ghp July 2015 | 21 industry insight Dr Sandström’s research has proved that Biocool has improved the active daily life of patients with both minor and more server foot problems, including many of those which often affect diabetic patients. The tests were car- ried out on a non-randomised selection of patients from a regular office practice, all of whom had onychomycosis covering 60% or more of the nail bed of the great toes. The product is a powder which, when dissolved in water and used to bathe feet, can considerably reduce the impact of various types of foot fungus, as well as improving the integrity of the skin. BioCool was found to kill Trichophyton rubrum, which is one of the most common causes of athlete’s foot. This was tested on both patients as well as in a lab experiment which showed that when a piece of the fungus was placed in 1ml of Biocool at room temper- ature no growth was recorded in the fungus spores. The fungus was found to be dead within one to three hours of the application of the Biocool. Patients suffering from warts on their feet also saw a significant improvement when treated with Biocool and those with onychomycosis, a fungal nail infection, also saw dramatic improvements under the same treatment. These results have vast implications for the treatment of these fungi in diabetic patients. Whilst previously these treatments have been thought to be cosmetic and trivial because of the unsightly growths which these fungi often produce, these minor issues in diabetics can quickly escalate and cause bacterial infections as well as more serious foot injuries. They can also lead to more serious blood born infections. Due to problems with the nerves and circulation to the feet, diabetics are often more prone to mild foot prob- lems which are not direct symptoms of the condition, but which are increased because of reduced circula- tion in the feet and nerve issues caused by diabetes. Often these problems are caused by other symptoms of diabetes, such as calluses and corns which may develop due to abnormal alignment of the feet or abnor- mal gait and hammertoes, or bent toes which are often caused by muscle weakness. Other issues include tinea pedis, or athlete’s foot, bunions and ingrown toenails. There are also more serious, life-threatening implications of these foot problems for diabetes, such as the devel- opment of ulcers caused by a combination of decreased sensation and reduced blood flow to the feet. If these Dr Gunnar Sandström and his Programme Committee at the Huddinge Department of Laboratory Medicine Division of Clini- cal Microbiology at the Karolinska Institutet and Karolinska Uni- versity Hospital have been investigating BioCool, a medicated foot bath which offers relief from mild foot problems. The results of these studies could have vast implications for the treatment diabetes sufferers. ulcers remain starved of oxygen then tissue death, also known as gangrene, can occur, which is potentially fatal. Other potentially serious problems that may develop in- clude cellulitis and osteomyelitis; sepsis is also possible. The results of this research could reduce the suffering and infection rate in many patients suffering from diabetes who develop such foot problems. The use of Biocool to treat these infections could improve the dai- ly lives of diabetic patients and could also reduce the risk of bacterial infections and further, more serious foot problems developing out of the smaller infections. The study also found that the skin on sufferer’s feet was generally left in an improved condition after the prolonged use of Biocool, which could help diabetes patients to stave off repeat infections and improve the overall health of their skin. The fungal pathogen which causes Trichophyton rubrum is currently poorly understood which means that sufferers often experi- ence other dermatological problems such as various forms of dermatophytosis alongside it, which can be improved by the use of Biocool. Affected areas, including infected nails, show a marked improvement when treated with Biocool which will help diabetics to reduce the rate of infection in their feet and to help them to contain the infection before it spreads to further nails or other areas of their feet. It could also reduce the risk of more serious foot problems in diabetics which could potentially lead to the loss of feet in sufferers of the disease. There are already several systemic antifungal treat- ments available for these infections but they are often accompanied by side-effects which include headaches, itching, loss of sensation of taste, gastrointestinal symp- toms, rashes, fatigue and abnormal liver function which could all cause serious harm to diabetic patients. Also the slow growth of the nails often means that even after successful treatment using systemic antifungal treat- ments the nail does not return to its usual appearance. Therefore, Dr Sandström and his team’s study will have broad ramifications for the treatment of foot in- fections in diabetes sufferers and could potentially go further, with the findings suggesting that ingredients from Biocool could be isolated to harness their healing capabilities to help diabetes patients repel other forms of fungal infection. In addition, the uses of this cream could be expanded upon to include other skin prob- lems which could improve the lives of both diabetes sufferers and those without the disease.