Like policeman's heel and tennis elbow which are not confined to their namesakes, it affects many more than just athletes. The name is in some ways apt though: it is common in younger people (males in particular) and often spreads though use of showers and changing rooms.
Signs and Symptoms of Athlete's Foot
Athlete's foot usually starts with redness and itching on the foot, more often than not around or between the toes. The skin can become dry and flaky and sometimes cracked at which point the condition may become painful. Occasionally it can spread to other parts of the foot including the sole. Diagnosis is usually made from the clinical features although sometimes the doctor will take a skin scraping for laboratory investigation.
Once skin cracking has occurred there is a risk of bacterial infection which can extend as far as the tissues beneath the skin giving rise to cellulitis, a potentially serious condition
Pathology of Athlete's Foot
The fungi which cause athlete's foot are known as dermatophytes (literally 'skin-plant') because they live off of keratin – the major protein in skin. Various fungi cause the condition, mostly the Trichophyton, Microsporum and Epidermophyton fungi. These organisms can cause similar infections in other parts of the body such as the trunk and arms (ringworm), the hand (tinea manum), groin (tinea cruris), nails (onychomycosis) and hair and scalp (tinea capitis).
Some of these fungi live normally on the skin in small numbers causing no harm. However changes in the bacterial flora of the skin or in the composition of the protective oils of the skin or in the immune system generally, can allow the the fungi to multiply and start to cause problems.
Prevention of Athlete's Foot
If you use the gym, do sports or go swimming frequently it will be impossible to avoid picking up fungal spores but it doesn't follow that infection will follow. Good hygiene will help prevent infection. Frequent washing of the feet and thorough drying (fungi usually like damp conditions) are important as is changing footwear often. Cotton socks are best for keeping the feet cool.
Treatment of Athlete's Foot
There are quite a few over the counter topical remedies available; creams, ointments, powders and sprays. Athlete's foot normally responds well and resolves in a week or two. Occasionally if the condition is stubborn or becomes widespread oral medication from the doctor is required.
Common topical treatments are: terbinafine, clotromazole, ecanozole and ketanozole. They are all pretty much the same in terms of efficacy although the Cochrane Collaboration, which examines the evidence base of healthcare, suggests that terbinafine is bit more effective. Very few side effects have been noted with these medications other than some skin irritation and an occasional allergic response.
There are also a number of traditional remedies which can be tried. They are generally safe but all have the potential for irritating the skin. Below is a list of the more frequently used treatments.
- Vinegar
- Tea tree oil
- Boric acid solution
- Lavender oil
- Bergamot oil
Test these out on unaffected skin first just in case they cause irritation. Essential oils like lavender and bergamot should only be used diluted in a carrier oil such as almond or olive oil.
This article is for information only. If you have any health concerns you should consult the appropriate health professional.
Resources
Medicine eds. Souhami and Moxham Pub. Churchill Livingstone 2002
British National Formulary 2004 BMA publishing
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