Athlete’s Foot: Fungal Infection and Foot Complications

picture of athletes_foot

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

Signs and symptoms of athlete’s foot include a scaly rash that usually causes itching, stinging and burning. Athlete’s foot 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 over-the-counter antifungal medications, but the infection often recurs. Prescription medications also are available.

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Athlete’s foot facts

  • Athlete’s foot is a common skin infection of the webs of the toes and soles of the feet.
  • When caused by a fungus, athlete’s foot may spread to the palms, groin, and body.
  • Fungal infections of the feet are contagious and can be spread person to person or by walking on contaminated objects and floors.
  • Athlete’s foot may cause foot itching, burning, pain, and scaling.
  • When athlete’s foot is caused by a fungus, it can be treated with antifungal medications, many of which are available over the counter.
  • Keeping the feet dry by using cotton socks andbreathable shoes can help prevent athlete’s foot.

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What Causes Athlete’s Foot?

The majority of athlete’s foot cases are caused by a variety of fungi all belonging to a group called dermatophytes, which also causes jock itch and ringworm. The fungi thrive in closed, warm, moist environments and feed on keratin, a protein found in hair, nails, and skin. Rarely, athlete’s foot can be caused by non-dermatophytes, like yeast (candida).

Athlete’s foot is mildly contagious. It can be spread through direct contact with the infection and by skin particles left on towels, shoes, or floors.

Walking barefoot may increase your chance of contracting athlete’s foot. The risk of developing athlete’s foot can also depend on your susceptibility. For example, people who have impaired immune systems or diabetes are at greater risk.

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Symptoms of Athlete’s Foot

The most common symptom is cracked, flaking, peeling skin between the toes or side of the foot. Other symptoms can include:

  • Red and itchy skin
  • Burning or stinging pain
  • Blisters that ooze or get crusty

If the fungus spreads to your nails, they can become discolored, thick, and even crumble.

Athlete’s foot may occur at the same time as other fungal skin infections such as jock itch.

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Risk factors of Athlete’s Foot

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

  • Are a man
  • Frequently wear damp socks or tight-fitting shoes
  • 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
  • Have a weakened immune system

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What does athlete’s foot look like?

Most cases of athlete’s foot are barely noticeable with just slightly dry, flaky skin. More extensive athlete’s foot may look like red, peeling, dry skin areas on one or both soles of the feet. Sometimes the dry flakes may spread onto the sides and tops of the feet. Most commonly, the rash is localized to just the bottoms of the feet. The space between the fourth and fifth toes also may have some moisture, peeling, and dry flakes.

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There are three common types of fungal athlete’s foot:

  1. soles of the feet, also called “moccasin” type
  2. between the toes, also called “interdigital” type; and
  3. inflammatory type or blistering.

Occasionally, it may appear as small or large blisters of the feet (called bullous tinea pedis), thick patches of dry, red skin, or calluses with redness. Sometimes, it may look like just mild dry skin without any redness or inflammation.

Fungal athlete’s foot may present as a rash on one or both feet and even involve the hand. A “two feet and one hand” presentation is a very common presentation of athlete’s foot, especially in men. Hand fungal infections are called tinea manuum. Fungal athlete’s foot may also be seen along with ringworm of the groin (especially in men) or hand(s). It is helpful to examine the feet whenever there is a fungal groin rash called tinea cruris. It is important to treat all areas of fungal infection at one time to avoid reinfection. Simply treating the soles and ignoring the concurrent fungal infection of toenails may result in recurrences of athlete’s foot.

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Treatment for Athlete’s Foot

Over-the-counter antifungal powders or creams can help control the infection:

  • These contain medicine such as miconazole, clotrimazole, terbinafine or tolnaftate.
  • Keep using the medicine for 1 to 2 weeks after the infection has cleared to prevent it from returning.

In addition:

  • Keep your feet clean and dry, especially between your toes.
  • Wash your feet thoroughly with soap and water and dry the area carefully and completely. Try to do this at least twice a day.
  • To widen and keep the web space (area between the toes) dry, use lamb’s wool. This can be bought at a drugstore.
  • Wear clean cotton socks. Change your socks and shoes as often as needed to keep your feet dry.
  • Wear sandals or flip-flops at a public shower or pool.
  • Use antifungal or drying powders to prevent athlete’s foot if you tend to get it often, or you frequent places where athlete’s foot fungus is common (like public showers).
  • Wear shoes that are well-ventilated and made of natural material such as leather. It may help to alternate shoes each day, so they can completely dry between wearings. Do not wear plastic-lined shoes.

If athlete’s foot does not get better in 2 to 4 weeks with self-care, or frequently returns, see your health care provider. Your provider may prescribe:

  • Medicines to take by mouth
  • Antibiotics to treat bacterial infections that occur from scratching

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Athlete’s Foot Complications

Your athlete’s foot infection can spread to other parts of your body, including:

  • Your hand. People who scratch or pick at the infected parts of their feet may develop a similar infection in one of their hands.
  • Your nails. The fungi associated with athlete’s foot can also infect your toenails, a location that tends to be more resistant to treatment.
  • Your groin. 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 as the fungus can travel on your hands or on a towel.

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