new customer

care

Guides
athletes foot

Introducing

Canestens once daily cream

to ght athletes foot
Use this training to:

Refresh your knowledge of treating athletes foot and the

range of treatments
Learn about Canesten Bifonazole Once Daily 1% w/w Cream
Help you recommend suitable products for different
customers and give condent advice
Improve customer care with tips to prevent athletes foot
Tinea pedis or athletes foot is very common one in four
people will suffer at some point in their lives.1 It is a manageable
condition, and can be treated with an antifungal cream
containing clotrimazole (e.g. Canesten AF Dual Action Cream)
or if inflammation is present, clotrimazole and hydrocortisone
(e.g. Canesten Hydrocortisone). Now available is a once daily
cream containing bifonazole that is easy to use and treats the root
cause of the condition.
Canesten Bifonazole Once Daily 1% w/w Cream:
Once daily application for two to three weeks
Bifonazole penetrates well into the skin where it keeps
working for 36-48 hours2
Convenient for the customer to use
Bifonazole is a broad-spectrum antifungal and can be
recommended for all types of athletes foot (without
inammation)
This means that Canesten now offers a range of athletes foot
treatments that can suit the needs of your customers.

now
available

Bifonazole

Advising customers
Now you can put your new product knowledge into practice
using the following customer scenarios.

customer
scenario

30-year-old builder John

asks you for advice as he
has had athletes foot on
and off for several months
He tells you he wears
the same work boots
every day
He wants a product that is
effective and easy to use
so that he can get rid of
athletes foot

Athletes foot symptoms are easy to recognise and there are a

number of treatment options. Before recommending a product,
remember to make sure that you ask the WWHAM questions:

Who is the medicine for?

From your conversation, you already know that this medicine is
for John.

What are the symptoms and How long has he had

them? Ask him to conrm his symptoms.
He tells you he has flaky, peeling skin between his fourth and fifth
toes and on the soles of his feet. He has been having symptoms on
and off for several months.
There are other types of athletes foot with different symptoms
and these include:
Plantar or moccasin affects toes, sides and soles of feet
Vesicular small vesicles or blisters on the instep on one or
both feet

Action has he already tried a treatment?

He has tried an antifungal product but he doesnt want to keep
having to apply the cream several times a day.

Medication is he taking any other medicine?

He is taking a daily multivitamin but is taking no other medicines.
While speaking to John, you can explain to him that there are
certain things he can do to prevent athletes foot from recurring.
For example, it is important to keep feet and toes dry as fungi need
a damp, moist environment to thrive.
Other prevention tips you could advise customers about include:
After washing feet daily, dry thoroughly paying particular
attention to the area between the toes
Wear cotton socks and shoes made from natural materials
(e.g. leather) as these help the feet breathe and stop them
getting sweaty and damp
Change socks daily
Dont wear the same shoes every day
Dont share bath towels
Dont walk around barefoot in communal changing areas
wear shoes or ip-ops to protect feet
Wash hands after applying treatment to prevent the spread
of infection

Recommendation
You could recommend the Canesten Bifonazole Once Daily 1% w/w
Cream, which is for all types of athletes foot without inflammation.
Its once-a-day application makes it convenient to use. Once applied to
the skin, bifonazole keeps working for 36-48 hours.2
He should apply the cream directly to the affected area as well as
4-6cm of the healthy adjacent skin, as the fungi may be lurking there.
Point out that if he does get inflamed skin, then he could use Canesten
Hydrocortisone cream, but only for up to seven days.
Make sure that you emphasise the importance of treating his athletes
foot correctly as if he has had the condition for months, it could
increase his chances of experiencing complications such as fungal
nail infections.

now
available

Advising customers

customer 2
scenario

Laura is an active woman in her mid-20s who

comes into your pharmacy wearing her gym kit
She asks you for a quick relief treatment for
inamed, sore and red skin in between her toes
She wants a product that will treat the infection
and the inammation that shes experiencing

While Laura has given you some information, you need to ask
the WWHAM questions before making a recommendation.

Who is the medicine for?

Youve learnt from your conversation that the medicine is for her.

What are the symptoms?

She tells you she has flaky, peeling skin between her fourth and
fifth toes and on the soles of her feet as well as a small area of
inflammation.

How long has she had the symptoms?

She has had the symptoms for a few days.

Action has she already tried a treatment?

Shes tried an antifungal product which has soothed the area but
it is still inflamed, red and sore.

Medication is she taking any other medicine?

She is not taking any other medication.

Recommendation
You can recommend Canesten Hydrocortisone, which is a
triple-action cream that provides a complete treatment for inflamed
athletes foot. Canesten Hydrocortisone acts in three ways:
Antifungal treats the cause of the infection
Anti-inammatory reduces inamed, sore skin and itchiness
Antibacterial helps to reduce bacteria that may cause odour
Advise her that she should apply the cream twice daily for seven days
(not on broken skin) then continue using an antifungal cream such as
clotrimazole until the infection clears and for two weeks afterwards.
You could also recommend she uses an antifungal powder in her socks
and shoes to kill any residual fungal spores and prevent reinfection.
Also discuss preventative measures with her. Since she goes to the gym
several times a week, mention to her that she can pick up athletes foot
from communal shower floors or from the nylon lining of her trainers.
To avoid getting it in the future, advise her to wash and dry feet daily,
wear cotton socks and shoes made from natural materials and
change them regularly. She should also wear flip flops in showers
or changing rooms instead of going bare foot.

Clotrimazole &
Hydrocortisone

Treating athletes foot

with imidazoles
Antifungal agents (e.g. clotrimazole, bifonazole and miconazole) are
examples of imidazoles and can treat most types of athletes foot.
These agents can be divided into the following categories:
Fungistatics work by inhibiting the growth and reproduction
of fungi, resulting in their eventual death. Treatments include the
imidazole group of antifungals such as bifonazole (e.g. Canesten
Bifonazole Once Daily 1% w/w Cream), clotrimazole (e.g. Canesten
AF Dual Action Cream), undeconates and miconazole
Fungicidals work by killing the fungi (e.g. terbinafine)
Canesten offers a range of treatments for athletes foot, including:
Canesten Bifonazole Once Daily 1% w/w Cream
Canesten AF Dual Action Cream
Canesten Hydrocortisone

Compliance

Customers should follow the packaging information to ensure

they stick to the recommended treatment time as relieving
symptoms doesnt mean the infection has cleared.
The convenience of Canesten Bifonazole Once Daily 1% w/w Cream
addresses one of the main problems when treating athletes foot
compliance. Because it only needs to be applied once daily, its
convenient for customers to use and therefore they may be more
likely to complete the treatment.

When to refer to the pharmacist:

If left untreated, athletes foot can spread to other parts of the foot
such as the toenail. Other complications can be a secondary bacterial
infection (causing inflammation of the skin and yellow discharge)
due to breaking of the skin surface or a fungal nail infection. In these
cases, the customer should be referred to the pharmacist.

Customer care tips

Athletes foot, like most fungal infections, can be embarrassing
for customers as the symptoms are often uncomfortable. Assure the
customer that athletes foot is a common infection and it can be easily treated
with the right product. To minimise the customers embarrassment, practise
these elements of communication:
Maintain eye contact with the customer
Nod and agree to show you are listening to what they are saying
Talk condently but softly to avoid other people in
the pharmacy overhearing. This will let the customer
know that your conversation is condential

Recommending the right product

When to refer

Recommendation

Refer to the pharmacist if the

customer:
Suffers from diabetes
Also has a fungal infection of
the toenail
Has signs of a bacterial infection
Has used an antifungal
treatment for four weeks without
improvement
Is allergic to antifungal
treatments
Has associated pain or
discomfort

Canesten
Hydrocortisone
Cream:
Clotrimazole 1% w/w and
Hydrocortisone 1% w/w

Self help tips

for customers
To help prevent the condition
from recurring in the future,
advise customers to:
Keep feet and toes dry
Wash feet daily and dry
thoroughly, particularly
in between the toes
Wear cotton socks
and shoes made from
natural materials (e.g.
leather)
Change socks and
tights daily
Dont wear the
same shoes
every day
Dont share towels
Dont walk
around barefoot in
communal changing
rooms
Wash hands after
applying treatment to
avoid spreading the
infection

Canesten
Bifonazole
Once Daily 1%
w/w Cream
Cream:
Bifonazole 1% w/w

Canesten AF
Dual Action
Cream
Cream:
Clotrimazole 1% w/w

now

available

Clotrimazole

Benets ...

>

>

>

Suitable for

Contains clotrimazole and hydrocortisone

Triple-action cream has antifungal,
anti-inammatory and antibacterial effects
It relieves soreness, reduces redness,
inammation and stops itching
Treats the fungal infection and relieves
inammation
Suitable for sufferers with small areas of
inammation

Contains bifonazole fungistatic

antifungal agent
Only needs to be applied once a day in
order to eliminate the fungal infection,
helping to improve patient compliance
Effective against all relevant types of fungi
Works to inhibit growth of fungi and relieve
the symptoms in two to three days
Treatment takes 14 to 21 once daily
applications

Contains clotrimazole 1% w/w

Treats the root cause of infection
An antifungal treatment suitable for all
types of athletes foot (also known as
broad spectrum)
Helps cool and soothe the itching
and burning sensation

>

Sufferers of athletes
foot with small areas of
inammation

>

Customers who lead busy

lifestyles and want the
ease and convenience
of a once daily
application

>

Athletes foot sufferers

without inammation

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Assessing knowledge
Training is a key part of your role in helping to provide customers with a professional service.
If you know about athletes foot, you will be more confident when talking to customers and
when to recommend suitable treatments.
Now that you have read this guide, use the following questions to check your understanding
of athletes foot and its treatment. Discuss your answers with your pharmacist.
4. Canesten Hydrocortisone cream:

1. A customer suffering from athletes foot

may have which of the following symptoms?
a. Dry skin in between their toes
b. Swollen feet
c. Itchy skin between the fourth and fifth toes
d. Very dry skin on the soles of the feet

a. Treats the cause of the fungal infection

b. Reduces skin inflammation
c. Reduces bacteria that may be causing
any odour
d. All of the above

a. Wash feet once a week

b. Wear nylon socks
c. Always walk around barefoot
d. Keep feet and toes dry

6. Which of the following statements is true about

Canesten AF Dual Action Cream:

3. When recommending an antifungal cream you

should advise the customer to:
a. Use the cream sparingly
b. Apply only when the skin is itchy
c. Apply until the symptoms have completely
cleared
d. None of the above

5. What advice will help a customer to

prevent the condition from recurring:

2. When recommending Canesten Bifonazole Once

Daily 1% w/w Cream, you should recommend the
customer applies it:
a. Once a week
b. Once a day
c. Twice a week
d. Three times a day

a. It can help relieve inflamed skin

b. It has broad-spectrum, antifungal properties
c. It should be applied to the affected skin weekly
d. It contains clotrimazole 2% w/w

Answers to knowledge questions:

1.c, 2.b, 3.c, 4.d, 5.d, 6.b

A complete training resource for your pharmacy

E-learning modules

Customer Care Guides

on thrush, athletes foot, cystitis

and sweat rash

available to download from the website

This resource has not been awarded the NPA Training Seal.

Visit the Canesten Training Centre at:

www.canesten.co.uk/hcp
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Canesten Guide Athlete's Foot v5.indd 9

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Product Information for Canesten Hydrocortisone

Presentation: Canesten Hydrocortisone contains clotrimazole 1% w/w and hydrocortisone 1% w/w. Indications: Athletes foot and candidal
intertrigo where co-existing symptoms of inflammation require rapid relief. Dosage and Administration: Adults, elderly and children aged
10 years or over: Apply thinly and evenly twice daily. Rub in gently. For a maximum of seven days. Contra-indications: Hypersensitivity to
clotrimazole, hydrocortisone, or any of the other ingredients e.g. cetostearyl alcohol. Do not use on face, eyes, mouth or mucous membranes;
broken or large areas of skin; cold sores; acne; untreated bacterial skin diseases, chicken pox, vaccination reactions, perioral dermatitis, viral skin
diseases, or for longer than seven days. Unless prescribed by a doctor should not be used in children under 10 years; pregnancy and lactation;
on ano-genital area; to treat ringworm or secondarily infected skin conditions. Warnings and Precautions: This product contains cetostearyl
alcohol, which may cause local skin reactions (e.g. contact dermatitis). Long-term continuous therapy to extensive areas of skin should be
avoided. Avoid covering treated area with tight dressing. Side-effects: Allergic reaction, blisters, discomfort/pain, oedema, irritation, peeling/
exfoliation, pruritus, rash, stinging/burning. After use on large areas and/or after long-term use or use under occlusive dressings, skin atrophy,
teleangiectasis, hypertrichosis, striations, hypopigmentation, secondary infection and acneiform symptoms may occur. Use in pregnancy: Only
when considered necessary by a physician. RRP: 4.46 (excl. VAT). MA Number: PL 00010/0216. MA Holder: Bayer plc, Consumer Care Division,
Newbury, Berkshire RG14 1JA. Legal Category: P. Date of Preparation: July 2010.
= Registered trademark of Bayer AG.
Product information for Canesten Bifonazole Once Daily Cream
Canesten Bifonazole Once Daily 1% w/w Cream (bifonazole 1% w/w). Indications: Treatment of athletes foot. The preparation is not for vaginal
use. Dosage and Administration: Apply thinly and rub into the affected area once daily, preferably at night before retiring, for two to three weeks.
The affected areas should be washed and dried thoroughly before the cream is applied. A doctor or pharmacist should be consulted if symptoms
do not improve within 7 days. Contraindications: History of hypersensitivity to imidazole antifungal agents or any of the excipients. Treatment of
nail or scalp infections, or infants with nappy rash. Warnings and Precautions: This product contains cetostearyl alcohol which may cause local
skin reactions (e.g. contact dermatitis). If unsure of diagnosis the patient should seek confirmation from a doctor or pharmacist. Side-effects:
Very rarely, systemic hypersensitivity reactions may occur. Pain or peripheral oedema at administration site. Dermatitis contact, dermatitis allergic,
erythema, pruritus, rash, urticaria, blister, skin exfoliation, eczema, dry skin, skin irritation, skin maceration, skin burning sensation. These side-effects
are reversible after discontinuation of the treatment. Use in pregnancy and lactation: Only to be used during pregnancy or lactation after an
evaluation by a doctor. During the lactation period bifonazole should not be applied to the chest area. RRP: 4.57 (excl. VAT). MA Number: PL
00010/0508. MA Holder: Bayer plc, Consumer Care Division, Newbury, Berkshire RG14 1JA, UK. Legal Category: GSL. Date of Preparation:
February 2012.
= Registered trademark of Bayer AG.
Product Information for Canesten AF Dual Action Cream
Presentation: Canesten AF Dual Action Cream contains clotrimazole 1% w/w. Indications: Treatment of tinea pedis (athletes foot) and tinea
cruris (jock itch). Dosage and Administration: Apply thinly and evenly to the affected area two or three times daily. A physician should be consulted
if symptoms do not improve within 7 days. Contra-indications: Hypersensitivity to clotrimazole or any of the other ingredients e.g. cetostearyl
alcohol. Do not use to treat nail or scalp infections. Warnings and Precautions: This product contains cetostearyl alcohol, which may cause local skin
reactions (e.g. contact dermatitis). Side-effects: Allergic reaction, blisters, discomfort/pain, oedema, irritation, peeling/exfoliation, pruritus, rash,
stinging/burning. Use in pregnancy: Only when considered necessary by a physician. RRP: 15g tube 3.10 (excl. VAT), 30g tube 3.67 (excl. VAT).
MA Number: PL 00010/0016R. MA Holder: Bayer plc, Consumer Care Division, Newbury, Berkshire RG14 1JA. Legal Category: GSL. Date of
Preparation: July 2010.
= Registered trademark of Bayer AG.

References
1. www.canesten.co.uk
2. Plempel M et al, 1983. Antimycotic efficacy of bifonazole in vitro and in vivo. Arzneim-Forsch. / Drug Res. 33 (I)

For further information, visit the healthcare professional section of the Canesten website: www.canesten.co.uk/hcp
NPA Disclaimer - The training content has been approved by the NPA. The NPA in no way endorses any product(s) or product range(s) mentioned.
No part of this publication may be reproduced without the written permission of the publishers, Bayer Healthcare in
association with CIG Healthcare Partnership. CIG Healthcare Partnership, Linen Hall, 162-168 Regent Street, London W1B 5TB.
www. cighealthcare.co.uk

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