Athlete’s Foot

Written By Ellie Woodcock, Verified By Magdalena Czerwiec-Pichlinska

Tinea Pedis, better known as athlete’s foot, is a fungal infection that can grow on the skin of the feet. It is most commonly found between the toes and is caused by the same fungus that produces ringworm. It is a contagious condition caught via physical contact with those already suffering from this fungal infection, or from contaminated surfaces. Contaminated services can often be found in damp environments such as public showers and swimming pools.

Dermatophytes are commonly the main contributor to athlete’s foot; they are a group of fungi that flourish in warm, damp environments and feed on keratin (protein in your skin and nails). Typically symptoms of this condition cause patches of skin on your feet, mainly in between the toes, to become itchy, red and swollen.

You may notice several different changes on your feet which could lead to athlete’s foot, including:

• Itchy white spots with dry peeling skin between your toes.
• Sore white spots (with or without touch) Usually the spots turn red, which is a sign of inflammation.
• Cracked and bleeding skin.
• Blisters or dry skin, on the soles and sides of your feet.

The type of symptoms present will depend on the type of athlete’s foot. There are four main types of athlete’s foot:

Toe web infection: The most common variation of athlete’s foot presents as a toe web infection, which affects the skin between the fourth and fifth toe. It can cause changes in colour, cracks, peeling, or flaking and you may feel a burning sensation between your toes.

Moccasin-type infection: This type of infection affects the sole, heel and edges of your feet. It causes the bottom of your feet to become thick and crack, in turn leading to pain and soreness in the feet. In some cases, it can cause your toenails to become infected, which can potentially lead to developing ringworm in the nail. If left untreated this can spread to other parts of the body, such as the hands.

Vesicular-type infection: Vesicular athlete’s foot presents through bumps or fluid-filled blisters (vesicles) on the bottoms of your feet. It can occur anywhere on your feet, however, it primarily appears on the soles or between the toes.

Ulcerative infection: The rarest type of athlete’s foot is infection. It develops through open sores or ulcers on the feet, particularly in between the toes. If left untreated, an ulcerative infection can progress and become inflamed.

It is estimated that 3 – 15% of the population is affected by an athlete’s foot. Contracting an athlete’s foot can happen to anyone, as it is a moderately contagious condition and can be transmitted through direct contact with the skin or with infectious flakes of the skin. It occurs predominantly in our feet as they are often wet and moist from closed-in shoes and contain a large amount of keratin.

There are certain behaviours which can increase the risk of contracting a fungal infection. These risk factors can include:

• Having bare feet when using public places such as swimming pools, showers and changing rooms.
• Sharing towels, shoes, or socks with someone who has athlete’s foot.
• Having sweaty feet.
• Having wet feet for a prolonged period of time.
• Wearing shoes that are tight and have a closed toe.
• Having a small cut on the skin or nail on your foot.
• People with impaired immune systems (Diabetes, HIV) are more at risk from infection if they have any cuts.

It is beneficial to be mindful and aware of these factors, as they can contribute to the development of not only athlete’s foot but other ailments such as fungal nail infection. Some factors can contribute to, or if left untreated can cause the growth of another infection; being aware of this fact can help in limiting the possibility of its occurrence.

Tinea Pedis is predominantly diagnosed by symptoms and presentation. A medical professional can diagnose athlete’s foot through consultation and examination. If the practitioner is unsure about whether a fungal infection is present, then it can be confirmed by a skin lesion potassium hydroxide exam. These are conducted through testing a skin biopsy, using a potassium hydroxide solution. The solution dissolves the skin cells leaving only fungal cells, which are only observable under a microscope.

Athlete’s foot can be treated with over-the-counter antifungal medication. This can come in the form of sprays, creams and powders. If over-the-counter medication does not work, your doctor may recommend an oral or topical prescription-strength antifungal medication. In some cases, topical steroids or oral antibacterial medications may also be prescribed.

In addition to medications, there are ways to increase your ability to treat the infection yourself such as:

• Keeping your feet dry and clean (especially between your toes).
• Changing and using a separate towel for your feet.
• Changing your shoes regularly.
• Wearing clean socks.
• Wearing sandals when going to public showers or swimming pools.

There are several at-home practices that can be implemented to help prevent, or reduce the risk, of contracting athlete’s foot. These can include:

• Following good hygiene protocols for your feet, including washing your feet every day with soap (particularly between the toes).
• Drying your feet thoroughly, especially between the toes
• Applying antifungal powder, or talcum powder to your feet daily to help absorb moisture.
• Regularly changing your towels.
• Washing your socks and feet towels on a high wash. This helps to kill the infection.
• Protecting your feet when in public places by wearing flip-flops or sandals instead of going barefoot.
• Cleaning your shoes with antifungal wipes.
• Regularly changing your socks, especially if they become sweaty.
• Not sharing your shoes, socks, or towels.

On the initial onset of athlete’s foot, it is recommended to seek advice from a medical professional. Athlete’s foot rarely resolves itself on its own if left untreated.

It is recommended to call your GP or healthcare provider if your athlete’s foot:

• Has not improved with treatment.
• Is showing signs of infection such as red, purple, grey, or white skin, with irritation and swelling.
• Spreads to another area of your body including the groin or hands.