This little piggy itches like crazy
Athlete's foot is a common fungal infection (tinea pedis) characterized by an itchy, raw, sometimes painful rash between the toes, on the sides of the feet, and on the soles. Many people are not aware they have it. Most commonly it appears between the fourth and fifth toe. Acutely, the fungus can cause blisters on the sole and sides of the feet or between the toes, which can become inflamed, crack, and itch. The fungus that causes athlete's foot thrives in damp, warm places such as locker rooms and swimming pool decks, which are good breeding places for the moisture-loving fungus.
How Common Is Athlete's Foot?
This condition is very common in the United States. Athlete's foot affects all ages but is more common in teenagers and adults. Equal numbers of females and males contract this fungus.
What You Can Expect
Athlete's foot is usually cured or suppressed with four weeks of application of over-the-counter topical treatments. However, the fungus that causes athlete's foot is so common and spreads so easily that recurrence is common. If your skin cracks as a result of athlete's foot, you could be at risk for a secondary bacterial infection.
Goals of Treatment
Is the condition curable?
Athlete's foot can usually be cured or suppressed within four weeks.
Is there effective treatment available?
The fungus can be treated and eradicated with over-the-counter creams, ointments, and powders. More stubborn infections can be treated with an oral medication.
- Relieve itching and pain
- Eradicate fungus
- Prevent recurrence
Appropriate Health Setting
Outpatient care is sufficient.
Healthcare Who May Be Involved in Managing Your Condition
- Family physicians
- Physician assistants
- Nurse practitioners
You can treat athlete's foot at home using over-the-counter antifungal creams, ointments, or powders which should be applied twice a day after bathing. Be sure to dry your feet thoroughly, especially between the toes, and remove dead or thickened skin carefully before applying medicines. Some people find using a blow-dryer at a warm setting helps fully dry the affected area. In addition to using an antifungal, keep your feet cool and dry, going barefoot whenever possible. Continue to apply the medicine for seven to 10 days after the rash clears up or it may return. Most creams are to be applied twice a day for at least four weeks. Changing shoes and socks frequently and wearing quick-drying cotton socks will help prevent recurrences, as will drying shoes out completely between wearing and dusting the inside with an antifungal powder.
If you have marked pain, pronounced skin changes such as spreading to other areas, extreme redness, oozing, extreme cracking, or other persistent problems, consult your physician promptly. Stubborn infection may require an oral antifungal or antibiotic medication prescribed by your doctor.
|Drugs most commonly prescribed|
Topical antifungal medications used for athlete's foot include:
Oral antifungal medications may also be used, especially for persistent cases. All of them require a doctor's prescription:
Monitoring the Condition
Stubborn cases of athlete's foot may be treated with oral medication prescribed by your doctor. When griseofulvin or ketoconazole are used, liver-function blood tests are done prior to initiating therapy and at periodic intervals.
If the infection forms blisters that subsequently break open, a bacterial infection may develop. Physicians often treat this with antibiotics. Recurrent tinea of the feet may lead to tinea infection in the toenails (onychomycosis). This is more difficult to treat.
Considerations for the Elderly
Athlete's foot, while generally benign in youth, can be risky for the elderly for several reasons:
- The skin can be more easily permeated, increasing the risk for infection
- Wounds, especially foot sores, heal less efficiently
- As we age, diabetes or poor circulation is more common, and these conditions may clear a path for secondary infections
Current Therapies Available
Athlete's foot is treated with antifungal medication. Good hygiene is important to keep the foot clean, cool, and dry.
- Tea tree oil: derived from an Australian plant, it has powerful antifungal action. At the University of Rochester School of Medicine in New York, researchers studied 117 people with fungal toenail infections, a condition related to athlete's foot but more difficult to treat. The participants applied either a standard antifungal drug (clotrimazole) or tea tree oil (100% strength) twice a day for six months. Both treatments produced equally good results.
- Garlic: also contains antifungal compounds. Several studies show its juice effective against athlete's foot. In one study, Indian researchers treated athlete's foot with either garlic or a standard drug (ketoconazole). Both treatments were about equally effective.
Try crushing several cloves into a small amount of water or vegetable oil. Let the mixture sit overnight, then apply the liquid with a cotton swab once or twice a day. The only drawback: you may smell of garlic.
Last updated 25 May 2012
- Tinea pedis
In the majority of cases, athlete's foot is caused by a fungus of the trichophyton species. They flourish in moist environments, and are easily transmitted through direct contact with infected sites or through indirect contact with contaminated items like towels, shoes, or shower stalls.
Basically, anything that keeps your feet damp can increase your risk of contracting athlete's foot. Factors that suppress your body's natural defenses can also increase your chances of getting it. Some risk factors include:
- Hot humid weather
- Tight, poorly ventilated shoes
- Synthetic socks
- Infrequent washing of feet
- Infrequent changing of shoes or socks
- Use of public locker rooms or showers
- Constant moisture around feet
- Compromised immune system
Symptoms & Diagnosis
If you're wondering whether you have this condition, check to see if you have the following signs:
- Small blisters on sides of feet or between toes
- Scaly dry rash on bottom and sides of feet in a "moccasin" pattern
- Damp, soft, gray-white or red scales on feet (look closely between toes)
- Dead skin between toes, peeling skin on the soles
- Itching or burning in the irritated areas
- Musty foot odor
Conditions That May Be Mistaken for Athlete's Foot
Athlete's foot can often be mistaken for other conditions, including:
- Intertrigo (skin irritation due to dampness and rubbing)
- Hyperkeratosis (thickening of the skin)
- Contact dermatitis (inflammation of skin due to contact with a substance to which you have an allergy)
- Eczema (type of inflammatory skin condition that can cause cracking on the soles)
- Dyshidrosis (condition that causes blisters due to excessive sweating)
- Lichen planus
How Athlete's Foot Is Diagnosed
Diagnosis starts with a review of your symptoms. Physical examination looks for the characteristic location and appearance. Skin scraping and cultures confirm the diagnosis.
Your Medical History
This condition is very common and men are affected more often than women. However, it is contagious, so if someone in your household has it, do not use their towels or shoes. Any individual who is active in sports may be at increased risk because their feet are confined in shoes and therefore get damp during periods of perspiration. Also they spend more time in locker rooms where the fungus may be more readily spread. Those who live in warmer, wetter climates are also more likely to get this disease.
Two laboratory methods are commonly used to diagnose athlete's foot:
- Microscope examination of skin scrapings from infection (KOH prep)
Self care & Prevention
Preventing Athlete's Foot Flare-ups
To prevent a recurrence of athlete's foot:
- Bathe your feet with soap and water at least once a day. Dry thoroughly and dust with talc to absorb moisture.
- Wear socks made of cotton, wool, or other natural fibers.
- Wear thongs or shower sandals in public showers and around public pools.
- Change your shoes and socks daily.
- Avoid the fungus that causes athlete's foot. Highly contagious, it thrives in warm, moist places like public showers, locker rooms, pools, and spas. Wear sandals or thongs.
- At home, use a disinfectant on your shower and bathroom floors.
- The fungus needs moisture to grow, so keep your feet dry, especially between your toes. Try using a blow-dryer on your feet after bathing and towel-drying. Then dust your feet with cornstarch or powder to absorb excess moisture. Wear well-ventilated shoes (ideally, sandals) if the weather permits. Avoid wearing socks if possible. When you do wear them, stick to natural fibers like cotton and wool, which absorb moisture. Change your socks daily.