What is athlete’s foot?
Athlete’s foot is a very common skin infection of the bottom of the feet caused by fungus. The fungus that most commonly causes athlete’s foot is called Trichophyton. When the feet or other areas of the body stay moist, warm, and become irritated, fungus can thrive and infect the upper layers of the skin. Fungal infections can occur almost anywhere on the body, including the scalp, trunk, extremities (arms and legs), hands, feet, nails, vagina, mouth, and groin.
Athlete’s foot is caused by the ringworm fungus ("tinea" in medical jargon). Athlete’s foot is also called tinea pedis. The fungus that causes athlete’s foot can be found on many locations, including floors in gyms, locker rooms, swimming pools, nail salons, airport security lines, and in socks and clothing. The fungus can also be spread directly from person to person or by contact with these objects. Most people acquire fungus on the feet from walking barefoot on areas where someone else with athlete’s foot has walked. Some people are simply more prone to this condition while others seem relatively resistant to contracting it. It has been called "jungle rot" by those serving in wars, including the Vietnam War.
However, without proper growing conditions (a warm, moist environment), the fungus may not easily infect the skin. Up to 70% of the population may have athlete’s foot at some time during their lives. Some individuals are inherently more prone to recurrences during their lifetime.
What is the treatment for athlete’s foot?
The treatment of athlete’s foot can be divided into two parts. The first, and most important part, is to make the infected area less suitable for the athlete’s foot fungus to grow. This means keeping the area clean and dry.
Buy shoes that are leather or another breathable material. Shoe materials, such as vinyl, that don’t breathe cause your feet to remain moist, providing an excellent area for the fungus to breed. Likewise, absorbent socks like cotton that wick water away from your feet may help.
Powders, especially medicated powders (such as with miconazole [Lotrimin] or tolnaftate [Tinactin]), can help keep your feet dry. Finally, your feet can be soaked in a drying solution of aluminum acetate (Burow’s solution or Domeboro solution). A homemade remedy of dilute white vinegar soaks using 1 part vinegar and roughly 4 parts water, once or twice a day as 10-minute foot soaks may aid in treatment.
The second part of treatment is the use of antifungal creams and washes. Many medications are available, including miconazole, econazole nitrate (Spectazole), clotrimazole (Lotrimin), terbinafine (Lamisil) sprays and creams, and ketoconazole shampoo and cream (Nizoral), etc. Ask your health-care professional or pharmacist for a recommendation. 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 two- to three-week 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.
- Terbinafine: 250 mg once a day for two weeks
- Itraconazole: 100 mg twice a day for two weeks
- Fluconazole: 100 mg once weekly for two to three weeks
Topical corticosteroid creams can act as a fertilizer for fungus and may actually worsen fungal skin infections. These topical steroid medications have no role in treating athlete’s foot.
If the fungal infection has spread to the toenails, the nails must also be treated to avoid re-infection of the feet. Often, the nails are initially ignored only to find the athlete’s foot keeps recurring. It is important to treat all 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.
