What is athlete’s foot? – Symptoms, Risk Factors, and Treatment

What is an athlete’s foot? 

An athlete’s foot or tinea pedis is a commonly occurring fungal infection that affects the skin on the feet. The fungi dermatophytes cause athlete’s foot which is also responsible for causing jock itch and ringworm. The condition is widespread, affecting nearly one in four people at some point in their lives.  

Fungi or fungal germs are comparatively lower in number on human skin, where they typically cause no harm. However, the right circumstances allow them to infiltrate the skin, multiply and spread infection. Fungi prefer warm, moist and airless skin regions, like those found between the toes.

Causes of athlete’s foot

Athlete’s foot can affect anyone. People who sweat more or wear socks and shoes that make their feet sweat more frequently experience it. 

Additionally, athlete’s foot can spread from person to person. This might happen if a person walks barefoot in public showers or swimming pools that athletes or swimmers with infections use. 

While taking a shower, a small fragment of the infected skin of a person with athlete’s foot may come off. After that, other people might walk on it and become infected. Usually, an infection spreads along the skin after a small patch forms.

Risk factors for athlete’s foot

Frequently wearing enclosed footwear

The sweaty foot is more common in enclosed footwear which is an ideal environment for fungus proliferation. 

Sweat heavily 

Excess sweat creates dampness which is comfortable for fungi to live and multiply quickly.

Share mats, rugs, bed linens 

Fungus can easily contaminate mats, rugs and bedspreads when an infected person uses them. The probability of the infection spreading to other body parts is high while using the same products.

Sharing clothes or shoes with someone who has a fungal infection 

The clothes and shoes of a person with a fungal infection can transmit the fungus to a non-infected person who uses it.

Symptoms of athlete’s foot

Red and itchy skin 

The foot of a person with athlete’s foot becomes swollen and develops a rash. The rash becomes red, and itchiness occurs.

Burning or stinging pain 

With the increase in the intensity of the athlete’s foot, the rash and infection give a painful burning sensation.

Blisters that ooze or get crusty 

Since the condition is due to sweat and moisture content while wearing tight shoes, the feet are unable to breathe. This can bring about fluid-filled blisters. The blisters can ooze out their fluids and become crusty.

Scaly, peeling or cracked skin

The rash due to the fungal infection is usually red and scaly. When the condition progresses, the skin starts to peel off and might be itchy. Cracks in the skin between the toes are also noticeable. 

Dry, scaly skin

The feet become sore and dry due to fungal infection. The dry and scaly skin is initially at the bottom of the foot and extends to the sides.

Discoloured, thick and crumbly toenails 

Toenails serve as an ideal place for fungal infection since they are moist and warm. The nails become brittle and crumbly. The discolouration results from debris build-up beneath the nail, making it darken.

Toenails that pull away from the nail bed 

By growing between the toenails and nail beds, fungi can eventually make the nail fall off.

What are the types of athlete’s foot? 

The various symptoms of an athlete’s foot can be broadly classified into four types.  

Toe web infection 

The toe web infection is the most common infection that affects the area between the fourth and the fifth toe, causing red and cracked skin. 

Moccasin-type infection  

This type of athlete’s foot commonly affects the feet inches and the heel. In rare cases, This infection can spread to the toenails and cause them to fall out.  

Vesicular type infection 

This foot infection most commonly affects the bottom of the teeth and can also appear in other parts. People with this type of athlete’s foot infection develop fluid-filled blisters on their legs.  

Ulcerative infection 

Ulcerative infection is a severe infection that can cause a rare type of sore between the toes and the bottom of the feet, causing extreme discomfort.  

Diagnosis of athlete’s foot

KOH exam 

KOH prep test is a non-invasive procedure to diagnose fungal infections of the nails and skin. 

Cells collected from the infected skin region are analysed by placing them on a slide with potassium hydroxide (KOH) solution. By examining this slide under a microscope, signs of fungus can be detected.

Skin culture 

Fungal or skin culture helps detect the root cause of scaling, peeling, cracking or blistered skin. This can also help diagnose the reason for redness or constant irritation. Athlete’s foot is confirmed if there is the presence of fungi.

A skin biopsy  

A skin biopsy involves collecting skin samples of the infected region. This requires scraping the skin using a blade or sides of a slide to be placed under a microscope.

The sample on the slide is stained with dyes and chemicals that help analyse the presence of fungus.

Prevention of athlete’s foot

Keep the foot clean and dry

It is hard for fungus to thrive and survive in sweatless and moisture-less conditions. Keep the foot dry and clean by using talcum powder or an antifungal product to treat athlete’s foot effectively. Also, it is best to towel dry the foot after washing it with water. 

Antifungal product

Antifungal terbinafine (Lamisil AT) is an effective treatment for athlete’s foot. Clotrimazole (Lotrimin AF) also has the same effects. Ointment, gel, lotion, powder, cream or spray can also work for athlete’s foot. 

The working of clotrimazole is by killing the fungus that is the source of the infection. Clotrimazole kills it by making holes in the cell membrane of the fungus and allowing the contents to leak out. It also treats the infection by eliminating the fungus.

Change socks regularly 

It’s possible to prevent fungal infections of the foot, especially tinea pedis or athlete’s foot, by changing the socks regularly. To keep the feet as dry as possible, change socks frequently.

Wear light, well-ventilated footwear 

It’s crucial to invest in shoes that feel as comfortable as possible because athlete’s foot can result in foot pain. However, ventilation should be a top concern when choosing footwear. 

Ventilated footwear increases airflow and reduces moisture on the feet, which is beneficial for preventing infections and fungi.

Alternate pairs of shoes 

Using different pairs of shoes on alternate days helps dry them and prevent fungus survival.

Protect your feet in public places 

Dry foot is significant, especially while going out in public places. The fungus grows best in warm, humid environments, like the ones present inside warm, sweaty shoes. 

When it’s hot outside, wearing sandals or flip-flops is beneficial. Shoes made of synthetic materials, such as rubber and plastic, are more likely to make people perspire.

Try not to scratch the rash

Athletes’ foot is more likely to spread through contact with an infected person or from touching contaminated objects, including towels, floors and shoes. 

Also, it can spread from the foot to other areas of the body, particularly if one picks at or scratches the infected areas of the foot.

Don’t share shoes 

Athlete’s foot can spread easily, so it is never a good idea for someone with it to share shoes or socks.

Wear sandals or flip-flops at a public shower or pool 

When moving around swimming pools, gyms, shower or locker rooms, or hotel rooms, it is advisable to wear shower shoes, flip-flops or sandals. The athlete’s foot fungus might be on the floor. Wearing flip-flops or shower shoes even when showering in a gym prevents the spread of infection.

Treatments for athlete’s foot

Tablets 

An NCBI article titled ‘What helps to get rid of athlete’s foot?’ states that topical creams treat athlete’s foot most of the time. Only when topical therapy fails should tablets be considered. 

Tablets are mainly prescribed if the infection is bad or if it has spread to one or more toenails.

Terbinafine or itraconazole are the active ingredients present in tablets that treat athlete’s foot.

Typically, a 100 mg dose of itraconazole is taken once daily for four weeks. For two weeks, a 250 mg dose of terbinafine is generally taken once daily. If there is also the presence of fungal nail infection, the treatment takes longer to work. 

Powders 

An antifungal powder, such as Lotrimin AF, provides a potent effect against athlete’s foot.

One benefit of using 2% miconazole nitrate is that it has an active ingredient that stops the fungus from growing further. 

Adding to this, using this product will help keep the feet dry since dry feet are less likely to develop athlete’s foot in the first place. Since the product is in the form of a powder, they are easy to make the foot dry.

Liquids 

Similar to hydrogen peroxide, rubbing alcohol helps in killing the fungus on the skin surface. It is advisable to apply it directly to the area of infection or spend 30 minutes soaking the feet in a foot bath made of 70 per cent rubbing alcohol and 30 per cent water.

Sprays 

Tolnaftate, an antifungal substance, is a component of antifungal aerosol, liquid sprays that treat and prevent athlete’s foot. 

Using antifungal sprays makes application quick and simple. Benefits are visible on using these, even inside socks and shoes.

However, it should be noted that using a spray might make it harder to treat the athlete’s foot specifically. While a cream works by directly applying the product to the infected areas, sprays apply the product on a wider area, even on normal skin.

Antifungal medications work by interfering with the cell membranes of fungi, causing the membranes to break down and thereby killing the fungi.

Creams

 Cream works well to treat athlete’s foot since it reduces itching, stops fungal growth, and kills the fungi. 

However, for people with dry skin, a cream is more comfortable to use than a powder.

Visiting a doctor is mandatory to obtain a prescription for creams or ointments, including clotrimazole (Lotrisone), ciclopirox (Loprox, Penlac) or econazole (Ecoza, Spectazole). 

The use of creams becomes necessary when an athlete’s foot doesn’t respond to over-the-counter remedies and self-care.

Complication of athlete’s foot

Fungal nail infection 

Onychomycosis or nail fungus can occur due to athlete’s foot. The condition can occur when a fungal infection of the skin is between the toes and the feet.

Secondary bacterial infection 

Sometimes athlete’s foot coexists with bacterial infections. The skin is more susceptible to bacteria when athlete’s foot is severe and results in open sores. The infection has a chance of spreading from toe to toe if untreated.

Infected lymph system 

Untreated athlete’s foot or fungal infection spreads to the lymph system and results in lymphangitis or lymphadenitis, which are infections of the lymph vessels or lymph nodes, respectively.

Cellulitis 

The bacteria that enter the infected skin can cause cellulitis, which can lead to bone infections or blood poisoning if it penetrates the skin deep enough. Although extremely uncommon, this calls for prompt antibiotic treatment.

Allergy 

Allergic reactions to fungus causing the athlete’s foot occur in some patients. The allergy manifests in the form of blisters on the feet or hands.

Conclusion

A common fungal infection that affects the skin on the feet is called athlete’s foot. Athlete’s foot is caused by the fungus dermatophytes, which also causes jock itch and ringworm.

People who sweat more or wear socks and shoes that make their feet sweat frequently experience it. 

Tablets, creams, powders and ointments are effective treatments for athlete’s foot. Being precautious by keeping the foot clean and dry, wearing well-ventilated shoes and not sharing bedspreads, towels and shoes keep a person away from athlete’s foot.

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