Topical applications

Extensive research has given rise to various topical applications. Some of them are mentioned below.

Neuropathy

In diabetic neuropathy, there is a harsh burning feeling in both soles of the feet, which aggravates at night disturbing the sleep. There is hypersensitivity to pressure and touch on both feet. There may be gross sensation loss and an insensitive foot ulcer. TCAs (Tricyclic Antidepressants) are vital drugs in the treatment of neuropathy. The painkilling effect is unrelated to the antidepressant activity. It is effective even at less doses with fast start of reduction of pain, within a couple of weeks. It has various side effects like sleepiness, damaged cognitive work and undesired cardiovascular results. These are seen in case of one third of the patients. TCAs do not deal with the root cause of neuropathy nor do they retard its progress but definitely make life bearable by raising the comfort level. One such TCA is "Doxepin hydrochloride". In case of peripheral neuropathy related to Diabetes Mellitus, a contemporary application consists of the use of a lotion, ointment or cream containing "Capsicum Oleoresin" as an active constituent. If it is applied to the affected foot daily, the pain and burning may diminish.

Photodynamic therapy

It is pragmatic to photosensitize yeasts and dermatophytes by the use of ALA (5-aminolevulinic acid). This procedure is called Photodynamic therapy (PDT). 25% ALA is prepared in Eucerin cream. Then it is applied under dressings to the skin wounds of patients with interdigital mycosis of the feet. These lesions are irradiated with broadband red light after 4 hours. After a week, if the wounds are not visible no treatment is given. Or else three weekly treatments are given.
Recovery is evident in two third of the patients but reappearance of lesions is quick in some patients. Overall, ALA-PDT has good curative ability on interdigital mycosis of feet. The erratic three-dimensional shape of the feet causes a dissimilar release of red light over the lesions.

Athlete's foot

The infected foot is subjected with topical applications like salicylic acid, miconazole, itraconazole and terbinafine. These agents can get rid of the infection only one third of the time. They require minimum one and half month. As the itching sensation decreases fast, patients must not cease the therapy until the duration is over. Castellani's Paint is used for Intertrigo.

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