Athlete's foot

Athlete's foot, also called tinea pedis, is a very common skin infection of the feet caused by a fungus. It often makes the skin itch, peel, crack, and turn red. Sometimes, small blisters may form. The fungus usually grows between the toes, but it can also affect the bottom of the foot. In some cases, the same fungus can infect the nails or even the hands.

This infection is caused by different types of fungus, such as Trichophyton, Epidermophyton, and Microsporum. People can catch it by touching infected skin or coming into contact with fungus in places like swimming pools or locker rooms. It can also spread from animals. Doctors usually diagnose athlete's foot by looking at the symptoms, but they can also use a microscope or a culture to be certain.

Athlete's foot can happen to anyone, not just athletes. It may occur if someone walks barefoot in public showers, wears tight shoes, or forgets to change socks every day. The infection can be treated with special creams or medicines applied to the skin, and in more difficult cases, pills may be needed. It’s important to keep the feet dry and wear sandals to help the infection go away. Athlete's foot was first described in 1908 and affects about 15% of people around the world, especially older children and young adults.

Signs and symptoms

Athlete's foot is a common skin infection that can happen in four main ways. It often shows up between the toes, especially between the little toe and the one next to it. The skin might look red, feel itchy, or appear scaly and soft if it stays wet. In some cases, the skin can crack or develop small blisters.

Another type of athlete's foot affects the sole of the foot. Here, the skin might look slightly red and feel rough. A less common type can cause sudden itchy blisters on the sole. If left untreated, the infection can spread to the toenails or other parts of the body. Scratching the itchy areas can make the problem worse and help spread the infection to other places.

Causes

Athlete's foot is a common skin infection caused by tiny fungi that live on dead skin. These fungi like to eat a protein in our skin called keratin. The most common fungi that cause athlete's foot are called Trichophyton rubrum and T. mentagrophytes.

Athlete's foot can spread easily. It can be passed by touching someone who has it, or by touching things like towels, shoes, or floors that have the fungus on them. The fungus can also spread from other parts of the body to the feet if you scratch or touch those areas and then your feet. People who have had athlete's foot before, adults, men, or those with conditions like diabetes or weak immune systems are more likely to get it. Sweating a lot can also make it easier to get and harder to treat.

Diagnosis

When you see a doctor for athlete's foot, they will check your health history and ask questions about your symptoms, like itching or scratching. They will look at your skin to help figure out if it’s athlete’s foot.

If they are not sure, they might take a small piece of skin and look at it under a special light or microscope. This can show if the problem is caused by a fungus and not something else, like irritation from skin products.

Prevention

To help stop athlete's foot and keep it from coming back, it’s important to keep your feet clean and dry. Try to keep your toenails short and clean, and use a different nail clipper if you have an infection. Wear socks that let your feet breathe and change them often. It’s also good to wear sandals in places like gym showers or locker rooms.

The tiny germs that cause athlete's foot like warm, wet places. So, try to keep your feet dry, especially in shoes and socks. Cleaning things like bathtubs and shower floors with a special cleaning liquid can help stop the germs from spreading. Always keep your socks and shoes clean, and don’t share shoes or towels when you have an infection.

Treatment

Athlete's foot often gets better on its own in about 30 to 40% of cases, but using special creams or medicines on the skin works much better. To treat it, wash your feet well every day or every other day and then put on a special topical medication. Because the skin on your feet can get damaged, you need to keep using the medicine until all the skin has grown back, which can take 2 to 6 weeks after you feel better. It’s important to keep your feet dry and follow good hygiene rules to stop the fungus from coming back.

Sometimes, just treating your feet isn’t enough. If your socks or shoes have the fungus, wearing them again can make the infection come back. You can clean socks by washing them with bleach or in very hot water. It’s also important to treat any other places on your body that might be infected, like your toenails or hands, to prevent the infection from spreading back to your feet.

There are many different topical antifungal drugs that can help, such as miconazole nitrate, clotrimazole, and terbinafine. These come as sprays, powders, creams, or gels. For example, using butenafine once a day for a week or terbinafine once a day for two weeks usually works well. Sometimes, extra medicines like urea or salicylic acid are needed to help the antifungal medicine reach deeper skin.

In more serious cases, doctors might prescribe oral medicines such as terbinafine, fluconazole, or itraconazole. The most common side effect from these medicines is feeling sick to the stomach.

Epidemiology

Athlete's foot affects many people around the world. About 20% of adults and 70% of all people will get it at some point in their lives. It is more common in people who wear tight or non-breathable shoes, like rubber boots. The fungus that causes athlete's foot grows well in moist, warm places, such as between the toes.

People in jobs or activities that involve a lot of walking or sweating, like miners, soldiers, athletes, and runners, often get athlete's foot. Interestingly, places where people often go barefoot have much less athlete's foot compared to places where people wear shoes all the time. It was first noticed as a problem during World War I among soldiers. Later studies showed that many students and athletes got it too, especially in places like pools and gyms. Over time, doctors found ways to treat it better with special medicines.