Cuta-
neous Leishmaniasis,” Clinical and Experimental Der-
matology, Vol. 26, No. 1, 2001, pp. 21-26.
doi:10.1046/j.1365-2230.2001.00752.x
[12] K. E. Sharquie, A. A. Khorsheed and A. A. Al-Nuaimy,
“Topical Zinc Sulphate Solution for Treatment of Viral
Warts,” Saudi Medical Journal, Vol. 28, No. 9, 2007, pp.
1418-1421.
[13] K. E. Sharquie and A. A. Al-Nauaimy, “Treatment of
Viral Warts by Intralesional Injection of Zinc Sulphate,”
Annals Saudi Medical, Vol. 22, No. 1-2, 2002, pp. 26-28.
[14] F. Al-Gurairi, M. Al-Waiz and K. E. Sharquie, “Oral Zinc
Sulphate in the Treatment of Recalcitrant Viral Warts:
Randomized Placebo Controlled Trial,” British Journal
Dermatology, Vol. 146, No. 3, 2002, pp. 423-431.
doi:10.1046/j.1365-2133.2002.04617.x
[15] K. E. Sharquie, W. S. Al-Dori, I. K. Sharquie and A. A.
Noaimi, “Treatment of Pityriasis Versicolor with Topical
15% Zinc Sulphate Solution,” Iraqi Journal of Commu-
nity Medicine, Vol. 21, No. 1, 2008, pp. 61-62.
[16] I. G. Al-Tereihi, “Topical 10% Zinc Sulphate Solution in
the Treatment of Superficial Fungal Infections,” A Thesis
Submitted to the Iraqi Board for Medical Specializations,
Dermatology and Venereology, 2006.
[17] K. E. Sharquie, A. A. Noaimi and N. O. Kadir, “Topical
Therapy of Xeroderma Pigmentosa with 20% Zinc Sul-
phate Solution,” Iraqi Postgraduate Medical Journal, Vol.
7, No. 3, 2008, pp. 231-236.
Copyright © 2013 SciRes. JCDSA
... [19] Bromhidrosis Topical Topical 15% zinc sulphate solution was efficacious in management of bromhidrosis and foot malodour. [20,21] Pityriasis versicolor Topical Topical 15% zinc sulphate solution applied once daily for 3 weeks was effective in pityriasis versicolor. [22] Acne vulgaris Topical Topical 5% zinc sulphate was effective in mild to moderate acne. ...
... Topical antibacterials and antiperspirants are the treatment of choice along with maintenance of good hygiene. Owing to its antibacterial action, topical Dermatology Research and Practice 5 zinc sulphate has been tried and found effective in the management of axillary bromhidrosis and plantar malodor [20,21]. Sharquie et al. [21] in a single blinded placebo controlled therapeutic trial studied the efficacy of 15% zinc sulphate solution for foot malodor. ...
... Owing to its antibacterial action, topical Dermatology Research and Practice 5 zinc sulphate has been tried and found effective in the management of axillary bromhidrosis and plantar malodor [20,21]. Sharquie et al. [21] in a single blinded placebo controlled therapeutic trial studied the efficacy of 15% zinc sulphate solution for foot malodor. Zinc sulfate solution 15% was applied to sole and toe-webs once daily for two weeks and three times per week for next two weeks followed by single application weekly as maintenance after clearance of odor for two months. ...
Article
Full-text available
Zinc, both in elemental or in its salt forms, has been used as a therapeutic modality for centuries. Topical preparations like zinc oxide, calamine, or zinc pyrithione have been in use as photoprotecting, soothing agents or as active ingredient of antidandruff shampoos. Its use has expanded manifold over the years for a number of dermatological conditions including infections (leishmaniasis, warts), inflammatory dermatoses (acne vulgaris, rosacea), pigmentary disorders (melasma), and neoplasias (basal cell carcinoma). Although the role of oral zinc is well-established in human zinc deficiency syndromes including acrodermatitis enteropathica, it is only in recent years that importance of zinc as a micronutrient essential for infant growth and development has been recognized. The paper reviews various dermatological uses of zinc.
... Foot odour can be caused by etiological factors such as wearing closed shoes, hyperhidrosis (Connolly and de Berker, 2003), the maceration of skin, fungal infections and the proliferation of bacteria (Sharquie et al., 2013). The Brevibacterium species are specifically related to foot odour (Sharquie et al., 2013;Van Vuuren et al., 2014). ...
... Foot odour can be caused by etiological factors such as wearing closed shoes, hyperhidrosis (Connolly and de Berker, 2003), the maceration of skin, fungal infections and the proliferation of bacteria (Sharquie et al., 2013). The Brevibacterium species are specifically related to foot odour (Sharquie et al., 2013;Van Vuuren et al., 2014). Brevibacterium species ingest dead skin on the feet which leads to the conversion of methionine (an amino acid) into methanethiol, which is responsible for the sulfuric aroma and cheesy odour (Sharquie et al., 2013). ...
... The Brevibacterium species are specifically related to foot odour (Sharquie et al., 2013;Van Vuuren et al., 2014). Brevibacterium species ingest dead skin on the feet which leads to the conversion of methionine (an amino acid) into methanethiol, which is responsible for the sulfuric aroma and cheesy odour (Sharquie et al., 2013). Staphylococcus aureus and S. epidermidis are Gram-positive micro-organisms; they are common skin pathogens and commensals (Van Vuuren et al., 2014). ...
... Thirty-five of the 50 (70%) patients who completed the study showed complete clearance of foot odor compared to only 1 (2%) subject in the placebo group and the difference was statistically significant. 17 Pityriasis Versicolor: Pityriasis versicolor (PV), also known as tinea versicolor, is a chronic and benign superficial fungal skin infection caused by Malassezia yeasts. Zinc pyrithione 1% is a proven treatment modality for pityriasis versicolor. ...
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Zinc is a micronutrient used over the years for many dermatological conditions such as infections, inflammatory dermatoses, pigmentary disorders, neoplasias etc. It is used in both elemental as well as salt form, either in topical or in oral form as a therapy. An average adult weighing 70 kg has a body zinc content of 1.4–2.3 gm. The role of zinc in deficiency disorder like acrodermatitis enteropathica is already established and used widely as treatment. Zinc has been identified as effective in the treatment of various disorders but it cannot be used as the replacement for proven first line treatment. Zinc can be used as adjuvant therapy in many dermatological disorders. This is a narrative review where various use of zinc as therapy in dermatological disorders is highlighted.
... Over the years, Zn and its compounds like ZnO have been utilized as a therapeutic modality in treating some infectious skin diseases such as viral warts [29][30][31][32][33], cutaneous leishmaniasis [34,35], leprosy [36,37], tinea pedis [38], bromhidrosis [39] and pityriasis versicolor [40]. HSV-1 and 2 are two members of the herpesviridae family and responsible for orolabial and genital lesions, which are associated with high rate of recurrences. ...
Article
Aim: We aimed to determine the possible inhibitory effects of zinc oxide nanoparticles (ZnO-NPs) and polyethylene glycol (PEG)-coated ZnO-NPs (ZnO-PEG-NPs) on herpes simplex virus type 1 (HSV-1). Materials & methods: PEGylated ZnO-NPs were synthesized by the mechanical method. Antiviral activity was assessed by 50% tissue culture infectious dose (TCID50) and real-time PCR assays. To confirm the antiviral activity of ZnO-NPs on expression of HSV-1 antigens, indirect immunofluorescence assay was also conducted. Results: 200 μg/ml ZnO-PEG-NPs could result in 2.5 log10 TCID50 reduction in virus titer, with inhibition rate of approximately 92% in copy number of HSV-1 genomic DNA. Conclusion: ZnO-PEG-NPs could be proposed as a new agent for efficient HSV-1 inhibition. Our results indicated that PEGylation is effective in reducing cytotoxicity and increasing antiviral activity of nanoparticles.
... Foot odor is a type of body odor that affects the feet of humans and is generally considered to be an unpleasant smell. This problem practically is seen among people wearing closed shoes and specifically among sports and army people (Sharquie, et al., 2013). The main cause is foot sweat, sweat itself is odorless, but it creates a beneficial environment for certain bacteria to grow and produce badsmelling substances. ...
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Treating foot odor infected with pathogenic fungus and bacteria has been a major concern for pharmaceutical companies. Finding a right treatment with minimum side effects has been of particular importance. This study configures a homemade topical powder mix in treating foot odor. The homemade topical powder mix is free of any harmful chemical constituents; its main constituents being Chalcanthite, Alum, and Clove. Energy dispersive X-ray fluorescence was used for the determination of the chemical composition component of Chalcanthite, Alum, Clove, and the powder mix of Chalcanthite, Alum, and Clove. X-ray fluoresces techniques was able to measure elements such as oxygen, sulfur, aluminum, potassium, and copper in kα line. The antimicrobial activity of the powder mix of Chalcanthite, Alum, and Clove was studied against two pathogenic fungi, which are Epidermophyton sp., and Trichophyton sp., and two pathogenic bacteria, which are Brevibacterium sp., and Staphylococcus sp. Screening for antibacterial and antifungal was done using agar disk diffusion. The growth inhibition zone measured ranged from 16 to 28 mm for all the sensitive fungal, and ranged from 14 to 27 mm for the sensitive bacteria.
... A 15% solution of Zn sulphate was found to have high efficiency in reducing foot odour in 70% of patients in a 2-week study. This high level of clearance was sustained by applying the solution as maintenance therapy once a week [52]. Although this solution was found to have high efficiency, the Zn concentration in cosmetic products is limited to 1% in the European Union [29], and so further studies have to be performed to confirm the effectiveness at lower concentrations. ...
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It is well known that zinc ions are widely used in cosmetic products. Their popularity is associated with the multifunctional profile of Zn²⁺, which is classified as an essential chemical element in the human body. This review examines numerous beneficial biological properties of zinc‐containing compounds and classifies the compounds used in cosmetic products according to their functionality profile: antioxidant, sunscreen, anti‐inflammatory, anti‐pigmentation, anti‐aging, anti‐acne, antimicrobial, anti‐odour, cleansing or stabilising activity. It also underlines the significance of zinc in enzymatic processes, which depends on the enzyme type acts as inhibitor or enzymatic stimulator. Moreover, the article describes the chemical nature of the most interesting groups of Zn compounds. This article is protected by copyright. All rights reserved.
... When worn along with shoes, socks increase the surface area in which the bacteria can thrive. Brevibacteria are considered a major cause of foot odor (Sharquie et al. 2013) via ingestion of dead skin from the feet and conversion of methionine into methanethiol, which has a putrid smell (Smith 2006). Propionibacteria produce propionic acid by breaking down amino acids (Woskow 1991), releasing a vinegar-like odor (Pommerville 2016). ...
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Yearly, huge amounts of sock refuse are discarded into the environment. Socks contain many molecules, and worn ones, which are rich in smell-causing bacteria, have a strong influence on animals’ behaviors But, the impacts of sock odor on the oviposition behavior of dengue vectors is unknown. We assessed whether Aedes albopictus changes its oviposition activity in response to the presence of used socks extract (USEx) in potential breeding grounds, using choice and no-choice bioassays (NCB). When furnished even chances to oviposit in two sites holding USEx and two others containing water (control), Ae. albopictus deposited significantly less eggs in USEx than in water sites. A similar pattern of oviposition preference was also observed when there were more oviposition options in water. When there were greater oviposition opportunities in USEx sites, Ae. albopictus oviposited preferentially in water. Females laid significantly more eggs during the NCB involving water than USEx. Also, significantly more mature eggs were retained by females in the NCB with USEx than in that with water. These observations strongly suggest the presence of molecules with either repellent or deterrent activities against Ae. albopictus females, and provide an impetus to advocate the integration of used socks in dengue control programs. Such applications could be a realistic end-of-life recourse to reroute this waste from landfills.
Article
Hyperhidrosis is a common and distressing condition involving increased production of sweat. A variety of treatment modalities are used to try to control or reduce sweating. Sweat is secreted by eccrine glands innervated by cholinergic fibers from the sympathetic nervous system. Primary hyperhidrosis most commonly affects palms, axillae and soles. Secondary hyperhidrosis is caused by an underlying condition, and treatment involves the removal or control of this condition. The treatment options for primary hyperhidrosis involve a range of topical or systemic medications, psychotherapy and surgical or non-surgical invasive techniques. Topical antiperspirants are quick and easy to apply but they can cause skin irritation and have a short half life. Systemic medications, in particular anticholinergics, reduce sweating but the dose required to control sweating can cause significant adverse effects, thus, limiting the medications’ effectiveness. Iontophoresis is a simple and well tolerated method for the treatment of hyperhidrosis without long-term adverse effects; however, long-term maintenance treatments are required to keep patients symptom free. Botulinum toxin A has emerged as a treatment for hyperhidrosis over the past 5–6 years with studies showing good results. Unfortunately, botulinum toxin A is not a permanent solution, and patients require repeat injections every 6–8 months to maintain benefits. Psychotherapy has been beneficial in a small number of cases. Percutaneous computed tomography-guided phenol sympathicolysis achieved good results but has a high long-term failure rate. Surgery has also been shown to successfully reduce hyperhidrosis but, like other therapies, has several complications and patients need to be informed of these prior to undergoing surgery. The excision of axillary sweat glands can cause unsightly scarring and transthoracic sympathectomy (either open or endoscopic) can be associated with complications of compensatory and gustatory hyperhidrosis, Horner syndrome and neuralgia, some of which patients may find worse than the condition itself.
Article
Background Viral warts are common dermatological diseases; although the rate of spontaneous recovery is high, it usually takes a long time, and some patients might not show this spontaneous healing. Zinc has an important effect on the immune system and it has been used as an immunomodulator to treat a variety of skin disorders. Objective To assess whether oral zinc was effective in treating viral warts of patients evaluated between May 1999 and April 2000. Patients and methods This was a placebo-controlled clinical trial. Eighty patients with viral warts (common, plantar and plane) were all resistant to all forms of treatment. Each patient had > 15 warts. Forty patients were treated by oral zinc sulphate at a dose of 10 mg kg−1 daily up to 600 mg day−1 and followed-up for resolution of their warts and for any evidence of recurrence for 2–6 months. Another 40 patients were given a placebo oral treatment in the form of glucose, and followed-up for the same period. Results Only 23 patients of the first group (zinc treated) and 20 patients of the second group (placebo treated) completed the study. In all patients the serum level of zinc was low. In the zinc-treated group, the overall response was complete clearance of warts observed in 20 patients (86·9%) after 2 months of treatment. Fourteen patients (60·9%) showed complete disappearance of their warts after 1 month. Three patients (13·3%) failed to respond to the treatment after 2 months of therapy. The response to treatment was directly related to the increment in serum zinc level. No patient of the placebo-treated group showed any response. Conclusions We conclude that zinc sulphate at a dose of 10 mg kg−1 daily seems to be a highly efficacious therapeutic option for recalcitrant viral warts and proved to be safe with few adverse effects.
Article
To evaluate effectiveness of 2% tea lotion in comparison with 5% zinc sulphate solution in the treatment of acne vulgaris. This is a single-blind randomly comparative therapeutic clinical trial carried out in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from June 2006 to December 2007. Full history and clinical examination were studied for each patient regarding all relevant points of the disease, to evaluate the severity of acne. Forty-seven patients with acne vulgaris were divided randomly into 2 groups, and were instructed to use the following solutions twice daily for 2 months; group A used 2% tea lotion, group B used 5% zinc sulphate solution. Patients with papulopustular lesions were included in the study, while patients with severe acne were excluded. The clinical improvement was scored by counting the number of inflammatory lesions before, and after treatment. Forty patients completed the study, their ages ranged from 13-27 years with a mean+/-standard deviation of 19.5+/-3.5 years with 20 patients in each group. Two percent tea lotion was statistically significant in decreasing the number of the inflammatory lesions in acne vulgaris, while 5% zinc sulphate solution was beneficial, but did not reach statistically significant level as tea lotion. Two percent tea lotion was a good alternative remedy to be used in the treatment of acne vulgaris, and was much superior than topical 5% zinc sulphate solution.
Article
Short-chain fatty acids from the socks and feet of subjects either with strong foot odour or with weak or no foot odour were extracted with ethyl ether, and then analysed by gas chromatography/mass spectrometry (GC/MS). Short chain fatty acids were found in greater amounts from those subjects with strong foot odour. Iso-valeric acid was present in all the subjects with foot odour but was not detected in those without. Olfactory evaluations of the various short-chain fatty acid solutions were in agreement with the GC/MS analyses. By incubating sweat and lipid from subjects with strong foot odour, we succeeded in reproducing the foot malodour. GC/MS analyses of reproduced foot odour revealed that short-chain fatty acids were present in a similar composition to that found in vivo.
Article
In subjects exposed to a hot environment, short-term topical pretreatment with aluminium zirconium tetrachlorhydrate delayed the onset of visible sweating although it failed to prevent the response. The delay was considered most probably to be due to the occlusive action, in the duct within the upper epidermis, of aluminium-containing conglomerates, which disappear after continuous sweating. However, microanalytical evidence indicated that ionic transport within the fundus secretory cells was also modified.
Article
A clinical trial to evaluate the efficiency of oral zinc sulphate in the treatment of cutaneous leishmaniasis was conducted. One-hundred and four patients with parasitologically proven cutaneous leishmaniasis were included in the trial. Patients were assigned randomly to receive 2.5, 5 or 10 mg/kg of zinc sulphate orally, and a control group of patients did not receive any treatment. All patients were followed up for 45 days. At the end of the follow-up period, lesions were assessed and parasitological proof of cure or otherwise was sought. Results showed that the cure rate for the 2.5 mg/kg group was 83.9%, for the 5 mg/kg treatment group it was 93.1% and for the 10 mg/kg treatment group it was 96.9%. No lesions in the control group showed any sign of healing during the follow-up period. Therefore, oral zinc sulphate can be recommended as a very safe therapy for cutaneous leishmaniasis.
Article
Primary (idiopathic) hyperhidrosis is a benign disease of unknown etiology, leading to the disruption of professional and social life and emotional problems. A variety of treatment methods have been used to control or reduce the profuse sweating. In this study, we report the efficacy of direct current (d.c.) administration in the treatment of idiopathic hyperhidrosis. One hundred and twelve patients with idiopathic hyperhidrosis were enrolled in the study. Initial sweat intensities of the palms were measured by means of the pad glove method. The patients were treated in eight sessions with d.c. administration using a complete regulated d.c. unit based on tap water iontophoresis. The final sweat intensities of responders were determined 20 days after the last treatment. Nonresponders returned earlier than 20 days, with final sweat intensities measured at least 5 days after the last treatment. In 26 responders, plantar hyperhidrosis was also treated. After the first remission period, the second of eight treatments was applied to the palms of 37 responders. This therapy controlled palmar hyperhidrosis in 81.2% of cases. The final sweat intensities of the palms of responders were significantly reduced after eight treatments (P < 0.001). The first average remission period was 35 days. Minimal undesirable effects were noted. This technique appears to control hyperhidrosis on the palms and soles only if regular treatment is applied. Plantar hyperhidrosis appeared to resolve simultaneously when palmar hyperhidrosis was successfully treated.
Article
Hyperhidrosis is a common and distressing condition involving increased production of sweat. A variety of treatment modalities are used to try to control or reduce sweating. Sweat is secreted by eccrine glands innervated by cholinergic fibers from the sympathetic nervous system. Primary hyperhidrosis most commonly affects palms, axillae and soles. Secondary hyperhidrosis is caused by an underlying condition, and treatment involves the removal or control of this condition. The treatment options for primary hyperhidrosis involve a range of topical or systemic medications, psychotherapy and surgical or non-surgical invasive techniques. Topical antiperspirants are quick and easy to apply but they can cause skin irritation and have a short half life. Systemic medications, in particular anticholinergics, reduce sweating but the dose required to control sweating can cause significant adverse effects, thus, limiting the medications' effectiveness. Iontophoresis is a simple and well tolerated method for the treatment of hyperhidrosis without long-term adverse effects; however, long-term maintenance treatments are required to keep patients symptom free. Botulinum toxin A has emerged as a treatment for hyperhidrosis over the past 5-6 years with studies showing good results. Unfortunately, botulinum toxin A is not a permanent solution, and patients require repeat injections every 6-8 months to maintain benefits. Psychotherapy has been beneficial in a small number of cases. Percutaneous computed tomography-guided phenol sympathicolysis achieved good results but has a high long-term failure rate. Surgery has also been shown to successfully reduce hyperhidrosis but, like other therapies, has several complications and patients need to be informed of these prior to undergoing surgery. The excision of axillary sweat glands can cause unsightly scarring and transthoracic sympathectomy (either open or endoscopic) can be associated with complications of compensatory and gustatory hyperhidrosis, Horner syndrome and neuralgia, some of which patients may find worse than the condition itself.