Athlete's Foot (Tinea Pedis)

Who gets athlete's foot and how do you get it?

Athlete's foot is a common fungal infection of the skin on the feet. Fungus germs (fungi) are common, and are often found in small numbers on human skin where they usually do no harm. However, if conditions are right they can 'invade' the skin, multiply, and cause infection. The conditions fungi like best are warm, moist and airless areas of skin, such as between the toes.

Anyone can get athlete's foot. Athlete's foot can also be passed on from person to person. For example, this may occur in communal showers used by athletes or swimmers. A tiny flake of infected skin from a person with athlete's foot can fall off whilst showering. It may then be trodden on by others who can then develop the infection. Once a small patch of infection develops, it typically spreads along the skin.

What are the symptoms of athlete's foot?

Is athlete's foot serious?

Usually not. Most people treat their itchy toes before it spreads. Sometimes the infection spreads to the skin on other parts of the body. These are usually the moist and airless parts of the skin such as the groin. Fungi do not usually go deeper than the skin into the body. However, other germs (bacteria) may enter through the cracked skin of untreated athlete's foot. This can occasionally cause more serious infections of the foot or leg (such as cellulitis of the leg).

The infection sometimes spreads to a nail. This can be treated. However, it takes several weeks of antifungal tablets to clear the infection from a nail. Therefore, it is best to treat athlete's foot as soon as symptoms start.

What is the treatment for athlete's foot?

You can buy an antifungal cream from pharmacies, or get one on prescription. There are various types and brands. For example; terbinafine, clotrimazole, econazole, ketoconazole, miconazole, and sulconazole. These modern creams are good at clearing fungal skin infections.

• Apply the cream to the surrounding 4-6 cm of normal skin in addition to the rash.
• Apply for as long as advised. This varies between the different creams, so read the instructions carefully. Although the rash may seem to go quite quickly, you still need to apply the cream for 1-2 weeks after the rash has gone. This is to clear the fungi completely from the skin, which will prevent the rash from returning.
• For skin that is particularly inflamed, your doctor may prescribe an antifungal cream combined with a mild steroid cream. This would normally be used for no more than seven days. You may need to continue with an antifungal cream alone for a time afterwards. The steroid reduces inflammation and may ease itch and redness quickly. However, the steroid does not kill the fungus and so a steroid cream alone should not be used.

An antifungal tablet is sometimes prescribed if the infection does not clear with a cream, or if the infection is severe, or if the infection is in many places on the skin in addition to the toes. For example, terbinafine, griseofulvin, or itraconazole tablets.

You do not need to stay away from work, school or sports. However, try to keep your feet covered in communal changing areas until the rash is gone. Also, try not to scratch the affected skin, as this may spread infection to other sites.

The following tips may prevent athlete's foot recurring

• Wash your feet and toes daily.
• Dry the skin between your toes thoroughly after washing. This is perhaps the most important point. It is tempting to put socks on when your feet are not quite dry. The soggy skin between the toes is then ideal for fungi to grow.
• Do not share towels in communal changing rooms. Wash towels frequently.
• Change your socks daily. Fungi may multiply in flakes of skin in unwashed socks. Cotton socks and leather footwear are probably better than nylon socks and plastic footwear, which increase sweating.
• Ideally, alternate between different shoes every 2-3 days to allow each pair to dry out fully after being worn.
• Ideally, wear flip-flops or plastic sandals in communal changing rooms and showers. This prevents the soles of your feet coming into contact with the ground, which may contain flakes of skin from other people.
• Ideally, when at home, leave your shoes and socks off as much as possible to let the air get to your feet. However, this may not be practical for some people.