Athlete’s Foot, medically labeled as “Tenia Pedis” is also known as ringworm of the foot. Athlete’s foot is a contagious fungal infection that develops in moist, dark areas and can cause profuse itching, burning, redness and scaly feet on the skin and in other areas. Fungal infections of the foot affect approximately 5% of people on a yearly basis and most people will develop a fungal infection at least once in their lives. Athlete’s foot is a common condition and can be treated with over the counter or prescription medicine, as well as natural remedies.
Athletes Foot Symptoms
Athlete’s foot can present a number of symptoms depending on the severity of the case. The majority of cases present with visually mild symptoms but there are many symptoms of foot fungus, including:
- Itching and burning on the feet and between the toes
- A red rash on the soles of the feet and between the toes
- White, cheesy looking matter between the toes
- A strong foot odor that does not subside
- Peeling, cracking and weeping skin on the feet
There are three classification of Athlete’s foot based on the appearance of the symptoms. They are:
- Moccasin- Affects the soles of the feet
- Interdigital- Affects the skin between the toes
- Inflammatory- Red and blistering
Athlete’s foot can be fund on either or both feet, on the hands and in the groin area, where it is then classified as jock itch.
Causes of Athlete’s Foot
Athlete’s foot is a highly transmittable fungal infection which anyone can contract, including athletes, children and pregnant women. The fungus that causes Athlete’s foot lives in wet, warm and dark places awaiting contact with skin. The fungus can also be transmitted from person to person through means of wearing someone’s socks or shoes, or by sharing towels. The most common ways that Athlete’s foot is contracted and spread are:
- Wearing shoes made of synthetic material that do not allow the feet to breathe
- Repeatedly wearing socks without washing them
- Using communal showers and locker rooms without sandals
- Walking beside the pool barefoot
- Children wearing shoes that are too tight
- People/athletes who sweat heavily and do not regularly change socks/wear open shoes
- Pregnant women whose feet swell and perspire
Diagnosing Athlete’s Foot
Athlete’s foot can often be confirmed based on visual inspection. The doctor will look for common identifying symptoms such as redness, cracking and peeling and visible irritation or white matter between the toes. However, some of the symptoms of Athlete’s foot can mimic those of Eczema, Psoriasis, Yeast or other unrelated foot infections. If the physician is unsure of a diagnosis, he may employ additional testing in order to make a positive identification. The most common diagnostic methods are:
Potassium Hydroxide testing (KOH) is a test that is usually performed in the doctor’s office.
Using a blunt instrument, the doctor will scrape some skin tissue from the affected site to view under a microscope. Before viewing, the skin is placed in a potassium hydroxide solution, which kills off all cells, except fungal cells. This allows the doctor to clearly see if there is a fungal infection.
A Biopsy may be performed if the diagnosis is still unclear.
In this procedure, a small piece of skin is removed and sent to the laboratory for diagnostic testing. In some cases this is done as part of the initial diagnostic process. However, a skin biopsy may also be performed after unsuccessful treatment by more routine methods. The physician will want to be sure that what he is treating is actually Athlete’s foot.
Wood’s lamp (black light) – Developed by Robert Williams Wood.
The Wood’s lamp is used to highlight areas of damage or infection on the skin by fluorescent projection. In order to be effective, the lamp must be used in a darkened room. Looking at the skin through this lamp displays various colors depending on the condition of the skin in that area. For example, brown means the skin that has been damaged by the sun and light violate indicates dehydration. The color which would indicate Athlete’s Foot is blue/green.
Treatment of Athlete’s Foot
Treating Athletes Foot is relatively easy once diagnosed, but requires diligence to ensure the fungal infection is fully eradicated. Medication comes in either topical or oral form and patients should be careful to complete the entire course of medications prescribed by the physician. Oftentimes the medication course may exceed the symptoms, but it is important to continue, as there still may be fungi that has not yet been killed.
In addition to the use of medication, other measures should be taken to ensure healing including:
- Cleaning the affected area twice a day with a mild soap, without dyes or perfume
- Frequently change socks, especially in hot or humid weather
- After washing, be sure to dry feet thoroughly, especially in between the toes
- Wear sandals by the pool, in locker rooms and in common showers
- Do not share socks or towels
- Wash hands thoroughly to avoid spreading the infection to other parts of the body
Common medications for Athlete’s Foot
1. Topical medication
There are many over the counter antifungal creams that may be effective for mild cases of Athlete’s Foot. In these creams, the active ingredients are often the antifungal agents Miconazole, Clotrimazole, or Tolnaftate. Name brands include Tinactin, Lotrimin and Scholl. Many over the counter antifungal medications are also available in powder form, which works to absorb moisture, while treating the infection, as well as sprays. Be sure to follow the directions for best results.
Prescription strength topical creams may be necessary for a stubborn fungal infection. These creams contain a higher level of often stronger medication than over the counter drugs. Common prescription athlete’s Foot medications include Exelderm, Oxistat and Naftin.
2. Oral Medications
In cases of an acute infection (severely crusted, weeping or resistant cases), an oral medication may be prescribed to eliminate the fungal infection. These medications work systemically to eradicate deep seated infections from the inside out. However, it is important to note that these medications are very strong and have potential side affects. It is important to weigh the risks and discuss all preexisting medical conditions and current medication with your doctor before taking oral antifungal medication. A common treatment is Ketoconazole. Below is a description, dosage and also lists of possible interactions and side affects.
This is a prescription grade medicine found in both topical and oral Athlete’s Foot medications. Ketoconazole is a very strong antifungal agent and is found in the name brands Feoris and Nizoral (oral) and Extina and Ketoderm (topical). Oral doses are usually limited to once daily, due to the high strength of this medication.
Before using Ketoconazole, it is important to discuss your medical history and current medications with your physician. This medicine should not be taken if you are pregnant or breastfeeding, or trying to become pregnant. Currently, Ketoconazole is known to cause problems for individuals with:
- Allergies to animals, plants, food or environmental agents.
- Those with cardiovascular conditions
- Individuals who use controlled substances
- Those with HIV and AIDS
- Individuals suffering from Kidney or Liver Disease
Medication Interactions of Ketoconazole
Ketoconazole can interfere with and cause bodily harm when combined with some other medications. It is important to furnish your doctor with a complete list of current and past medications and supplements to avoid a potentially dangerous drug interaction. Current known interactions include:
- Blood thinners and anti-coagulants
- Calcium channel blockers
- HIV medications
- Diabetes drugs
There are other medications that Ketoconazole may be taken with, but not in the same timeframe. The following medications should be taken at least two hours after Ketoconazoleto limit harmful interactions:
- Ulcer medication
- Medicine for Parkinson’s disease
- Medication for Urinary tract infections
- Irritable Bowel Syndrome
The side affects of Ketoconazole are numerous, so it is very important to carefully monitor any adverse reactions and report them to your doctor. Side affects include:
- Profuse itching
- Stinging of the skin
- Burning sensation
Rarer, but more serious side affects include:
- Toenail discoloration
- Blistering and crusting of the skin
- Ulcers of the mouth and gums (oral medication)
- Bleeding from the mouth (oral medication)
Terbinafine is another oral antifungal medication and is often prescribed when the fungal infection has also infected the toenails and caused discoloration and corrosion. Sold under the brand names Lamisil and Terbinex, this medication is usually taken once daily for a twelve week duration.
As with many prescription medications, Terbinafine is associated with side affects, including the following:
- Itching and hives
- Loss or reduction of sense of taste
More serious side affects include:
- Extreme fatigue
- Prolonged nausea and vomiting
- Lack of appetite
- Severe and progressive skin rash
- Discolored bowel movements
- Infection, indicated by sore throat or fever
Medication Interactions ofTerbinafine
Terbinafine can interact negatively with certain medications, so it is important to provide your physician with a complete list of any medications, herbs or dietary supplements that you are taking. Terbinafine is currently known to cause interference with the following types of medications:
- Blood thinners and anticoagulants
- Beta blockers
- Immune suppressant drugs
Individuals with the following conditions should exercise caution in using Terbinafine:
- Clotting disorders
- HIV or AIDS
- Kidney or Liver disease
Alternative Health Treatments for Athlete’s Foot
Garlic is one of the oldest home remedies for treating Athlete’s foot and its effectiveness has been confirmed in major medical research studies. An active ingredient in garlic, “Ajoene” is a powerful antifungal agent and works especially well against Athlete’s Foot and has proven even more effective than Lamasil. Athlete’s Foot relief can be found by crushing garlic and adding it to a 30 minute daily foot soak. Another alternative is to add crushed garlic to a small amount of olive oil and swab the affected area.
Tea Tree oil
Tea Tree oil is used to heal many skin and scalp issues, as it contains potent antiseptic and antifungal agents called terpenoids. In the case of Athlete’s foot, Tea Tree oil has been shown to be very effective in reducing itching, flaking and redness. However, it is not as effective as prescription topical ointments in totally eradicating fungus. Tea Tree oil can be used in addition to medicated creams to lessen redness and reduce flaking. Some individuals have also found relief by adding 40 drops of Tea Tree oil to a foot soak. Note that Tea Tree oil may cause hormonal fluctuation and has been shown to cause breast enlargement in boys. Tea Tree oil should also not be used by pregnant or nursing women.
Apple Cider Vinegar
Apple Cider Vinegar has also been shown to relieve some of the symptoms of Athlete’s Foot. It is recommended to soak feet in a mixture of ¾ water and ¼ Apple Cider Vinegar two to three times a day for best results. Some individuals have used undiluted vinegar, but this may cause uncomfortable stinging.
Olive Leaf Extract
Olive Leaf Extract has potent antibacterial, antifungal and antiviral properties and may be effective for treating Athlete’s Foot. Mix with water as a foot soak or a small amount of carrier oil and apply to the affected area.
Grapefruit Seed Extract
Grapefruit Seed Extract has natural antibacterial and antifungal properties. It can help kill the fungus that causes Athlete’s foot. Dilute ten drops in a half ounce of water and dab onto the affected area twice daily.
Athlete’s Foot is very treatable, but it is important to fully follow the course of medication or natural therapy chosen. The duration of treatment is usually two to four weeks, which is how long it takes to fully eradicate the fungus. Athlete’s Foot symptoms often reoccur, but this is because treatment is often discontinued once the visible signs of the fungus are no longer evident. However, it usually takes an additional two weeks after symptoms subside before the infection is totally cured.
In order to prevent Athlete’s Foot as much as possible, observe the following recommendations:
- Place powder or cornstarch in your shoes in warm weather to absorb excess moisture
- Change socks regularly, more so if you are an athlete or excessive sweater
- Always wear sandals in common swimming, bathing and changing areas
- Maintain good hygiene, washing feet regularly with soap and drying thoroughly
- Avoid wearing the shoes and sock of others or sharing towels
- Alternate footwear so that each pair has time to air out
- Frequently wash sheets and towels
- National Institute of Health. Skin Lesion KOH Exam:http://www.nlm.nih.gov/medlineplus/ency/article/003761.htm
- US National Library of Medicine. Terbinafine: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001069/
- US National Library of Medicine. Ketoconazole: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000780/
- US National Library of Medicine. Athlete’s Foot: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001878/
- UK National Health Service. Athlete’s Foot: http://www.nhs.uk/Conditions/Athletes-foot/Pages/Introduction.aspx
- The Mayo Clinic. Athlete’s Foot: http://www.mayoclinic.com/health/athletes-foot/DS00317
- Medicinal Remedies. Fungus Treatment Information:
- The New York Times. Remedies-Garlic for Athlete’s Foot: http://well.blogs.nytimes.com/2011/01/06/remedies-garlic-for-athletes-foot/
- Andrew Weil, Md. Condition Care guide-Athlete’s Foot: http://www.drweil.com/drw/u/ART02953/Athletes-Foot.html
- About.com Alternative Medicine. Tea Tree Oil: https://www.verywellhealth.com/benefits-of-tea-tree-oil-89521