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Athlete’s foot belongs to a group of skin infections, collectively termed as tinea, which is caused by a dermatophyte fungus that lives on the surface of the skin.
This common foot infection, which also goes by the name of tinea pedis in the medical circle, is most prevalent in tropical climates and urban settlements.
This is primarily because the fungus responsible for this infection tends to proliferate fast in warm and humid environments.
Image: Athlete’s Foot
Three main culprits are responsible for most cases of tinea pedis, namely, Trichophytonrubrum, T. interdigitale, and Epidermophyton floccosum, all of which belong to the dermatophyte category.
Almost anyone can contract this infection, but there is an increased prevalence of athlete’s foot in men than in women.
The reason for this higher incidence rate among males is still unclear and requires further scientific investigation.
Most cases of athlete’s foot present no significant trouble, besides the usual skin discomforts associated with it.
However, one cannot disregard the fact that it is a highly contagious infection that can take a turn for the worse if not treated soon enough.
Causes of Athlete’s Foot
There are various strains of dermatophyte fungi that are responsible for athlete’s foot, but most cases can be traced back to three species in particular, namely, Trichophyton rubrum, Trichophyton interdigitale, and Epidermophyton floccosum.
The dermatophyte species live on or in the surface layer of the skin, or the epidermis, and generally thrive in warm, damp places, such as the sweat-prone area between the toes.
It is precisely for this reason that people who tend to perspire a lot are more vulnerable to this infection.
That said, one must note that this infection is not limited to sweaty or oily skin alone. There are numerous instances where the fungi have taken root in dry, flaky skin as well.
Such cases are most prevalent during the summers when the skin on your feet becomes increasingly dry due to the heat and loses its natural protective lipids.
Plus, the friction against footwear can result in injuries or cuts on your feet that give easy access to the infection-causing fungi.
People who regularly wear closed shoes are also susceptible to this infection. Repeatedly wearing dirty socks can only make it easier for the fungus to gain access to your feet.
Avoid wearing the same pair of shoes every day. Rotate your shoegear which allows them to air out time to time.
Additionally, the hot, sweaty confines of the shoe make it easier for the fungi to multiply and spread the infection.
People can contract athlete’s foot through direct or indirect contact with the skin of an infected individual.
The floors of communal pools, showers, and changing rooms are particular breeding grounds as they offer favorable conditions for the proliferation of this fungi.
People with this infection shed their skin onto these surfaces and contaminate the floors with the fungi. The infection can then be picked up by someone else who walks barefoot on the contaminated grounds.
Athlete’s foot can also be contracted by coming in direct contact with the infected skin of someone who has the infection.
Signs and Symptoms
The following symptoms usually accompany a typical case of athlete’s foot:
- The skin of your feet appears extremely dry.
- Itching and burning are felt between the toes, which may increase as the infection spreads to other parts of the feet.
- A red, scaly rash appears on the infected skin, usually spreading from between the toes to the insteps of the feet.
- Blisters may develop on the feet, which often peel or crack open when the skin is scratched, exposing small areas of raw, weepy tissue underneath.
- There is inflammation or swelling in and around the affected region.
- The infected foot may give off a foul smell.
Diagnosing Athlete’s Foot
Athlete’s foot is a pretty common infection with some characteristic physical traits that can be easily picked up by a trained eye.
Most cases are diagnosed by way of a simple visual examination of the feet. Your doctor will most likely inquire about your other symptoms and take into account any history of fungal infections as well.
The doctor may also ask about symptoms present elsewhere on the body. There are other diseases of the skin that may mimic an athlete’s foot.
In cases where the infection presents atypical symptoms or if the standard treatment fails to provide adequate relief, the need for additional testing may be required.
To that end, your doctor may take a skin or nail scraping from the site of the infection and test it in the lab for the presence of the suspected fungi.
The doctor will most likely use a scalpel with a blunt edge or a toothbrush to gently scrape off a piece of the infected skin.
This skin sample will then be examined closely, and the results of the test will either confirm or negate the diagnosis. However, sometimes the result is a false negative and additional testing is required.
Once the doctor knows what the underlying problem is, he/she will prescribe the appropriate treatment accordingly.
Athlete’s foot is more or less a harmless condition that can be easily treated at home with the help of medicated lotions, creams, or sprays that do not require a prescription.
Note that when you do go looking for a suitable over-the-counter cream or ointment for this purpose, make sure that it contains miconazole, clotrimazole, terbinafine, or tolnaftate.
Follow the manufacturer’s instructions in order to know the correct dosage and method of application. Dab a tiny amount of the product onto the affected area and massage it gently until it gets absorbed.
Repeat this application two to three times a day, and make sure to clean your hands before and after every application.
It is essential to continue using the cream for at least 2 weeks after your symptoms have cleared up to ensure that the fungus has been eradicated.
Severe cases of athlete’s foot may warrant a stronger treatment that goes beyond these preliminary over-the-counter options. Your doctor may prescribe antifungal pills or topical medicine to apply on your skin.
How to Manage Athlete’s Foot at Home
Here’s what you can do at home to speed up your recovery from athlete’s foot.
1. Self-Care Is a Must
- Keep your feet clean by washing them daily with antifungal soap and water. Once washed, let them dry until no trace of moisture if left on the skin before you put on socks or shoes.
If you are in a hurry, you can use a clean towel that is meant specifically for your feet to dry them thoroughly. The space between the toes often takes longer to dry as the air does not reach these confined spots easily.
It is important you dry out any dampness that may be trapped in these tight spots and skin folds.
- You can even use dusting powder on affected area. Be carefull not to use too much as this can be irritating in between the toes.
- Use a cotton or foam wedge to spread out your toes and keep the space between them properly ventilated.
- People with diabetes should take special care of their feet as they are especially prone to foot problems such as this.
It is important to adhere to your doctor’s instructions in this regard and get regular foot examinations to rule out the possibility of any infection.
- Because your toenails can harbor the causative fungi and contribute to the spread of the infection, you can minimize your risk by keeping them clean and filed short.
- Avoid wearing ill-fitting shoes that squeeze your toes together, which allow sweat to gather between them and encourage the growth of fungal infection.
- During the summers, try to wear sandals, flip-flops, or other open footwear to avoid sweaty feet.
If you must wear shoes, opt for those that are light, airy, and made from natural materials.
- Choose shoes that have a wide and deep toe box that allows enough room for your toes to breathe.
For trainers, choose the ones that have ventilation holes in them.
- Avoid cotton and nylon socks, as they trap moisture close to the skin; acrylic is better.
- No matter how intensely your foot itches, resist the urge to scratch it. Scratching the already damaged skin will further aggravate the condition and slow down recovery.
Rinsing your feet with cool water is a better option to relieve the itch.
- If you suspect that your regular soap and shampoo are contributing to the skin irritation and damage caused by athlete’s foot, replace them with milder substitutes that are more skin-friendly.
- The clearing of the athlete’s foot symptoms does not guarantee that the fungus has been eliminated. Even though you may feel that you have fully recovered after several days or weeks of treatment, the fungus can still make a comeback when presented with an infection-conducive environment.
So, it is very important that you continue practicing the recommended foot hygiene regimen and shoe rotation for at least 2 weeks after the symptoms have disappeared.
2. Green Tea Works as a Natural Health Tonic
One folk remedy that is beneficial for athlete’s foot is practiced in Japan and is based on the therapeutic prowess of green tea.
Green tea is known to work as a natural astringent due to its tannic acid content, which may help keep the skin free of excess moisture and restrict the fungal activity.
Findings of one randomized controlled trial that involved 94 patients with interdigital tinea pedis elaborated on the positive effect of bathing and cleaning with green tea on athlete’s foot. (1)
When patients with interdigital tinea pedis were treated with a foot bath infused with green tea polyphenols for a continuous period of 3 months, a considerable improvement in their skin condition was observed, in terms of erythema and maceration of the skin. (1)
This healing effect can be largely attributed to the astringent and growth inhibitory activities of the tannins and catechins present in green tea. (1)
- Steep five tea bags in 4 cups of boiling water for 5 minutes.
- Allow the water to cool.
- Soak your feet in the tea bath for half an hour.
- Dry your feet thoroughly.
- Repeat this process twice daily for 5-6 weeks.
Green tea works as a health-restorative drink that may help you heal from within. According to current research data, there are virtually no known side effects attributed to this soothing beverage, but there is still a lack of substantial evidence in support of green tea as a therapeutic agent for relieving athlete’s foot. Thus, more elaborate studies are required to comprehensively establish the health benefits of green tea in this regard.
3. Tea Tree Oil Can Help Eliminate Fungal Growth
Topical application of tea tree oil may help your skin heal fast from athlete’s foot, although there is still room for further investigation to establish its potential benefits.
According to a dermatological review concerning the application of tea tree oil for skin conditions, the liquid was found to exhibit some therapeutic effect. (2)
However, the findings also reveal that the oil at its original potency can be too harsh for your skin and cause a number of adverse skin reactions. (2)
Concentrated versions of tea tree oil can damage the skin barrier and leave it utterly irritated. The toxic effects of undiluted tea tree oil can also make your skin susceptible to allergic contact dermatitis and systemic contact dermatitis, especially after prolonged use.
Note: There is a lot of buzz about the skin-healing potential of tea tree oil, but one cannot expect to reap the benefits of this skin salve unless it is used properly. Tea tree oil is not toxic by nature, but it can be too harsh for your skin when used at its original strength.
Thus, it is extremely important to dilute the potency of this oil before using it topically, especially in the case of athlete’s foot when your skin is already quite sensitive and irritated due to the infection.
There isn’t enough scientific evidence to substantiate the skin-healing benefits of tea tree oil, especially for tinea treatment. More extensive research is required to establish the therapeutic potential of tea tree oil, as well as its appropriate dosage and the safest mode of application for the treatment of athlete’s foot.
4. Vinegar Works as a Natural Astringent
Being acidic by nature, vinegar may help reduce the alkalinity of the skin to make it less habitable for the dermatophyte fungus and prevent it from spreading.
The astringent properties of vinegar may also come into play in reducing the moisture content of your epidermal skin, thereby aiding the healing process.
One review on the topic stated that the antifungal and antimicrobial virtues of vinegar could be traced back to acetic acid, which is its main component. (3)
Not only does this acid account for vinegar’s extremely low pH, but it is also known to penetrate the cell membranes of microorganisms, ultimately causing the cells to die.
Bear in mind, however, that vinegar can be quite acidic at high concentrations and is not safe for a topical application unless diluted. It is also ill-advised to use this relatively potent liquid on your skin for extended periods as it can leave you with skin burns. (5)
Given that there are no direct studies to validate the therapeutic benefits of vinegar for the treatment of athlete’s foot, further research is warranted to ascertain the same. The currently available studies point to the antifungal and antimicrobial properties of vinegar, which are promising for combating superficial infections such as athlete’s foot. Moreover, there is considerable anecdotal evidence that supports the use of vinegar for relieving the symptoms of this fungal infection.
5. Garlic Can Help Inhibit Fungal Activity
Garlic contains two major organosulfur compounds, namely, ajoene and allicin, which may exhibit some degree of antifungal activity against the dermatophytes responsible for athlete’s foot.
Garlic is considered to be at its potent best when raw, which when crushed, undergoes a chemical process that leads to the secretion of the antifungal compound allicin. (6)
The medical virtues of garlic extract for the treatment of athlete’s foot require further investigation, as there is a dearth of carefully obtained evidence that can conclusively legitimize its clinical efficacy.
Given the lack of research, one cannot rule out the possibility of adverse side-effects as well. In fact, there has been some incidence where the oral administration of garlic extracts resulted in the onset of contact dermatitis. (7)
One must reiterate, however, that such negative outcomes are not a common occurrence but have been reported in random cases. (7)
Garlic packs quite an antifungal punch, which can be utilized for treating a mild case of athlete’s foot. It can help promote recovery by weakening the pathogen responsible for the infection. However, for garlic to work, you must use it in the right amount. The topical application of garlic is unlikely to trigger any side-effects like skin irritation or dermatitis, but extended usage may cause problems.
How Can an Athlete’s Foot Be Prevented?
Podiatric hygiene is extremely essential for your overall health, but a lot of people fail to recognize its true importance until they are faced with problems such as athlete’s foot.
To save yourself the pain and discomfort that are characteristic of such conditions, it is best that you keep your feet in optimal condition.
You can minimize your risk of contracting the fungal infection responsible for athlete’s foot by adopting the following preventive measures:
- Never go barefoot into a public shower, bathroom, or other such common infection sites.
Always wear shower shoes or flip flops to avoid coming in direct contact with the possibly contaminated floors in such communal settings.
If you have an infection yourself, protective footwear will prevent you from shedding your infected skin on the floor for others to pick up.
- If you are prone to excessive perspiration, dab some talcum powder on the problem areas to reduce the sweating. Antiperspirant may also be helpful.
In the case of athlete’s foot, this applies to your feet, particularly the area between your toes.
- You can reduce your risk of developing athlete’s foot by regularly changing your socks and shoes, especially if you perspire heavily.
It is generally recommended to wear synthetic blend socks that tend to absorb moisture readily.
- If you have been wearing tightly-strapped shoes on a stretch, it is recommended to either loosen your laces or open your shoes completely from time to time.
This allows air to circulate within the confines of the shoes and dry out your sweaty feet.
- It is best to avoid wearing sharing footwear with other people, more so if you suspect that the other person has a foot infection or if you have one.
Risk Factors for Athlete’s Foot
The following factors can make you increasingly predisposed to an athlete’s foot infection:
- If you have a genetic predisposition to the infection, revealed by the fact that other people in your family have had it
- If you have any pre-existing allergies
- If you have other pre-existing skin conditions such as eczema
- If you have particularly sweaty feet
- If you suffer from blood circulation problems in the legs, often a by-product of diabetes or constricted blood vessels
- If you have a compromised immune system, on account of a serious illness or the long-term use of certain Immunosuppressive medication
- If you are actively involved in certain sports, especially running and swimming
Complications Associated with Athlete’s Foot
However benign this condition may be, athlete’s foot must be treated in a timely manner to prevent the spread of infection and the complications that arise thereafter.
If the infection is left to fester for too long, it can spread to the toenails, causing them to thicken and turn yellow. This kind of infection is far more stubborn and, consequently, harder to treat.
Considering how contagious fungal infections are, an athlete’s foot can also escalate to a more widespread condition encompassing different parts of the body.
If you ignore the infection, it is more likely to spread from your feet to other areas of your skin such as your hands, groin, and scalp.
Thus, the importance of timely treatment cannot be emphasized enough for containing the spread of this infection.
This kind of aggravation usually results from inadequate hygiene practices, such as using a common towel to dry your infected feet as well as the rest of your body.
The best way to arrest the growth of fungi and contain the infection is by addressing the condition as soon as you notice the symptoms.
Myths and Facts
1. The athlete’s foot, by virtue of its name, is often mistaken to be an infection that is restricted to sports people alone.
However, this is far from the truth. Almost anyone can contract this infection, but athletes are certainly more prone to it for the simple reason that they are more physically active than the general population.
They are also more frequently exposed to damp environments, which provide a suitable breeding ground for the fungus to thrive, such as community pools, public showers, and changing rooms at gyms. Thus, they are more likely to pick up this infection.
2. There is a common misconception that superficial infections such as athlete’s foot tend to resolve without any self-care measures or medical help and that you can just let your skin heal on its own.
However, this kind of misguided approach only aggravates your foot condition and can pave the way for future complications.
If athlete’s foot is not treated in due time, the symptomatic discomfort will worsen, and the fungus may spread to the nail bed and other areas of the body.
In some cases, an untreated athlete’s foot can give rise to a more serious bacterial infection that necessitates antibiotic treatment.
The only way to avoid such adverse outcomes is to address the condition at the earliest by doing the above-mentioned home remedies and/or applying the prescribed antifungal treatment.
3. A lot of people are confused about whether the athlete’s foot can affect other parts of the body aside from the foot.
While it is true that the infection-causing fungus can get transferred to other areas of the body, the resulting infection is not referred to as athletes’ foot.
For instance, if a person touches the infection-ridden foot and then touches his groin and inner upper thighs with his contaminated hands, the resulting infection is called jock itch.
If you spread the fungus to your hands, the infection that grows on your hands is termed as tinea manuum.
In short, although all these varying infections of the different parts of the body are caused by the same fungi, they are considered as separate conditions with their own individual names and mode of treatment.
When to See a Doctor
Most cases of fungal infections such as athlete’s foot often resolve themselves naturally provided you practice proper foot care and hygiene.
However, if you fail to register any improvement in your symptoms despite routine foot care for more than 2 weeks, it is best to consult a podiatrist or healthcare provider.
Expert Answers (Q&A)
Answered by Dr. Hai-En Peng (Podiatrist)
If athlete’s foot is left untreated, it can lead to a whole host of issues. It can jump into your nails, causing nail fungus.
You can get a bacterial infection from the constant scratching that can lead to life-threatening infection and possibly lose your leg.
Not usually. The odor could be a sign of another problem not necessarily related to athlete’s foot.
It is a nice natural solution that can help, but it’s best to use it in conjunction with topical medication, not as primary treatment.
It can help dry out the dampness and sterilize the affected foot. Please be sure to use the right amount.
There are many different types of effective topical creams/gels/lotions that can help you get rid of athlete’s foot. It can be as quick as 2 weeks, depending on what medication your physician writes for you.
You can if you want. You don’t necessarily have to stop wearing socks if you have athlete’s foot. Just be sure to wash them well after use.
The socks can also help the prescription medication get into the skin better.
Yes, it can. These blisters, if popped, are sterile, clear fluid.
We are an active society. We are constantly trying to lose weight and stay healthy, so we spend a lot of time in gyms and swimming pools.
The locker rooms are breeding grounds for fungi causing athlete’s foot, so please help yourself by wearing protective footgear as you shower in the locker room area.
When going swimming, use supportive sandals to protect your feet on the pool deck. If you are into martial arts, yoga or dance, if you can wear socks to protect your feet at the studio, then do so. If you can’t, then be sure to wash your feet when you get home.
You can never trust the habits of other people at the studio. Do not become overly obsessive about it, but be smart. If you do, you’ll be able to significantly lessen your chance of picking up athlete’s foot.
About Dr. Hai-En Peng, Podiatrist: Dr. Peng was born in Nyack, NY, and went to California College of Podiatric Medicine in San Francisco, CA. He spent 4 years there and graduated in the top 15% of his class. Dr. Peng also completed a 3-year advanced surgical residency in reconstructive foot and ankle surgery.