Hygiene Practices Against Dermatophytic Fungi: A Review of Strategies to Combat Antifungal Resistance

Area of Science:

• Dermatology
• Infectious Diseases
• Environmental Hygiene

Background:

• Superficial fungal infections of the feet, including tinea pedis and onychomycosis, are common and recurrent.
• Reinfection frequently stems from contaminated footwear, textiles, and podiatric instruments.
• Environmental sources of fungal contamination are often overlooked in clinical settings, contributing to antifungal resistance.

Purpose of the Study:

• To critically review historical and current methods for sanitizing footwear, socks, and podiatric tools.
• To evaluate the efficacy and limitations of various disinfection strategies for environmental fungal contamination.
• To emphasize the importance of environmental hygiene in managing recurrent fungal foot infections and reducing resistance.

Main Methods:

• Systematic review of peer-reviewed literature from 1938 to 2025.
• Analysis of disinfection methods including chemical agents, thermal treatments, laundering, UV/ozone technologies, antimicrobial textiles, and sterilization protocols.
• Assessment of efficacy, limitations, and practical considerations for each method.

Main Results:

• A wide spectrum of disinfection efficacies and practical challenges were identified across reviewed methods.
• Steam sterilization demonstrated the highest reliability for disinfecting reusable podiatric instruments.
• No single method universally eliminated fungal contamination, highlighting the need for combined strategies.

Conclusions:

• Breaking the cycle of fungal foot infection reinfection requires a combination of antifungal treatment and consistent environmental disinfection.
• Clinical education and further research are necessary to develop scalable and effective disinfection strategies for the clinical environment.
• Addressing environmental reservoirs of fungal pathogens is critical for managing recurrent infections and mitigating antifungal resistance.