Athlete's foot

Skin

Athlete's foot is a common fungal infection affecting the skin of the foot, particularly in the gap between the little toes. It is unsightly, irritating and contagious. It is called athlete's foot because the infection can easily be caught in changing rooms, but it affects people of all ages and not just athletes.

Athlete's foot, or to give it its medical name tinea pedis, is caused by a type of fungus called a dermatophyte. There are several dermatophytes that cause athlete’s foot, the most common is Trichophyton rubrum. This fungus lives on dead skin and toenails and thrives in warm, damp places. Moisture and warmth created by shoes and socks provides the ideal conditions for the fungus to flourish, particularly between the toes.

Athlete’s foot is highly contagious and can be spread through direct contact with someone with the infection, or indirectly through shared towels or footwear, and by contact with the damp floor of changing rooms and swimming pools.

Skin affected by athlete's foot is itchy, red and sore, especially between the fourth and fifth toes. It can flake, peel or crack and become ‘soggy’. If untreated, the infection can spread to the toes and other parts of the foot, causing the whole area to blister and become very sore. It may be painful to walk if the infection has spread to the soles of the feet. The feet may develop an unpleasant smell. If the infection spreads to the toenails, they turn yellow, thicken, become brittle and crumble. Cracks in the skin may become infected.

Athlete’s foot is treated with antifungal drugs. There are a number of antifungal agents available such as clotrimazole, ketoconazole, miconazole, terbinafine, tolnaftate, undecenoates and amorolfine. These antifungal agents are available in a wide variety of creams, sprays, powders and nail lacquers and all may bought without a prescription from a pharmacy.

Most cases of athlete’s foot can successfully be treated within six weeks depending on the extent of the infection and the product used.

See your pharmacist to confirm that you have athlete’s foot. You may be referred to a chiropodist or doctor if you have diabetes.

In most cases, your pharmacist will recommend a product that is best suited to you and will explain whether you should use a cream, spray or powder. It is important that use of the antifungal agents is continued after the signs of the infection have gone to prevent the infection from reappearing. Your pharmacist will tell you how long each preparation should be used.

The pharmacist will also give you advice about changing footwear and other simple precautions you can take to avoid catching athlete’s foot again.

If you have diabetes you should see your doctor before you try any over-the-counter treatments as poor circulation and loss of feelings in the feet can mask the signs of any infection and wounds may take longer to heal.

Seek help if over-the-counter remedies have not worked or if the problem is recurring. Your doctor may prescribe similar antifungal agents in the form of tablets or take a scrape of the tissues from the area to confirm that the diagnosis is correct.

If the infection has spread to the toenails, and nail lacquer has not worked, your doctor may decide to prescribe a course of antifungal tablets, possibly lasting for several months to clear the infection completely.

Good foot and footwear hygiene is the best way of reducing the risk of athlete's foot by creating an environment that makes it difficult for the fungus to grow.

Put on a fresh, clean pair of socks every day. Change into a different pair of socks if you are active during the day, for example if gardening, playing sport, exercising or walking. Wear a different pair of shoes from the previous day or, if this is not possible, allow your shoes to air thoroughly over night before putting them on again the next day. Wear socks and shoes of the right size; squeezing your feet into tight fitting socks and shoes prevents the air from circulating and encourages a warm damp environment in which the fungus can thrive. Socks made from natural fibre such as cotton and shoes made from leather rather than plastics will also allow your feet to breathe and help prevent the build up of moisture.

Wash your feet regularly with cold water and dry thoroughly, especially between the toes, but avoid rubbing too vigorously as this can break the skin and increase the risk of infection. Instead, gently dab your feet and between your toes with a towel. Use a different towel if drying other parts of the body to avoid transferring the fungus.

Avoid passing the infection on to others. Wear flip flops in the shower and when walking around changing rooms or swimming pools.

If you do have athlete's foot it is best to start treatment as soon as possible as the infection is harder to treat if it spreads, particularly if it spreads to the toenails. Use all medications as instructed. It is tempting to stop treatment as soon as symptoms start to ease, but it is important to continue treatment sometimes for many weeks to prevent the fungus from reappearing. Continue with foot and footwear hygiene during and after the treatment period to prevent recurrence.