Athlete's foot

Definition

Athlete's foot is a common fungus infection in which the skin of the feet, especially on the sole and toes, becomes itchy and sore, cracking and peeling away. Athlete's foot, also known as tinea pedis, can be difficult to clear up completely.

Athlete's foot received its common name because the infection is often found among athletes. This is because the fungi flourish best in the around swimming pools, showers, and locker rooms.

Description

Athlete's foot is very common, so common that most people will have at least one episode with this fungal infection at least once in their lives. It is found more often in adult males. In fact, symptoms that appears to be athlete's foot in young children are probably caused by some other skin condition.

Causes & symptoms

Athlete's foot is caused by a fungal infection that especially affects the skin between the toes. The fungi that cause

Athlete's foot fungus on toes of patient. (Custom Medical Stock Photo. Reproduced by permission.)

athlete's foot include Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum. These fungi live exclusively on dead body tissue, such as hair, the outer layer of skin, and the nails. The fungus grows best in moist, damp, dark places with poor ventilation. The problem is rare in children and those who customarily go barefoot.

Most people carry fungus on their skin. However, it will only flourish to the point of causing athlete's foot if conditions are right. The fungi multiply on the skin when it is irritated, weakened, or continuously moist. Sweaty feet, tight shoes, synthetic socks that do not absorb moisture well, a warm climate, and not drying the feet well after swimming or bathing, all contribute to the overgrowth of the fungus. Symptoms include itchy, sore skin on the toes, with scaling, inflammation, and blisters. Blisters that break, exposing raw patches of tissue, can cause pain and swelling. The infected feet also may have an unpleasant smell. As the infection spreads, itching and burning may worsen. In severe cases, the skin cracks and seeps fluid. Sometimes a secondary bacterial infection is also present.

If it is not treated, athlete's foot can spread to the soles of the feet and toenails. Stubborn toenail infections, called tinea unguium, may appear at the same time, with crumbling, scaling, and thickened nails, and nail loss. The infection can spread further if patients scratch and then touch themselves elsewhere (especially in the groin or under the arms). It is also possible to spread the infection to other parts of the body via contaminated bed sheets, towels, or clothing. Athlete's foot is more severe and more common in people taking antibiotics, corticosteroids, birth control pills, drugs to suppress immune function, and in people with obesity, AIDS, and diabetes mellitus.

Diagnosis

A dermatologist can diagnose the condition by physical examination and by examining a preparation of skin scrapings under a microscope. Not all foot rashes are athlete's foot, which is why a physician should diagnose the condition before any remedies are used. In order to properly diagnose the infection, the physician may do a fungal culture. Using nonprescription products on a rash that is not athlete's foot could worsen the rash, therefore, proper diagnosis is important.

Treatment

The infected foot should be kept well ventilated. A foot bath containing cinnamon has been shown to slow down the growth of certain molds and fungi, and is said to be very effective in clearing up athlete's foot. Eight to ten broken cinnamon sticks are boiled in four cups of water, simmered for five minutes, and then steeped for 45 minutes. The mixture can be then placed in a basin and used daily to soak the feet.

Herbal remedies used externally to treat athlete's foot include goldenseal (Hydrastis canadensis), tea tree oil (Melaleuca spp.), myrrh (Commiphora molmol), garlic (Allium sativa), oregano oil (though its smell is quite pungent), and calendula. The affected area should be swabbed with an herbal mixture twice daily or the feet should be soaked in a herbal footbath. Pau d'arco, also called taheebo or lapacho, can be used for athlete's foot as well. The tea bags can be soaked in water for about 10 minutes and then placed on the affected areas, or by making a tincture and directly rubbing the tea onto the toes.

Aromatherapy may be helpful. Several drops of the essential oils of tea tree, peppermint (Mentha piperita), or chamomile (Matricaria recutita), can be added to the bath water. Chamomile may be applied directly to the toes.

Allopathic treatment

Simple cases of athlete's foot usually respond to antifungal creams or sprays, such as tolnaftate (Aftate or Tinactin), clotrimazole, miconazole nitrate (Micatin products), or Whitfield's tincture made of salicylic acid and benzoic acid. Athlete's foot may be resistant to topical medication and should not be ignored. If the infection is resistant, the doctor may prescribe an oral antifungal drug such as ketoconozole or griseofulvin. Untreated athlete's foot may lead to a secondary bacterial infection in the skin cracks.

Expected results

Athlete's foot usually responds well to treatment, but it is important to complete the recommmended treatment, even if the skin appears to be free of fungus; otherwise, the infection could return. Tinea unguium may accompany athlete's foot. It is typically very hard to treat effectively.

Prevention

A healthy diet should be maintained. Foods with a high sugar content should be avoided, including undiluted fruit juice, honey, and maple syrup.

Good personal hygiene and a few simple precautions can help prevent athlete's foot. These include:

  • The feet should be washed daily; care should be taken to avoid contact with other parts of the body.
  • The feet should be kept dry, especially between toes.
  • Tight shoes and shoes made of synthetic material should not be worn.
  • The feet need to be kept well ventilated, especially in the summer; bare feet and sandals are recommended.
  • Absorbent polypropylene or white cotton socks are recommended; they should be and changed often.
  • Bathing shoes should be worn in public bathing or showering areas.
  • A good quality foot powder should be used to keep the feet dry.
  • If anyone in the family has athlete's foot, towels, floors, and shower stalls should be washed with hot water and disinfectant after use.

Resources

BOOKS

Donahue, Peggy Jo. Relief from Chronic Skin Problems. New York: Dell Publishing, 1992.

Orkin, Milton, Howard Maibach, and Mark Dahl. Dermatology. Connecticut: McGraw–Hill Professional Publishing, 1991.

Stoffman, Phyllis. The Family Guide to Preventing and Treating 100 Infectious Illnesses. New York: John Wiley and Sons, 1995.

Thompson, June, et al. Mosby's Clinical Nursing. St. Louis: Mosby, 1998.

ORGANIZATIONS

American Podiatric Medical Association. 9312 Old Georgetown Rd., Bethesda, MD 20814.

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