Athlete's foot

Overview

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.

Conventional Treatment

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.

Specific goals

• Relieve itching and pain
• Eradicate fungus
• Prevent recurrence

Appropriate Health Setting

Outpatient care is sufficient.

Healthcare Who May Be Involved in Managing Your Condition

• Internists
• Pediatricians
• Family physicians
• Dermatologists
• Podiatrists
• Physician assistants
• Nurse practitioners

Treatment Considerations

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.

Drug Therapy

Drugs most commonly prescribed
Topical antifungal medications used for athlete's foot include:
Lamisil Cream
Nizoral Cream
Oral antifungal medications may also be used, especially for persistent cases. All of them require a doctor's prescription:
Nizoral (ketoconazole)
buy Terbinafine
Sporanox (itraconazole)
Diflucan http://www.nmihi.com/f/fluconazole.html

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.

Possible Complications

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.

Alternative care

Herbs

• 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.