Athlete's foot

Overview

Athlete's foot (tinea pedis) is a fungal skin infection that usually begins between the toes. It commonly occurs in people whose feet have become very sweaty while confined within tight-fitting shoes.

Signs and symptoms of athlete's foot include an itchy, scaly rash. The condition is contagious and can be spread via contaminated floors, towels or clothing.

Athlete's foot is closely related to other fungal infections such as ringworm and jock itch. It can be treated with antifungal medications, but the infection often comes back.

Symptoms

Athlete's foot can affect one or both feet. Common signs and symptoms are:

• Scaly, peeling or cracked skin between the toes
• Itchiness, especially right after taking off shoes and socks
• Inflamed skin that might appear reddish, purplish or grayish, depending on your skin color
• Burning or stinging
• Blisters
• Dry, scaly skin on the bottom of the foot that extends up the side

When to see a doctor

If you have a rash on your foot that doesn't improve within two weeks of beginning self-treatment with an over-the-counter antifungal product, see your doctor.

If you have diabetes, see your doctor if you suspect that you have athlete's foot. Also see your doctor if you have signs of an infection — swelling of the affected area, pus, fever.

Causes

Athlete's foot is caused by the same type of fungi (dermatophytes) that cause ringworm and jock itch. Damp socks and shoes and warm, humid conditions favor the organisms' growth.

Athlete's foot is contagious and can spread through contact with an infected person or from contact with contaminated surfaces, such as towels, floors and shoes. You can also spread it from the foot to other parts of the body, especially if you scratch or pick the infected parts of your foot.

Risk factors

You are at higher risk of athlete's foot if you:

• Frequently wear enclosed footwear
• Sweat heavily
• Share mats, rugs, bed linens, clothes or shoes with someone who has a fungal infection
• Walk barefoot in public areas where the infection can spread, such as locker rooms, saunas, swimming pools, communal baths and showers

Complications

The athlete's foot infection can spread to other warm, moist parts of the body. Jock itch is often caused by the same fungus that results in athlete's foot. It's common for the infection to spread from the feet to the groin because the fungus can travel on hands or towels.

Athlete's foot can sometimes lead to bacterial infections.

Prevention

These tips can help you avoid athlete's foot or avoid spreading it to others:

• Let your feet air out. When you can, wear sandals to let your feet air out as much as possible.
• Wash your feet daily. Use warm, soapy water and rinse and dry your feet thoroughly, especially between the toes. Apply a medicated foot powder (Tinactin, Gold Bond, others) or other medicated powder (Lotrimin AF, Zeasorb, others) if you're prone to athlete's foot.
• Change socks regularly. Change your socks at least once a day — more often if your feet get really sweaty. Moisture-wicking socks, such as those made from cotton, help keep your feet drier than do nylon socks.
• Alternate pairs of shoes. Use different shoes from day to day. This gives your shoes time to dry after each use.
• Protect your feet in public places. Wear waterproof sandals or shoes around public pools, showers and lockers rooms.
• Be aware of the risk factors for spreading the condition. If you live with others, don't share shoes or unwashed bedding and towels.

Diagnosis

Your doctor may be able to diagnose athlete's foot simply by looking at it. Some types of athletes foot look like dry skin or dermatitis. To help confirm the diagnosis and rule out other conditions, your doctor might take a skin scraping from the affected area for testing in a lab.

Treatment

If your athlete's foot doesn't respond to nonprescription products and self-care, you may need to see a doctor to get a prescription-strength cream or ointment, such as clotrimazole, econazole (Ecoza) or ciclopirox (Loprox). If you have a more serious infection, your doctor might prescribe antifungal pills, such as terbinafine or itraconazole (Sporanox, Tolsura). Or you might need both topical and oral medicine.

Lifestyle and home remedies

These tips can help you ease the symptoms of athlete's foot or avoid a recurrence:

• Keep your feet clean and dry. Wash your feet twice a day and gently towel-dry between the toes.
• Use an antifungal product. After washing and drying your feet, apply an antifungal product. The antifungal terbinafine (Lamisil AT) has been shown to be very effective. Another option is clotrimazole (Lotrimin AF). You may need to experiment to find the product and formulation — ointment, gel, cream, lotion, powder or spray — that work for you. Apply the product to the affected skin as directed — usually twice a day until a week after the rash clears up. It might take 2 to 4 weeks to see results. If the condition comes back, you might need to start applying the product again.
• Change socks regularly. Change your socks at least once a day — more often if your feet get really sweaty.
• Wear light, well-ventilated footwear. Avoid shoes made of synthetic material, such as vinyl or rubber. Wear sandals when possible to let your feet air out.
• Alternate pairs of shoes. Use different shoes from day to day. This gives your shoes time to dry after each use.
• Protect your feet in public places. Wear waterproof sandals or shoes around public pools, showers and lockers rooms.
• Try not to scratch the rash. You can try soothing your itchy feet by soaking them in cool water.
• Don't share shoes. Sharing risks spreading a fungal infection.

Preparing for an appointment

Your primary care doctor or a skin specialist (dermatologist) can diagnose athlete's foot. You don't need any special preparations for an appointment to diagnose athlete's foot.

What you can do

Before your appointment, you might want to write down a list of questions to ask your doctor. Examples include:

• What's the most likely cause of my symptoms?
• Are tests needed to confirm the diagnosis?
• What treatments are available?
• Is this condition temporary or long lasting?
• Is there a generic alternative to the medicine you're prescribing?
• Can I wait to see if the condition goes away on its own?
• What can I do to prevent the infection from spreading?
• What skin care routines do you recommend while the condition heals?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• When did you first notice your symptoms?
• What did the rash look like when it first started?
• Is the rash painful or itchy?
• Does anything seem to make it better?
• What, if anything, makes it worse?
• Does a family member also have athlete's foot?
• Have you spent time at swimming pools, locker rooms, saunas or other places where athlete's foot might be spread?