A-Z OF SKIN

Athlete’s Foot

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Athlete’s foot is a fungal infection that involves the skin on the feet, usually between the toes. The same fungus can also spread to the hands and toenails. The name comes from the fact that the infection is commonly seen in athletes, such as runners, who shower often and have damp shoes and socks.

Also known as Tinea Pedis

Athlete’s foot occurs when the foot comes into contact with a fungus (type of organism), generally from the group of fungi called dermatophytes. This can happen if the foot directly touches the fungus, either from another infected person or a surface that has been contaminated. The fungi thrive in warm, moist environments such as locker rooms and gym showers. It feeds off keratin, a protein that makes up our skin, hair and nails.

Athlete’s foot also has an increased risk of occurring in certain groups of people including those with an impaired immune system and diabetes. The infection is more likely to occur in these groups of people if they have a cut or open sore on their feet.

In athlete’s foot the skin between the toes and feet is usually scaling, peeling and cracked. The skin can also have a whitish and soft appearance. In some cases blisters can form, and raw skin (ulcers) can appear.

People with athlete’s foot commonly experience itching. Sometimes a burning and stinging sensation can also occur.

Very rarely people have an allergic reaction to the fungus, causing blistering of the hands or feet.   Severe complications can also form such as:

  • secondary bacterial infections which causes the foot to be very painful, swollen and hot.
  • bacterial infection of the skin can also spread to the lymphatic system (part of the immune system) and lymph nodes.

The diagnosis is usually made by a doctor, based on the clinical appearance and symptoms experienced. If the doctor is unsure if the cause of the symptoms are a fungal infection, they may order a skin scrape test.

Potassium Hydroxide Skin Test

The most common skin test used is the potassium hydroxide skin test. The doctor scrapes off some skin from the infected area and it is placed in potassium hydroxide (type of chemical). The potassium hydroxide destroys our normal, healthy cells and leaves the fungus, which can be seen easily under a microscope.

The condition can often be treated with non – prescription, over the counter topical (direct on to the skin) medications. If required, stronger pharmacy medication can be prescribed by the doctor. Other treatments, that can be tried at home, can also be recommended by the doctor to help eliminate the infection.

Non – Prescription Products “leave-on products”

Non prescription products such as antifungals, which are able to destroy the fungi, can be used to treat athlete’s foot. These products that usually need to be applied to the area (topical) include:

  • miconazole
  • terbinafine
  • clotrimazol
  • butenafine
  • tolnaftate

Prescription “leave-on products”

Some medication may need to be prescribed by the doctor including:

  • prescription-strength clotrimazole or miconazole, which are stronger versions of the non presciption-products
  • steroid medications to help reduce skin redness and irritation (inflammation)

Prescription oral preparations

Certain medications can be prescribed by the doctor and need to be taken via the mouth (orally) such as:

  • oral antifungal medications like terbinafine, itraconazole or fluconazole
  • oral antibiotics if bacterial infections occur

Other Treatments

The doctor may recommend other treatments to try at home:

  • soaking feet in salt water or diluted vinegar to help treat and dry up blisters
  • tea tree oil, applied to the skin infection

Prevention

There are many ways to prevent athlete’s foot infection. These usually revolve around keeping the foot clean and dry and stopping the fungi from growing:

  • Wash your feet, especially the space between your toes, with soap and water regularly and dry thoroughly afterwards
  • Wear sandals in public spaces where water might touch your feet such as public showers and near swimming pools
  • Wash bed sheets, sock and towels in hot water (60C or higher) and disinfect shoes using wipes or sprays
  • Don’t share socks or shoes with others
  • Change your socks when your feet become sweaty

Athlete’s foot will generally improve and clear up if treated well. Athlete’s foot will usually respond to treatments that the doctor recommends. However, this can vary depending on if the disease is mild or severe. Sometimes the infection disappears quickly, but in other situations it can last for a long time. Occasionally treatment may be needed long term to prevent the infection from reappearing.

This information was provided by Niyaz Mostafa and Professor Stephen Schumack. Published Feb 2020

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