A Study of Efficacy of Zinc Oxide Nanoparticles Coated Socks in Prevention of Unpleasant Foot Odor
A Study of Efficacy of Zinc Oxide Nanoparticles Coated Socks in Prevention of Unpleasant Foot Odor
This study aimed to study the efficacy of zinc oxide nanoparticles coated socks in prevention
 of unpleasant foot odor
Introduction Pitted keratolysis is a common skin disease, caused by various gram-positive
 bacteria including Corynebacterium species, Kytococcus sedentarius, Dermatophilus congolensis
 and Actinomyces species. These bacteria create small tunnels in the stratum corneum, causing
 pitted lesions at plantar areas. This condition is frequent accompanied by feet malodor and
 is commonly found in young male adults, especially in soldiers, miners and athletes. The
 reported prevalence of pitted keratolysis among naval cadets in Thailand was 38.7%.
 Predisposing factors related to pitted keratolysis are pedal hyperhidrosis and prolonged feet
 occlusion. Although this condition is generally not painful, our previous study in 2018
 revealed adversely affects patients' quality of life.

 Regarding treatment modalities of pitted keratolysis, various medications and life-style
 modification have been recommended. Previous studies revealed efficacy of topical choices,
 including benzoyl peroxide gel, clindamycin-benzoyl peroxide gel, glycopyrrolate cream,
 erythromycin gel, clindamycin solution, chlorhexidine scrub4 and mupirocin ointment. Oral
 antibiotics and botulinum toxin injection were also beneficial in pitted keratolysis. As to
 life-style modification, wearing cotton socks and opened footwear, and proper hygiene, have
 also been suggested.

 Previous studies demonstrated efficacy of zinc oxide in broad-spectrum antibacterial
 properties. Thus, zinc oxide has been used in various medical and apparel industrial
 products. Moreover, Commander Choopong Chailark invented socks coated with zinc oxide
 nanoparticles and reported antibacterial property of those socks.

 Objective The present study aimed to study the efficacy of zinc oxide nanoparticles coated
 socks in prevention of unpleasant foot odor

 Material and Methods First-year naval rating cadets, who had no pedal malodor were invited to
 enroll in this study. Consent was informed and obtained from all participants. Participants
 were assessed for behavioral risk factors and level of foot odor measured by a self-assessed
 visual analogue scale (VAS), using questionnaires. Subjects were randomly assigned either
 zinc oxide nanoparticles coated socks or ordinary socks.During the study, using of other
 topical treatment such as topical antibiotics, antiperspirant or aluminum chloride was not
 allowed. Participants were advised to wear those socks every day and regularly washed thier
 socks. All were able to regularly participate in physical military training during the study.
 Two weeks after the study clinical examinations by dermatologists and the cadets'
 self-assessment questionnaires, including feet odor by using VAS, treatment satisfaction and
 adverse effects, were used to evaluate the effectiveness. Pitted lesions improvement at
 plantar areas, evaluated by dermatologists, was divided into no improvement, slight
 improvement (decrease of pitted lesions at feet for 1 level) and much improvement (decrease
 of pitted lesions at feet for at least 2 level). Data were analyzed using Predictive
 Analytics SoftWare Statistics version 18 (SPSS, Inc., Chicago, Illinois, USA).

 Duration of study: 4 months

 Study design: Randomized control trial
Inclusion Criteria:

 -  First-year naval rating cadets, who had no pedal malodor

 Exclusion Criteria:

 -  The cadets who previously received any topical treatment including topical antibiotic,
 antiperspirant or aluminum chloride within 6 months prior to the study.