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Athlete’s Foot

Overview

Athlete’s foot is a contagious fungal infection that occurs in people whose feet are confined in shoes for long periods. The medical term for this condition is known as tinea pedis. It usually begins in between the toes, but it can spread to nails and other parts of the foot as well. Athletes’ foot was given its name because it is predominant among athletes who have to wear tight, fitted shoes for a prolonged duration. This infection can spread from one infected person to another through direct or indirect contact. Treatment can be done with the use of antifungal medications. 

Causes

Athletes’ foot is caused by a certain type of fungi known as dermatophytes. These fungi are also involved in the development of ringworm and jock itch. A warm, humid area is required for the growth of these fungi. When you wear shoes for too long and perform physical activity, the sweat and warmth released from your feet provide a favorable environment for these fungi to flourish. These fungi typically cause skin infection between the toes first. Other regions of the foot can also be affected.

 

Athlete’s foot is a contagious infection. It can spread by contacting an infected person directly or sharing personal items with them, such as socks, shoes, or towels. It can also spread from the foot to other parts of your body, such as the groin region. This can occur if you itch the affected area and touch other skin regions with your fingers. 

Risk Factors And Epidemiology

The risk of athlete’s foot is higher if you wear fitted footwear for a prolonged duration. Tight shoes do not allow the passage of air, and moisture accumulates inside, which favors the growth of fungi. Visiting public areas such as swimming pools, locker rooms, showers, etc., with bare feet can also increase the risk of indirect contamination. If you have a condition where you sweat more than necessary (hyperhidrosis), you may develop athlete’s foot. People with diabetes and a weak immune system are at risk of developing a severe form of athlete’s foot.

 

Athlete’s foot is predominant among men than women. Approximately 24.2% men and 6.1% women are affected by this condition annually in United States. It can develop at any age, but it is often observed in young adults actively engaged in sports and physical activities. 

Signs And Symptoms

Athlete’s foot can affect one or both feet. Signs and symptoms may vary depending on the severity of your condition. In majority of the cases, itchiness begins between the toes. The skin appears scaly, peeling, and cracked. Redness of grayish color can be present in the affected skin regions, which is a sign of inflammation. You may feel a burning or stinging sensation in your feet, especially after taking off your shoes. The soles of your feet can also be affected and present with dry, scaly skin patches. If the disease has extended to your toenails, they will appear discolored and have an irregular texture. Blisters may also be present. 

Diagnosis

Athlete’s foot is commonly diagnosed on the basis of its clinical presentation alone. Your doctor may require a brief history of wearing tight shoes or having sweaty feet to determine the possible cause. Because dry, cracked skin in athlete’s foot may resemble some other skin conditions, your doctor may perform some diagnostic tests for accurate diagnosis. The best test is skin lesion potassium hydroxide exam. In this case, a small area of the affected skin region is scraped off and placed in potassium hydroxide. This chemical destroys normal skin cells, leaving fungal cells behind that can be viewed on a microscope. 

Differential Diagnosis

Other skin conditions that may resemble symptoms of athlete’s foot include psoriasis, contact dermatitis, cutaneous candidiasis, keratoderma, maceration of interdigital space, erythrasma, and dyshidrosis. Differentiation is made on the basis of history and diagnostic tests. 

Treatment

Athlete’s foot can be treated by the use of over-the-counter topical antifungals. They can be available as a cream, gel, lotion, ointment, powder, or spray. You have to wash and dry your feet first before applying medication. These antifungals are used for a few days until the symptoms appear to improve. Some other lifestyle modifications are also required. Wash your feet twice a day and towel-dry them afterwards. Wear open footwear such as sandals to allow passage of air. If you have to wear shoes, change your socks at least once or twice a day and give your feet time to breathe in between.  Avoid scratching your feet and sharing personal items to prevent the spread of this condition.

 

Commonly available OTC antifungals include miconazole, terbinafine, tolnaftate, butenafine, and clotrimazole. If you have a serious infection, your doctor may give prescription medications such as econazole, ciclopirox, itraconazole, etc. Oral dosage will be necessary if topical medications are not sufficient enough.  

Prognosis

Athletes’ foot resolves within a few days with medications in people with no underlying conditions or immune diseases. If you have diabetes or immunodeficiency, this disease may persist for longer. Athlete’s foot may recur in most people. 

Prevention

Athlete’s foot can be prevented by maintaining proper hygiene and wearing light footwear whenever possible. If you have to wear shoes for long periods, try to keep an extra pair of socks and shoes to change once during the day. Wash and dry your feet once or twice a day. Prevent your feet from being wet for a long time. Avoid going barefoot in public places. Wear sandals or open footwear more often to let feet air out.