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Definition
A fungus infection of the foot caused by various dermatophytes which invade the "dead" outer layers of the skin. Also called tinea pedis.
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Description
Athlete's foot, or tinea pedis, is a common, generally harmless foot infection caused by fungi that thrive in warm, moist, and dark environments.
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Causes and Risk Factors
Wearing poorly ventilated shoes and socks that harbor perspiration provide an ideal breeding ground for the germs that quickly multiply to cause athlete's foot. Contact with surfaces (shower and locker-room floors) that harbor the organism also contributes to development of this problem.
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Symptoms
Typical symptoms include scaling and peeling in the toe webs (the area between the toes) generally without any accompanying pain, odor, or itching.
Some forms of athlete's foot may present as redness, blistering, and scaling along the sides and soles of the feet, taking on what is termed a moccasin pattern. In more advanced cases, the toe webs develop whitened, softened, and soggy; they may severely itch, and there may be a foul odor. As the condition worsens, painful cracking in the toe webs and some oozing may develop.
If it stays long enough, athlete's foot may eventually affect the toenails, developing a crumbly white texture, and causing the nails to thicken. In advanced cases, this can become very painful.
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Diagnosis
It is important to rule out other causes of similar symptoms. For example, hot, tight shoes may make the feet sweaty in warm weather; the moisture and friction may cause softening and peeling of the skin on the soles. Dyes, adhesive cements, and other substances inside the shoes may cause irritation, as may powders and nail polishes. Eczema, psoriasis, and scabies are other possible causes of similar symptoms.
The doctor may do a KOH (potassium hydroxide) preparation, which involves gently scraping the scaly skin onto a microscope slide, adding KOH, and looking under the microscope for signs of fungus.
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Treatment
Treatment for athlete's foot is usually simple, uncomplicated, and usually carried out at home. Topical antifungal preparations should be effective in treating dry and scaly areas. These include topical clotrimazole and miconazole (available over the counter) and terbinafine cream.
Sometimes, prescription oral antifungal medication may be required if the condition is severe. Medications may include griseofulvin, itraconazole, or terbinafine.
To relieve symptoms if the toe webs are macerated (soggy), doctors often recommend soaking the feet for twenty minutes, two times a day in a solution of aluminum subacetate, or 30 percent aqueous aluminum chloride. Broad spectrum antifungal creams and solutions may also be useful.
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Prevention
Athlete's foot is stubborn and will return when the conditions are right, no matter what common sense precautions one may take. To delay or help prevent its onset, a number of procedures should be followed:
- Always dry the feet, paying particular attention to the toe webs.
- After drying, apply antifungal lotion and follow this with an antifungal foot powder. Zeasorb AF is good because it contains no cornstarch, a substance that can encourage fungal growth.
- Wear socks made of absorbent fibers, and change them daily.
- When the feet are going to perspire excessively for extended periods of time, wear socks made of high turbo acrylic fiber. This will wipe the moisture away from the feet and carry it to the sock's outer layer to evaporate.
- When the weather is hot and humid, go barefoot whenever possible.
- Avoid tight, poorly ventilated shoes. Sandals or perforated shoes are best.
- Be sure to air your shoes at night and, if possible, do not wear the same street shoes or athletic footwear every day.
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Questions to Ask Your Doctor
Can this spread to the fingernails or other parts of the body?
What treatment do you recommend?
How long does it usually take to resolve the problem?
What measures need to be taken to prevent athlete's foot?
Are there any reasons or conditions that should warrant a call to the doctor's office?
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