Athlete's Foot

Athlete’s foot—also called tinea pedis—is a contagious fungal infection that affects the skin on the feet and can spread to the toenails and sometimes the hands. The fungal infection is called athlete’s foot because it is commonly seen in athletes. Athlete’s foot is not serious, but sometimes it is hard to cure. However, if you have diabetes or a weakened immune system and suspect that you have athlete’s foot, call you doctor immediately.

Athlete’s foot occurs when the tinea fungus grows on the feet. You can catch the fungus through direct contact with an infected person or by touching surfaces contaminated with the fungus. The fungus thrives in warm, moist environments and is commonly found in showers, on locker room floors and around swimming pools.

Anyone can get athlete’s foot, but certain behaviors increase your risk. Factors that increase the risk of athlete’s foot include:

• visiting public places barefoot, especially locker rooms, showers and swimming pools
• sharing socks, shoes, or towels with an infected person
• wearing tight-fitting, closed-toe shoes
• keeping your feet wet for long periods of time
• having sweaty feet
• having a minor skin or nail injury on your foot

There are many possible symptoms of athlete’s foot. You may experience one or more of the following symptoms:

• itching, stinging, and burning between the toes
• itching, stinging, and burning on the soles of the feet
• blisters on the feet that itch
• cracking and peeling skin on the feet, most commonly between the toes and on the soles
• dry skin on the soles or sides of the feet
• raw skin on the feet
• discolored, thick, and crumbly toenails
• toenails that pull away from the nail bed

A doctor may diagnose athlete’s foot by the symptoms alone or may order a skin test if he or she is unsure if a fungal infection is causing your symptoms.

A skin lesion KOH exam is the most common test for athlete’s foot. A doctor scrapes off a small area of infected skin and places it in potassium hydroxide (KOH). The KOH destroys normal cells and leaves the fungal cells untouched so they are easy to see under a microscope.

Athlete’s foot can often be treated with over-the-counter (OTC) topical antifungal medications. If OTC medications fail to treat the fungal infection, your doctor may prescribe topical or oral prescription-strength antifungal medications. Your doctor may also recommend home treatments to help clear up the infection.

OTC Medications

There are many OTC topical antifungal medications, including:

• Desenex (Miconazole)
• Lamisil AT (Terbinafine)
• Lotrimin AF (Clotrimazole)
• Lotrimin Ultra (Butenafine)
• Tinactin (Tolnaftate)

Prescription Medications

Some of the prescription medications your doctor may prescribe for athlete’s foot include:

• topical prescription strength clotrimazole or miconazole
• oral antifungal medications such as itraconazole (Sporanox), fluconazole (Diflucan), or terbinafine (Lamisil)
• topical steroid medications to reduce painful inflammation
• oral antibiotics if bacterial infections develop due to raw skin and blisters

Home Care

Your doctor may recommend that you soak your feet in salt water or diluted vinegar to help dry up blisters.

Alternative Therapy

Tea tree oil (Melaleuca alternifolia) has been used as an alternative therapy for treating athlete’s foot with some success. A scientific study published in the August 2002 issue of the Australian Journal of Dermatology reported that a 50 percent solution of tea tree oil effectively treated athlete’s foot in 64 percent of trial participants. Tea tree oil can cause skin dermatitis in some people.

Athlete’s foot can lead to complications in some cases.

Mild complications include:

• the fungal infection returns after treatment
• an allergic reaction to the fungus, which can lead to blistering on the feet or hands

More severe complications include:

• a secondary bacterial infection develops. If this is the case, your foot might be swollen, painful and hot. Pus, drainage, and fever are additional signs of a bacterial infection.
• the bacterial infection spreads to the lymph system. A skin infection could lead to lymphangitis (infection of the lymph vessels) or lymphadenitis (infection of the lymph nodes).

Athlete’s foot infections can be mild or severe. Some clear up quickly, and others last a long time. Athlete’s foot infections generally respond well to antifungal treatment. However, sometimes fungal infections are difficult to eliminate. Long-term treatment with antifungal medications may be necessary to keep athlete’s foot infections from returning.

There are several things you can do to help prevent athlete’s foot infections. These include:

• wash your feet with soap and water every day and dry them thoroughly, especially between the toes
• put antifungal powder on your feet everyday
• do not share socks, shoes, or towels with others
• wear sandals in public showers, around public swimming pools, and in other public places
• wear socks made out of breathable fibers, such as cotton or wool, or made out of synthetic fibers that wick moisture away from your skin
• change your socks when your feet get sweaty
• air out your feet when you are at home by going barefoot
• wear shoes made of breathable materials
• alternate between two pairs of shoes, wearing each pair every other day, to give your shoes time to dry out between use