Athlete's Foot

Athlete’s foot, or tinea pedis, is a fungal infection of the foot and toes. Many people will be familiar with the symptoms of athlete’s foot; dry, flaky skin that occurs between the toes, often occurring with a red, itchy rash. Athlete’s foot is a very common condition that will affect most people to some degree during their lives. It is normally easily treated using over-the-counter medicines and will clear up in around 7 – 10 days.

Athlete’s foot is caused by fungi known as dermatophytes that live as part of the normal bacteria and fungi on your skin. Dermophytes feed on dead skin and thrive in warm, damp and humid environments – an environment perfectly provided by your feet. The conditions provided by sweaty feet and shoes allow the fungi to multiply resulting in athlete’s foot.

Athlete’s foot is very contagious and is particularly common in people who exercise regularly as the fungi thrives in communal areas such as showers, swimming pools and changing rooms. It, therefore, tends to be more common in teenagers and males but can affect anyone at any age.

Many people will be unaware of the early symptoms of athlete’s foot unless they regularly inspect their feet. It is usually noticed when it begins to itch or the rash becomes uncomfortable.

The symptoms of athlete’s foot normally include:

• Dry, flaky skin between the toes
• A red, itchy rash around the flaking skin

Athlete’s foot normally starts between the little toe and the toe next to it, moving along your toes as the infection spreads.

In more severe infections the following symptoms may also be present:

• Spreading of the above symptoms to the side or bottom of the feet
• Small, inflamed blisters
• Cracked, painful skin
• Red, hot, swollen areas of skin (may indicate cellulitis)
• Fungal nail infection

All of the above symptoms of more severe infection (other than fungal nail infection, which can be self-treated) should be checked with your GP.

A formal diagnosis from a healthcare professional isn’t usually necessary in mild/moderate cases of athlete’s foot in people who are otherwise healthy. Unless symptoms of more severe infection are present (see’ Symptoms’ above), self-treatment with over-the-counter medicines will clear up the majority of cases. If your infection does not clear up after 10 – 14 days of using anti-fungal medication from a pharmacy, you should see your GP.

People suffering from diabetes should always see their GP for any foot complaints, including athlete’s foot, due to the increased risk of complications.

Most cases of athlete’s foot will clear up with simple antifungal medication and self-care methods detailed below in ‘Prevention’. It is important that both regimes are adhered to strictly to allow the infection to clear up and prevent re-infection. The self-care methods will also help to prevent the spread of your infection to others.

The common antifungal preparations include:

• Creams/Gels (Lamisil, Daktarin, Canesten AF, Clotrimazole)
• Powders (Daktarin Powder, Mycota)
• Sprays (Lamisil Spray, Daktarin Activ)
• Once Film (Lamisil Once)

Creams and gels are the standard topical treatments for athlete’s foot. They are normally applied twice a day for up to 14 days (check the individual treatments for specific details). Athlete's foot cream should be applied to any areas of flaky or red skin and the surrounding areas of healthy skin when they are clean and dry.

Powders have the dual action of being anti-fungal as well as helping to absorb moisture from the feet. They can be used in combination with creams or gels to give thorough coverage and increase the likelihood of successful treatment. They can be used to dust the feet, shoes and socks to kill any fungus and prevent re-infection.

Sprays can be used instead of creams/gels as a more convenient and pleasant method of application for people who struggle to apply the cream to their toes or do not want to touch the areas of infection.

Lamisil Once is a one-off anti-fungal application that creates a film over the infected area and treats the infection over a 7-day period. It has the advantage of not requiring further applications.

You should always ensure that the treatments are applied to clean, dry feet and your hands are thoroughly washed after touching the infected area to reduce the spread of infection. With most of the athlete’s foot treatments, excluding Lamisil Once, you will need to continue applying the treatments for around 7 days after the infection disappears to have cleared up to prevent re-infection.

You can also use a combination cream containing an anti-fungal and hydrocortisone (Canesten HC, Daktacort) to treat athlete’s foot that is particularly red, sore or inflamed. The added hydrocortisone will help to reduce the inflammation associated with the infection as well as the action of the included anti-fungal. It should be used for a maximum of 7 days and it should never be used on areas of broken skin.

It is important to practice preventative measures against athlete’s foot if you are in a group that is more likely to suffer from it, such as teenagers, adult males or those who frequently exercise.

However, it is equally important for those suffering from athlete’s foot to adopt these preventative measures whilst suffering from the infection to speed up recovery and prevent spread.

• Wash your feet thoroughly at least once a day ensuring you clean between your toes
• If you suffer from sweaty feet, dust them with talcum powder or antifungal athlete’s foot powder
• Wear breathable shoes that fit correctly – avoid tight-fitting synthetic shoes
• Ensure your feet are properly dried before putting on shoes and socks
• Change socks/tights regularly
• Switch shoes as often as possible to ensure you are always wearing a dry pair
• Take off shoes when possible to allow air to dry your feet – try not to go barefoot to prevent spreading the infection
• Do not share towels, shoes or socks to prevent spreading
• Wear flip-flops in communal areas such as showers and changing rooms to prevent spread
• Wash towels and bedclothes often in a hot wash