ATHLETE’S FOOT: CAUSES, SYMPTOMS, AND SOLUTIONS

Athlete's Foot is a highly contagious fungal skin infection found on the feet that affects up to 10% of the world's population. The scientific name for this infection is tinea pedis.

Tinea means 'worm' and refers to all ringworm infections, while pedis relates to the feet. Ringworm was mistaken for a worm before the discovery of the fungus responsible. While tinea pedis affects the feet, tinea cruris affects the groin (known as jock itch), and tinea manuum affects the hands.^[1]

Like mold, the foot fungus thrives in warm, moist conditions. It is highly infectious and can be disseminated speedily in public places. As with other tinea infections, contact with soil, animals, or other humans can induce the infection.

The discovery of Athlete’s Foot only occurred during the 20th century.^[2] It was associated with modern socks, closed shoes, sweaty feet, and communal showers or public pools. Companies began using the name when marketing treatment options to athletes, who were more likely to contract the infection.

Over time, the term became widely used to describe the fungal infection of the feet, regardless of whether the person affected was an athlete.

This blog outlines the causes and treatments of Athlete's Foot to help you better understand and manage this condition.

What Causes Athlete's Foot?

Dermatophytes of the trichophyton species cause Athlete's Foot^[3]. Trichophyton rubrum is responsible for up to 70% of Athlete's Foot cases, yet 80-90% of all tinea cases.^[4] The remaining cases comprise of T mentagrophytes, T interdigitale, and Epidermophyton floccosum.

These fungi thrive in warm, moist environments. They grow on floors, towels, and clothing. When the feet come into contact with these fungi, they can become infected. It is easier for trichophytes to attach to skin that is already damaged, moist, or rarely seeing sunlight.

These strains of fungi produce specialized enzymes that dissolve skin keratin, a protein that gives skin its structure. Trichophyton fungal cells also possess other compounds in their membranes, like mannans, that suppress the immune system and evade detection.

Types of Athlete's Foot

There are four types of Athlete's Foot^[5]:

1. Interdigital infection: This type of Athlete's Foot affects the skin between the toes, particularly the space between the fourth and fifth toes. The prime symptoms are redness, itching, and skin peeling in the affected area. It is also known as a toe-web infection.
2. Moccasin-type infection: Moccasin-type Athlete's Foot starts with dryness and scaling on the soles of the feet. Over time, the skin may become thickened, cracked, and calloused. This infection can also spread to the sides of the feet and the heels.
3. Vesicular-type infection: The formation of small blisters on the feet identifies this type. The sores may be filled with clear fluid and can cause itching and discomfort. They may break open and lead to further infection.
4. Ulcerative infection: Ulcerative Athlete's Foot is a severe infection that can cause open sores or ulcers on the feet. These ulcers may be painful and can become infected. This type of Athlete's Foot often occurs in people with weakened immune systems.

It is important to note that the treatment for Athlete's Foot may vary depending on the type and severity of the infection.

If you suspect you have Athlete's Foot, consult with a doctor for an exact diagnosis and timely treatment.

Risk Factors for Athlete's Foot

Specific factors can elevate your chances of contracting Athlete's Foot. These include:

• Walking barefoot in public places, especially in communal showers and swimming pools
• A weakened immune system
• Wearing tight, closed-toe shoes for extended periods
• A history of Athlete's Foot or other fungal infections
• A family history of Athlete's Foot
• Low skin levels of defensin beta 4, an immune compound that can inhibit skin infections
• A fungal nail infection
• Having sweaty feet
• Wearing damp socks or shoes
• Having a skin injury on the feet
• Ailments prone to poor circulation, such as diabetes
• Old age

Symptoms of Athlete's Foot

Athlete's Foot can look like various foot conditions, depending on which type one develops. It most commonly presents with peeling skin and sometimes causes blistering.

The symptoms of Athlete's Foot can vary from person to person, but the most common symptoms^[6] include:

• Itching on the foot, burning, or stinging sensations
• Red, scaly, or cracked skin on the feet
• Peeling or flaking skin on the feet
• Blisters on the feet
• Dry skin on the feet
• Discolored, thick, or crumbly toenails
• Foul odor from the feet
• Pain or discomfort when walking or standing

If you experience any of these symptoms, seeking treatment to thwart the infection from spreading and causing further discomfort is essential.

Complications

Athlete's Foot can lead to several complications if left untreated. Some of the complications associated with Athlete's Foot include:

1. Severe Athlete's Foot: If untreated, Athlete's Foot can progress to more severe forms such as moccasin Athlete's Foot or vesicular Athlete's Foot. These forms can lead to calluses or blisters.
2. Spread to other body parts: Athlete's Foot can spread to the nails, hands, and groin, causing additional fungal infections like nail infections. Prompt treatment prevents spreading.
3. Secondary bacterial infections: Athlete's Foot can create openings for bacteria to enter, causing secondary infections with increased redness, swelling, pain, and pus. Prompt treatment prevents these infections.
4. Infected lymph system: Rarely, Athlete's Foot can infect the lymphatic system, causing red streaks, swelling, and tenderness. Seek medical attention if these symptoms occur.
5. Cellulitis: Athlete's Foot can lead to cellulitis, a bacterial skin infection that causes red, swollen, and tender skin. If untreated, it can circulate to lymph nodes and the bloodstream, leading to severe complications.
6. Spread through towels: Athlete's Foot spreads through contaminated towels. Avoid sharing towels to prevent Athlete's Foot transmission.

It is crucial to pursue medical treatment if you think you might have Athlete's Foot to prevent these complications and ensure proper healing.

Diagnosis

A physical examination and laboratory tests are common avenues for diagnosing foot fungus.

A healthcare practitioner will examine the affected area, usually the feet, to look for signs and symptoms of Athlete's Foot. They will check for redness, scaling, cracking, blistering, and other characteristic skin changes associated with the infection.

Other tests a dermatologist may perform include:

Skin Scraping and KOH Test: Your doctor may perform a skin scraping test. They will carefully scrape off a small sample of the skin involved and examine it under a microscope. The sample gets treated with a potassium hydroxide (KOH) solution, which helps to dissolve the skin cells and reveal any fungal elements. This test can confirm the fungus responsible for Athlete's Foot.

Culture Test: In certain situations, a culture test may identify the specific type of fungus causing the infection. A sample of the affected skin is collected and placed in a culture medium that promotes the growth of fungi. This test allows the healthcare professional to identify the fungus and specify the most appropriate course of action.

Sometimes, other skin conditions, such as dermatitis or psoriasis, can mimic the symptoms of Athlete's Foot. To rule out these conditions, the healthcare professional may conduct additional tests or refer you to a dermatologist for further evaluation.

Setting up an appointment with an experienced doctor to diagnose the Athlete's Foot accurately is essential. They will be able to determine the type and severity of the infection and recommend the most appropriate treatment plan.

Medical Treatments for Athlete's Foot

A doctor usually prescribes topical or oral antifungal medications to treat Athlete's Foot. These treatments aim to kill the fungus or prevent it from growing.

Topical Antifungal Medications

Topical antifungal medications are available in creams, lotions, sprays, and powders. They are applied directly to the affected area for 2-4 weeks.

Oral Antifungal Medications

If the infection is severe or does not respond to topical treatments, your doctor may prescribe oral antifungals. One takes these medications by mouth, and they help kill the fungus from the inside out.

Following your doctor's instructions and completing the entire treatment course is necessary, even if your symptoms improve before the course of medication is completed.

Preventing Athlete's Foot

The best way to manage and prevent Athlete's Foot is to practice good foot hygiene and take precautions in public places.

Here are some tips to help overcome Athlete's Foot and prevent it from occurring in the future:

• Clean your feet with soap and water every day, and dry them well, especially between each toe.
• Use powder to absorb excessive moisture.
• Wear shoes in public places, especially in communal showers and swimming pools.^[7]
• Wear shoes that enable comfortable foot respiration and avoid tight, closed-toe shoes for extended periods.
• Wear clean cotton or wool socks and shoes and change out of them if damp to lessen moisture buildup.
• Use antifungal powders or sprays in your shoes to help prevent the growth of fungi.
• Do not share towels, socks, shoes, or other similar personal items with others.
• If you have a fungal infection on another part of your body, such as jock itch, make sure to treat it promptly to prevent it from spreading to your feet.

Home Remedies for Athlete's Foot

While over-the-counter and prescription treatments are available for Athlete's Foot, some home remedies can help alleviate symptoms and speed up healing. These include:

• Soak your feet in vinegar. Add a cup of vinegar to a heated foot bath and immerse your feet for 15-20 minutes to help kill the fungus.
• Apply tea tree oil to affected feet daily. Tea tree oil is understood to have potent antifungal properties that can overturn Athlete’s Foot for some.
• Use baking soda. Baking soda combined with water to produce a paste may offer relief from itching when applied to the area.

While these home remedies can offer temporary relief to some, they are not a substitute for medical treatment or hygiene measures that can counter Athlete's Foot.

If your symptoms persist or worsen, it is crucial to seek medical attention.

When to See a Doctor

If your symptoms do not improve with home remedies or over-the-counter treatments, or if they worsen, it is vital to see a doctor. You should also seek medical attention if you have a weakened immune system, diabetes, or a condition that affects your circulation, as these can increase your risk of complications from Athlete's Foot.

Your doctor may prescribe strong medications or suggest additional treatments, such as phototherapy or laser therapy.

In Conclusion

Athlete's Foot is a common fungal infection easily treatable with over-the-counter or prescription medications. Practicing good foot hygiene and taking precautions in public places can prevent Athlete's Foot from occurring. If you experience Athlete's Foot symptoms, seek treatment to stop the infection from spreading and causing further discomfort. You can get back on your feet and enjoy a healthy, active lifestyle with proper treatment.

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