• Fungal Infection (Foot); Onychomycosis; Ringworm; Tinea Pedis
Principal Proposed Natural Treatments
• Tea Tree Oil
Other Proposed Natural Treatments
• Ageratina pichinchensis (Snakeroot) ; Essential Oils; Garlic; Ozonized Vegetable Oil; Solanum chrysotrichum (Sosa) ; Various Tropical/Traditional Medicinal Plants
Athlete's foot is the common name for a fungal infection of the foot, often called ringworm (although there is no worm involved). The three fungi most commonly implicated in athlete's foot— Trichophyton rubrum , T. mentagrophytes , and Epidermophyton floccosum —favor the warm, moist areas between the toes and tend to flare up during warm weather. Similar infections can occur in the nails, scalp, groin, and beard.
Infection with these fungi generally causes mild scaling between the toes, but it can also cause more severe scaling, an itchy red rash, or blisters that cover the toes and the sides of the feet. Since the fungus may also cause the skin to crack, it can lead to bacterial infections, especially in older people or those with poor circulation in their feet. If the infection takes root under the toenails, it is called onychomycosis, and can be very difficult, if not impossible, to eradicate.
Because the fungi that cause athlete's foot thrive in warm, moist areas, it's important to keep the feet clean and dry. Over-the-counter or prescription topical antifungal treatments containing miconazole, clotrimazole, econazole, or ketoconazole can generally cure athlete's foot, but treatment may have to be continued for a month or more for full results. In severe cases, oral antifungal medications may be necessary.
Principal Proposed Natural Treatments
Preliminary evidence suggests that tea tree oil might be helpful for athlete's foot.
Tea Tree Oil
Tea tree oil ( Melaleuca alternifolia ) has a long traditional use in Australia for the treatment of skin and other infections. This use is supported by evidence that tea tree oil is an effective antiseptic, active against many bacteria and fungi. 1,2 Three double-blind studies suggest it may be helpful for athlete's foot.
In a double-blind, placebo-controlled trial, 158 people with athlete’s foot were treated with placebo, 25% tea tree oil solution, or 50% tea tree oil solution, applied twice daily for 4 weeks. 20 The results showed that the two tea tree oil solutions were more effective than placebo at eradicating infection. In the 50% tea tree oil group, 64% were cured; in the 25% tea tree oil group, 55% were cured; in the placebo group 31% were cured. These differences were statistically significant . A few people developed dermatitis in response to the tea tree oil and had to drop out of the study, but most people did not experience any significant side effects.
Another double-blind, placebo-controlled trial followed 104 people given either a 10% tea tree oil cream, the standard drug tolnaftate, or placebo. 3 The results showed that tea tree oil reduced the symptoms of athlete's foot more effectively than placebo, but less effectively than tolnaftate.
A third double-blind study followed 112 people with fungal infections of the toenails, comparing 100% tea tree oil to a standard topical antifungal treatment, clotrimazole. 4 The results showed equivalent benefits; however, because topical clotrimazole is not regarded as a particularly effective treatment for this condition, the results mean little.
For more information, including dosage and safety issues, see the full Tea Tree article.
Other Proposed Natural Treatments
Vegetable oils treated with ozone have antifungal properties. A double-blind (but not placebo-controlled) study of 200 people with athlete’s foot found that ozonized sunflower oil was as effective as the drug ketoconazole cream. 21
Solanum chrysotrichum (sosa) is an herb used in Mexico for the treatment of athlete’s foot and related infections. In a double-blind study of 101 people, 4 weeks of application of a special extract made from this herb produced benefits equivalent to those of the drug ketoconazole (as 2% cream). 22 However, due to the lack of a placebo group, these results cannot be taken as fully reliable. A similar study found potential benefit with the Mexican herb Ageratina pichinchensis (snakeroot). 23
Besides tea tree oil, other essential oils may be helpful as well, but the evidence remains weak. One open study hints that oil of bitter orange, a flavoring agent made from dried bitter orange peel, might have some effectiveness against athlete's foot when applied topically. 11 Test tube studies indicate that the aromatic constituents of other essential oils such as peppermint and eucalyptus also have antifungal activity, but they have yet to be tested on people. 12
More than 120 plants traditionally used to treat skin diseases in Mexico, Palestine, British Columbia, and Guatemala have demonstrated antifungal properties in test tube studies. Further research is needed to determine if they are safe and effective for athlete's foot or other fungal infections. 14-19
1. Williams LR, Home VN, et al. The composition and bactericidal activity of oil of Melaleuca alternifolia (Tea tree oil). Int J Aromather. 1989;1:15-17
2. May J, Chan CH, King A, et al. Time-kill studies of tea tree oils on clinical isolates. J Antimicrob Chemother . 2000;45:639-643.
3. Tong MM, Altman PM, Barnetson RS. Tea tree oil in the treatment of tinea pedis. Australas J Dermatol . 1992;33:145-149.
4. Buck DS, Nidorf DM, Addino JG. Comparison of two topical preparations for the treatment of onychomycosis: Melaleuca alternifolia (tea tree) oil and clotrimazole. J Fam Pract . 1994;38:601-605.
6. Caporaso N, Smith SM, Eng RH. Antifungal activity in human urine and serum after ingestion of garlic (Allium sativum). Antimicrob Agents Chemother . 1983;23:700-702.
7. Agarwal KC. Therapeutic actions of garlic constituents. Med Res Rev . 1996;16:111-124.
8. Hughes BG, Lawson LD. Antimicrobial effects of Allium sativum (garlic), Allium ampeloprasum L (elephant garlic), and Allium cepa (onion), garlic compounds and commercial garlic supplement products. Phytother Res . 1991;5:154-158.
9. Ledezma E, DeSousa L, Jorquera A, et al. Efficacy of ajoene, an organosulphur derived from garlic, in the short-term therapy of tinea pedis. Mycoses . 1996;39:393-395.
10. Ledezma E, Marcano K, Jorquera A, et al. Efficacy of ajoene in the treatment of tinea pedis: a double-blind and comparative study with terbinafine. J Am Acad Dermatol . 2000;43:829-832.
11. Ramadan W, Mourad B, Ibrahim S, et al. Oil of bitter orange: new topical antifungal agent. Int J Dermatol . 1996;35:448-449.
12. Pattnaik S, Subramanyam VR, Bapaji M, et al. Antibacterial and antifungal activity of aromatic constituents of essential oils. Microbios . 1997;89:39-46.
13. Lozoya X, Navarro V, Garcia M, et al. Solanum chrysotrichum (Schldl.) a plant used in Mexico for the treatment of skin mycosis. J Ethnopharmacol . 1992;36:127-132.
14. Ali-Shtayeh MS, Abu Ghdeib SI. Antifungal activity of plant extracts against dermatophytes. Mycoses . 1999;42:665-672.
15. McCutcheon AR, Ellis SM, Hancock RE, et al. Antifungal screening of medicinal plants of British Columbian native peoples. J Ethnopharmacol . 1994;44:157-169.
16. Caceres A, Jauregui E, Herrera D, et al. Plants used in Guatemala for the treatment of dermatomucosal infections. 1: Screening of 38 plant extracts for anticandidal activity. J Ethnopharmacol . 1991;33:277-283.
17. Guiraud P, Steiman R, Campos-Takaki GM, et al. Comparison of antibacterial and antifungal activities of lapachol and beta-lapachone. Planta Med . 1994;60:373-374.
18. Chandra B, Lakshmi V, Srivastava OP, et al. In vitro antifungal activity of constituents of Hypericum mysorense Heyne against Trichophyton mentagrophytes. Indian Drugs . 1989;26:678-679.
19. Zehavi U, Polacheck I. Saponins as antimycotic agents: glycosides of medicagenic acid. Adv Exp Med Biol . 1996;404:535-546.
20. Satchell AC, Saurajen A, Bell C, Barnetson RS, et al. Treatment of interdigital tinea pedis with 25% and 50% tea tree oil solution: a randomized, placebo-controlled, blinded study. Australas J Dermatol . 2002;43:175-178.
21. Menendez S, Falcon L, Simon DR, Landa N. Efficacy of ozonized sunflower oil in the treatment of tinea pedis. Mycoses . 2002;45:329-332.
22. Herrera-Arellano A, Rodriguez-Soberanes A, De Los Angeles Martinez-Rivera M, et al. Effectiveness and tolerability of a standardized phytodrug derived from Solanum chrysotrichum on Tinea pedis: a controlled and randomized clinical trial. Planta Med . 2003;69:390-395.
23. Romero-Cerecero O, Rojas G, Navarro V, et al. Effectiveness and tolerability of a standardized extract from Ageratina pichinchensis on patients with Tinea pedis : an explorative pilot study controlled with Ketoconazole. Planta Med. 2006 Oct 18 [Epub ahead of print].
Last reviewed August 2013 by EBSCO CAM Review Board
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