Athlete's Foot

Athlete's foot facts

• Athlete's foot is a common disorder of the feet characterized by scaling and/or blistering of the soles, fissures of the toe webs, and itching.
• When caused by a fungus, athlete's foot may spread to the palms, groin, and body.
• Fungal infections of the feet are contagious and can be spread person to person or by walking on contaminated floors.
• Other causes of athlete's foot include contact allergy, erythrasma, bacterial infection, pompholyx, intertrigo, and occasionally psoriasis.
• When athlete's foot is caused by a fungus, it can be treated with antifungal medications, many of which are available without a prescription.
• Keeping the feet dry by using cotton socks and breathable shoes can help prevent athlete's foot.

 What is athlete's foot? What are causes and risk factors of athlete's foot ?

Athlete's foot is a term given to almost any inflammatory skin disease that affects the sole of the foot and the skin between the toes. It is usually a scaly, red, raw-appearing eruption and occasionally may be weepy and oozing with small blisters. It affects the feet of athletes and non-athletes alike. Although it is frequently caused by a fungal infection, other causes may be indistinguishable without proper testing.

The medical name for fungal athlete's foot is tinea pedis. There are a variety of fungi that cause athlete's foot, and these can be contracted in many locations, including gyms, locker rooms, swimming pools, communal showers, nail salons, and from contaminated socks and clothing. The fungi can also be spread directly from person to person by contact. Most people acquire fungus on the feet from walking barefoot in areas where someone else with athlete's foot has recently walked. Some people are simply more prone to this condition while others seem relatively resistant to it. Another colorful name for this condition is "jungle rot," often used by members of the armed services serving in tropical climates.

Fungal infections are promoted by warmth and moisture. There is some speculation that before enclosed shoes became common, tinea pedis was less prevalent. Up to 70% of the population may develop athlete's foot at some time. An infection by athlete's foot fungi does not confer any resistance to subsequent infections.

What are the symptoms and signs of athlete's foot ?

Many individuals with athlete's foot have no symptoms at all and do not even know they have an infection. Many may think they simply have dry skin on the soles of their feet. Common symptoms of athlete's foot typically include various degrees of itching, stinging, and burning. The skin may frequently peel, and in particularly severe cases, there may be some cracking, fissuring, pain, and itching in the toe webs. Occasionally, athlete's foot can blister.

What are risk factors for athlete's foot?

Walking barefoot in wet, dark areas frequented by many other individuals like indoor swimming pool decks, communal showers, and locker rooms result in frequent exposure to pathogenic fungi (dermatophytes) that cause athlete’s foot. Wearing occlusive footwear is thought to play a significant role in the increased frequency of tinea pedis. Exposure to moisture either from excessive sweating or from an external source is a risk factor. Wearing the same shoes and socks for an extended period may damage the skin. Patients with diabetes are predisposed to develop tinea pedis. Some believe that eczema (atopic dermatitis) can predispose one to tinea pedis. It appears that many more men have tinea pedis than women. Pedicure performed in contaminated environments can spread disease.

What is the treatment for athlete's foot?

Since there is no single cause for athlete’s foot there is no single treatment. Nevertheless, all causes of this condition benefit by promoting a dry, clean, and friction-free environment for the feet.

Occlusive shoe materials, such as vinyl, which cause the feet to remain moist, provide an excellent area for the fungus to proliferate. Likewise, absorbent socks like cotton that wick water away from your feet may help. Some individuals who sweat excessively benefit from the application of antiperspirants like 20% aluminum chloride (Drysol). Powders can help keep your feet dry. Although counterintuitive, if your feet can be soaked in a solution of aluminum acetate (Burow's solution or Domeboro solution) and then air dried with a fan, this can be very helpful if performed three or four times within 30 minutes. A home remedy of dilute white vinegar soaks, using one part vinegar and roughly four parts water, once or twice a day (as 10-minute foot soaks) may aid in treatment followed by evaporation can be helpful.

For fungus infection, there are plenty of options. Many medications are available, including miconazole (Micatin, Zeasorb powder), econazole (Spectazole), clotrimazole(Lotrimin), terbinafine (Lamisil), naftifine (Naftin), butenafine (Mentax), ciclopirox (Loprox), ketoconazole (Nizoral), efinaconazole (Jublia), luliconazole (Luzu), sertaconazole (Ertaczo), sulconazole (Exelderm), and tolnaftate (Tinactin). Ask your health care professional or pharmacist for a recommendation. It is difficult to know which of these drugs is most effective since they have not been tested against each other. Cost is probably the most significant differentiating factor, and many are available without a prescription. Treatment for athlete's foot should generally be continued for four weeks or at least one week after all of the skin symptoms have cleared.

More advanced or resistant cases of athlete's foot may require a course of an oral (pill) antifungal like terbinafine (Lamisil), itraconazole (Sporanox), or fluconazole(Diflucan). Laboratory blood tests to make sure there is no liver disease may be required before taking these pills.

Topical corticosteroid creams can act as a fertilizer for fungus and may actually worsen fungal skin infections by suppressing the body's immune defenses. These topical steroid medications have no role in treating fungal foot infections but can be quite effective in treating noninfectious causes of athlete’s foot.

If the fungal infection has spread to the toenails, the nails must also be treated to avoid reinfection of the feet. Often, the nails are initially ignored only to find the athlete's foot keeps recurring. It is important to treat all of the visible fungus at the same time. Effective nail fungus treatment may be more intensive and require prolonged courses (three to four months) of oral antifungal medications.