How to treat Athlete's Foot?

In a Nutshell

  • Athlete’s foot (also referred to as tinea pedis) is a common fungal infection that affects 3-15% of population mainly men & older individuals.
  • Prevention involves mainly around keeping the feet clean, dry, and aerated.
  • It can be managed by anti-fungal ointments, sprays, and creams but rate of recurrence is fairly high

What is Athlete's Foot?

Athlete’s foot is a common skin condition that is caused by fungi. It is fairly prevalent and according to latest estimates, about 3-15% individuals develop athlete’s foot at some point in their life. Men and older individuals are mostly affected.

The symptoms include itchy skin that cracks and flakes, especially between toes or sides/ soles of feet. In poorly managed cases, it may spread to nails to cause fungal nail infection. You can get athlete’s foot is you walk barefoot in public places with moist/ warm environment such as showers, changing rooms, locker rooms, swimming pool decks, etc. In addition, you can also catch infection by touching/ sharing articles from an infected person.

Symptoms of athlete’s foot can be managed by anti-fungal creams, ointments, or powder. In some cases, your GP may suggest steroid cream or other medicines if there are signs of bacterial infection.

Proven Preventive Regimen

Although the recurrence rate of athlete’s foot infection is fairly high, you can follow these tips to prevent re-infection

Keep Your Feet Clean & Dry

Fungal agents prefer moist and damp environment. Therefore, it is highly recommended to:

- Dab your feet dry after bathing or washing your feet. Give special emphasis to the area between toes and creases

Maintain caution with shoes

- Avoid wearing shoes when you are at home or resting to keep your skin exposed to fresh air

- Avoid wearing the same pair of shoes for more than two days in a row

- Avoid shoes that makes your feet hot and sweaty (especially in hot humid weather) such as shoes made from plastic or rubber

- In hot humid weather, wear flip flops or open sandals instead of covered shoes that makes your feet hot and sweat

Maintain Optimal Hygiene

- Keep a separate towel for your feet and make sure to wash it at periodic intervals

- Be sure to change your socks every day and always choose a breathable fabric for your sock (such as cotton)

- Avoid walking barefoot in exposed moist places such as showers, changing rooms etc.

- Never share your towel or personal articles (such as shoes, socks) with other people

Avoid Scratching

- If you have an active lesion, or infection, avoid scratching or touching it as it may spread the infection to other parts of the body

Antifungals

Most cases of athlete’s foot respond very well to topical antifungals that are available as over-the-counter gels, ointments, and creams. You can apply these once or twice a day for 2-4 weeks.

Common topical OTC antifungals are:

- Miconazole

- Terbinafine

- Clotrimazole

- Butenafine

- Tolnaftate

If your symptoms don’t improve with topical formulations, you should seek help from a healthcare professional who may advise oral antifungals (such as Fluconazole or Itraconazole) or prescription grade topical antifungals. The prescription grade antifungals are usually prescribed for 3-6 weeks. If your doctor suspects a bacterial infection along with fungal infection, you may be advised a course of Sulconazole or Ciclopirox and for 4 weeks.

Nuances/ Safety

Most cases of athlete’s foot can be managed at home; however, you may need to see a general physician if you are experiencing any of the following symptoms:

- Your feet are in severe pain or discomfort

- If your symptoms are not improving with over-the counter treatment options

- If you have a history of diabetes as people with diabetes develop more severe infection

- If you have compromised immune system (such as if you are on chemotherapy, have received a transplant or are on immunosuppressant medications)

Strength of Evidence:A

The recommendations presented in this article are based on the best practices as suggested by American Academy of Dermatology and The National Health Service.

Our Ruling

Athlete’s foot is a fungal infection that affects men who wear shoes/ boot for long hours in hot humid weather. Fungal agents grow and thrive in hot, humid, and sweating environment. The key to prevent athlete’s foot is to keep your feet dry, clean, and aerated. Avoid sharing shoes, towels and socks with other individuals and see a healthcare provider if you are experiencing severe or recurring infections.

Our Sources:

  1. https://www.aad.org/public/diseases/a-z/athletes-foot-prevent
  2. https://www.nhs.uk/conditions/athletes-foot/
  3. https://medlineplus.gov/athletesfoot.html
  4. https://www.medicinenet.com/athletes_foot/article.htm
  5. https://www.ncbi.nlm.nih.gov/books/NBK279549/#

Keywords:

Athlete’s foot, tinea pedis, fungal foot infection, antifungal creams

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