Athlete's foot (tinea pedis) is an infection of the feet caused by fungus. Athlete's foot may last for a short or long time and may come back after treatment. It is in the same family as ringworm (tinea corporis), jock itch (tinea cruris) and ringworm of the scalp (tinea capitis). Athlete's foot is a common infection, and while often seen among athletes, can occur in anyone.
Athlete's foot most often occurs between the toes. although it can spread to the toenails and tops of the toes. This is because shoes provide the warm, moist and dark environment the fungus likes best. The first symptoms are usually intense itching or burning between the toes.
Athlete's foot gets its name from when it seemed to occur commonly among athletes. Showers, pools and locker rooms are all ideal places for athlete's foot to hide, and athletes naturally frequent these places, also. The causative fungus is the dermatophyte, which are rather mold-like. When established in the skin, the dermatophytes multiply, spreading the itch and rash.
Athlete's foot causes you to develop a rash, usually in the spaces between your toes. The rash can cause your skin to become:
itchy
scaly
flaky
dry
red
As well as a rash in between your toes, you may notice other symptoms, including:
cracked skin
blisters (which may be oozing or crusting)
swelling of the skin
a burning or stinging sensation in your skin
scaling patterns around your sole and on the side of your foot
If the rash is very severe, your skin may start to crack, which can sometimes expose the raw tissue underneath. This can be particularly painful and increases your risk of developing a secondary bacterial infection.
The athlete's foot rash often begins in the spaces between your fourth and fifth toes. If the infection is not treated, a rash may form on the bottom and sides of your feet. Sometimes, the infection spreads to the toenails, causing them to become dry and crumbly.
If you scratch the infected skin then touch other parts of your body, you may spread the infection. It is important to treat the infection and always wash your hands thoroughly after touching the rash.
In some cases, the fungal infection that causes athlete's foot can spread to your hands. This is known as tinea manuum. The fungal infection is most likely to spread to your hands if you touch the infected skin on your feet and do not wash your hands afterwards.
The symptoms of tinea manuum are very similar to athlete's foot. Tinea manuum usually affects the palm of one of your hands, which can become dry, red and itchy. It can also cause areas of peeling skin on your hand.
The creases in the palms of your hands and the sides of your fingers are most commonly affected. A symptom of tinea manuum is increased markings on your skin, with similar symptoms occurring on both feet.
If your athlete's foot is treated, you usually only have symptoms for 1-10 days. If the infection is not treated or it does not respond to treatment, your symptoms may last for much longer (several months or even years).
See your general practitioner (GP) if your athlete's foot does not improve after two weeks of treatment. Also see your GP if the infection causes significant pain or discomfort. Your GP should be able to prescribe a stronger antifungal medicine, which will often be in tablet form.
Athlete's foot is caused by a fungal infection of one or both feet. Everyone has bacteria and fungi on their skin, most of which are harmless. However, in some conditions, these organisms can multiply and cause your skin to become infected.
Fungi are organisms that are similar to plants. They survive by feeding off broken-down tissue, including human tissue. Unlike plants, they cannot produce food using energy from sunlight (photosynthesis).
Athlete's foot is caused by a group of fungi called dermatophytes. These fungi are parasitic, which means they feed off other organisms to stay alive. Your feet provide a warm, dark and humid environment, which is the ideal condition for dermatophytes to grow.
Dermatophytes can cause fungal infections in areas such as the outer layers of the skin, nails, scalp and hair. Many other types of fungi cause various infections. However, the main groups of fungi that cause fungal infections such as athlete's foot are:
dermatophytes (tinea)
yeasts (candida)
molds
Athlete's foot is contagious, but you can take steps to prevent the spread of infection (see Preventing athletes foot for more details).
Athlete's foot can spread through direct and indirect contact.
Direct contact involves skin-to-skin contact. For example, someone may develop the infection if they touch your affected skin and do not wash their hands afterwards.
Indirect contact. For example, the fungi can be passed on through contaminated towels, bedsheets and clothing.
Showers, swimming pools and changing rooms are common places where infection can be passed on. This is because, like your feet, these places are usually warm and humid, which encourages bacteria and fungi to multiply.
Most people can treat athlete's foot at home. This type of fungal infection is usually mild and responds quickly to treatment.
Most cases of athlete's foot can be treated through self care and an antifungal medicine. If your infection is more severe, your GP may prescribe some stronger medication, such as oral antifungal medication.
If the infection is not treated, it can sometimes spread to your toenails and other parts of your body, such as the palms of your hands. Untreated cases of athlete's foot can also lead to complications such as bacterial infection.
The following steps can help you treat athlete's foot:
Wash your feet frequently and thoroughly with soap and water.
After washing, dry your feet, paying particular attention to the areas between your toes.
Wear clean cotton socks.
Change your shoes and socks regularly to help keep your feet dry, particularly after exercising.
Do not share towels, and ensure that they are washed regularly.
Antifungal medication will help kill the fungi causing your infection. This type of medicine is available in several different forms, including:
creams
sprays
liquids
powders
tablets
Topical antifungal medications for athlete's foot are widely available over-the-counter (OTC). 'Topical' means medication that is applied directly to the area being treated. Which form of antifungal medicine you use is usually a matter of personal preference. Ask your pharmacist which antifungal medicine would be most suitable.
Types of antifungal medicine available include:
terbinafine
clotrimazole
econazole
ketoconazole
miconazole
sulconazole
Different types of oral antifungal medicines are also available. These need to be prescribed by your GP. They include:
itraconazole
griseofulvin
terbinafine
Oral antifungal treatment is only recommended for severe cases of infection and when topical antifungal treatment has not worked. Oral medication is suitable for adults but not for children under 16 years old.
There are also some risks and side effects involved with taking antifungal medications. Do not take antifungal medications before talking to your health care provider.
As athlete's foot is usually a mild infection, it rarely causes complications. It is usually quick and easy to treat.
However, it is always best to use the appropriate treatment as soon as you begin to develop symptoms. This will help to minimize your risk of developing complications.
Although they are rare, athlete's foot can cause some complications, which are outlined below.
If you have severe athlete's foot, you may have cracked skin, which exposes the raw tissue underneath. It is unlikely that your fungal infection will spread to any exposed tissue because fungi usually only grow on the surface of your skin. Bacteria, however, can thrive inside the body and may cause infection if they enter your body through cracked skin.
Bacteria can release substances that break down skin and tissue. Once inside your body, bacteria can cause the infection to spread. If left untreated, a bacterial infection can potentially be very serious.
Cellulitis caused by a bacterial infection of the deep layers of skin, fat and soft tissue. If it is not treated, cellulitis can cause serious complications, such as blood poisoning (septicaemia), or the infection may spread to the bone.
Symptoms of cellulitis include a sore, red area of skin that is hot and tender to touch.
Although cellulitis is a rare complication of athlete's foot, it is important to treat it quickly. Most cases of cellulitis can be effectively treated using antibiotics.
If athlete's foot is not treated, the infection may spread to your toenails. A fungal nail infection causes your nail to become thick, discolored and crumbly. The skin beneath the nail (the nailbed) may also become painful and inflamed.
Most fungal nail infections can easily be treated using antifungal medication. This is taken either orally or it is painted onto your nail using a special antifungal nail paint. If left untreated, a fungal nail infection can cause significant pain and discomfort, which may make it difficult to wear shoes or walk around.
The best way to prevent athlete's foot is to practice good foot hygiene. The following steps can keep your feet clean and hygienic:
Wash your feet daily, particularly between your toes.
Reduce foot perspiration by using talcum powder on your feet.
Avoid tight-fitting footwear, particularly during the summer.
Wash your towels and bedding frequently.
Do not put on socks, tights or stockings before your feet are completely dry.
Where possible, wear flip-flops or plastic sandals in communal changing rooms or shower areas.
Change your socks, stockings or tights regularly.
Alternating footwear can ensure that shoes are dry at all times.
Avoid borrowing shoes to lower the risk of spreading the infection.
The Department of Health (DH) does not recommend that children with athlete's foot should be kept off school.
Instead, take precautions to ensure that your child does not walk barefoot while at school – for example, during physical education classes. This will help to stop the infection from spreading. It is also advisable to let their teacher know so they can make sure that your child is wearing the appropriate footwear.