Cara Tucker

What is athlete’s foot?

Athlete’s foot is a fungal infection of the skin, also known as tinea pedis. It is most commonly experienced as itchy, scaling cracks in the skin between the toes, particularly between the 4th and 5th toes. However some people may develop the infection on the soles of their feet, with thickening of the skin and underlying redness which can extend up the sides of their feet, or with small blisters usually around the arch and inner aspect of the foot. Some people may experience it as a burning sensation in their feet. For others there is no itching or discomfort and the infection can go undetected for a long time.

What causes it?

Athlete’s foot is caused by fungal organisms called dermatophytes infecting the skin of the feet. These fungi require keratin for growth, utilising the keratin found in our skin, nails and hair. Infection usually occurs through direct contact with the organism while walking barefoot in showers, communal changing facilities and swimming pool areas or sharing towels. It is possible to have the dermatophytes on the skin without them causing infection.

Who gets athlete’s foot?

Some people are more susceptible to getting fungal skin infections due to their health or certain risk factors. Adult males are more likely to get it than females, but anyone of any age can get it. Other risk factors include occlusive footwear, being in enclosed footwear for prolonged periods, hot humid environments, excessive sweating, prolonged exposure to water, walking barefoot in public changing rooms, having diabetes or immunodeficiency, use of medications that suppress the immune system, and having poor peripheral circulation or lymphoedema.

What are the treatment options?

Treatment involves use of antifungals alongside measures to reduce or eliminate risk factors through good hygiene and preventative measures.

Topical antifungal treatments applied to the skin include creams, gels, sprays and powders containing an antifungal ingredient such as terbinafine, clotrimazole, miconazole or tolnaftate, which work in different ways. Terbinafine has been shown to be the most effective for eliminating the fungus responsible for athlete’s foot. The most suitable treatment will depend on the type of athlete’s foot you have, your health and risk factors.

If topical treatment is not effective, an oral antifungal tablet may be obtained on prescription if suitable.

What can I do to prevent it?

The following measures can help in the treatment of an existing infection or prevent a further infection:

• Wash feet daily with mild soap and warm water
• Ensure feet are dried thoroughly after washing and after water based activities, paying particular attention to the spaces between the toes
• Use a separate towel for the feet and avoid sharing towels with others
• Put on socks before underwear to prevent spreading the fungus to the groin
• Throw out old shoes and slippers which may harbour infection
• Wear breathable footwear made of natural materials
• Wear moisture-wicking socks to keep feet dry and change them daily
• Avoid prolonged wear of occlusive footwear
• Allow shoes to dry out for at least 24 hours between wears
• Clean shoes with disinfecting sprays or wipes
• Wear flip flops or sandals when in communal changing facilities, gyms and pool areas
• Wash socks, towels and bedding in hot water
• Check feet daily for signs of infection
• Use an antifungal powder between toes if needed as a preventative
• Avoid scratching any active infection as this can encourage spread to your hands

What happens if it is not treated properly?

Left untreated, the dermatophytes which cause athlete’s foot can progress to infect the toenails, causing thickened, discoloured and crumbly fungal nails. The same dermatophytes may also spread to other areas of the body, infecting your hands, groin and other areas.

Persistent skin breakdown from athlete’s foot can cause more serious complications for people with diabetes, peripheral vascular disease or immunodeficiency, including secondary bacterial infection, impetigo, cellulitis and lymphangitis.

Occasionally a person may develop contact dermatitis from an allergic reaction to antifungal medications used to treat the athlete’s foot.