Athlete’s foot is a contagious fungal infection that leads to numerous skin issues on the feet, like itching, burning, and stinging rash on the affected skin. Availing of timely treatment can help eliminate the fungus and also prevent it from spreading. 

For medical students, understanding this topic is essential not only for covering their syllabus but also for diagnosing and treating patients in future. This article explains the causes, risk factors, and types of athlete’s foot, along with symptoms, diagnosis, treatment options, and more. 

Continue reading for detailed insight!

What is an Athlete’s Foot?

An athlete’s foot is a fungal infection that affects the outer layer of the skin on the foot, especially in moist, warm, and irritated conditions: 

• This condition is also known as tinea pedis or ringworm of the foot and is caused by a fungus called Trichophyton, which is commonly found on clothing or floors. 
• The fungus only infects the skin if conditions are suitable, such as the damp and warm environment inside a shoe.
• Due to this, only around 0.75% of people who regularly walk barefoot are affected. However, up to 70% of people experience athlete foot disease at some point.
• In addition, this infection most often appears between the toes and causes symptoms such as burning, redness, stinging, itching, and sometimes flaking skin. 
• It is the most common type of fungal infection, and although contagious, one can easily treat the condition using over-the-counter (OTC) antifungal medication. 

However, individuals with diabetes or a weakened immune system should seek medical help if symptoms develop. In some instances, the infection can even spread to the hands, a condition known as tinea manuum.

What are the Causes and Risk Factors of an Athlete’s Foot?

An athlete’s foot is caused by a specific fungus (Trichophyton) that grows on the skin of the feet. Although the same fungus can affect other areas of the body, it usually appears on the feet, particularly between the toes.

It is the most common type of tinea infection and thrives in warm, moist environments. The risk of developing athlete’s foot increases if a person:

• Wears closed shoes, especially those with a plastic lining
• Keeps their feet wet for long periods
• Sweats excessively
• Has minor skin or nail injuries

Athlete’s foot spreads easily through direct contact or by touching contaminated items such as socks, shoes, and surfaces in showers or swimming pools.

What are the Different Types of Athlete’s Foot?

The symptoms of an athletes foot may differ based on the type of infection. Following are the major types:

1. Toe Web Infection

This is the most common type and usually affects the skin between the fourth and fifth toes. The affected skin may change colour, peel, crack, or flake.

2. Vesicular-Type Infection

This type mainly affects the soles but can appear anywhere on the feet. It is characterised by fluid-filled blisters (vesicles) or bumps.

3. Moccasin-Type Infection

This infection affects the heels, soles, and edges of the feet. It may start with soreness, followed by thickened and cracked skin. In some cases, the toenails become infected, causing them to thicken, fall out, or break into small pieces.

4. Ulcerative Infection

This is the rarest form of athlete’s foot. It generally causes open sores (ulcers) between the toes and sometimes on the soles of the feet.

What are the Symptoms of an Athlete’s Foot?

Athlete’s foot can cause several symptoms, including:

• Itchy blisters on the feet
• Sensation of itching, stinging, and burning on the soles and between the toes of the feet
• Cracked and peeling skin, especially on the soles and between the toes
• Raw and irritated skin on the feet
• Flaky or rough skin on the soles or sides of the feet
• Toenails that separate from the nail bed
• Thick, crumbly, and discoloured toenails

How is an Athlete’s Foot Diagnosed?

A healthcare provider can diagnose an athlete’s foot by examining the skin. If further tests are required, they may include:

• A skin culture to identify the infection
• A KOH test, a simple procedure to check for fungus
• A skin biopsy by using a special Periodic acid–Schiff (PAS) stain to detect fungus

What are the Treatment Options for an Athlete’s Foot?

Athlete’s foot can be treated with antifungal medications, available in different forms. These treatments help eliminate the infection and prevent it from returning:

• Over-the-counter (OTC) and prescription antifungal creams, gels, ointments, sprays, or powders are effective treatments. These products contain antifungal ingredients such as clotrimazole, tolnaftate, miconazole, or terbinafine.
• Some prescription treatments also come in the form of pills containing fluconazole, terbinafine, or itraconazole.
• It is highly essential to complete the treatment course of medication, as stopping too soon may cause the infection to return and become harder to treat.

What are the Risks of Not Treating an Athlete’s Foot?

If an athlete’s foot is not treated, it can usually spread across the bottom of the foot, leading to a moccasin athlete’s foot: 

• In this condition, the skin on the heels, soles, and edges of the feet becomes itchy, dry, and scaly.
• In more severe cases, fluid-filled blisters or open sores may develop. Blisters sometimes appear on the soles but can form anywhere on the feet. 
• Open sores are usually found between the toes but may also develop on the soles. The feet may also have an unpleasant odour.

An athlete’s foot does not usually clear up on its own. If left untreated, it can spread to other areas of the body, including:

• Nails: Fungal nail infections can be harder to treat and may not respond well to some treatments.
• Hands: The infection can also spread to the hands, usually through scratching or using the same towel to dry both the hands and feet.
• Groin: The same fungus can even spread to the groin, causing jock itch. This often happens when using a towel to dry both the feet and groin after swimming or bathing.

What are the Possible Complications of an Athlete’s Foot?

Although an athletes foot is usually mild and complications are rare, experts recommend treating it as soon as possible to prevent further issues. Delayed treatment increases the risk of complications, which may include:

• Fungal Nail Infection

If left untreated, an athlete’s foot can spread to the toenails, leading to a condition called onychomycosis. This generally causes the nail to become crumbly, thick, and whitish in colour. The skin under the nail may become painful and inflamed. Severe cases can make wearing shoes or walking uncomfortable.

• Secondary Bacterial Infection

A bacterial infection can develop while causing the foot to become hot, swollen, and painful. Symptoms such as pus, fever, or drainage may also appear.

• Infected Lymph System

In some cases, the infection may even spread to the lymphatic system. This can lead to conditions such as lymphadenitis (infection of the lymph nodes) or lymphangitis (infection of the lymph vessels).

• Cellulitis

In rare cases, a bacterial infection can spread deeper into the skin while affecting the soft tissues and fat layers. This condition is also known as cellulitis and can lead to serious complications such as bone infection or blood poisoning (septicemia). Immediate antibiotic treatment is a must in such conditions.

• Allergic Reaction

Some individuals may be allergic to the fungus that causes athlete’s foot, leading to blistering on the hands or feet.

Treating an athlete’s foot early can significantly lower the risk of these complications.

How Can an Athlete’s Foot Be Prevented?

The best way to reduce the risk of an athlete’s foot is to keep the feet, socks, and shoes dry and clean. Some of the tinea pedis self-care tips include:

• Wash the feet twice daily with water and soap while ensuring the area between the toes is cleaned.
• Keep the feet dry. Using antifungal talcum powder can help prevent moisture buildup. Walking barefoot at home is also beneficial.
• Remove shoes immediately after exercise or sports activities.
• Wear loose-fitting, breathable shoes, especially in warm weather. Canvas or leather shoes are ideal.
• Always ensure that the feet are completely dry before wearing socks, tights, or stockings. Choose socks made from moisture-wicking materials such as silk, cotton, or wool.
• Wear pool slippers when walking in public swimming pools, showers, or communal changing rooms to prevent infection.
• Rotate shoes regularly to allow them time to dry.
• Avoid sharing footwear with others.
• Wash towels and bed sheets frequently to maintain hygiene.
• If a pet has hair loss, it may be infected with an athlete’s foot. A visit to the vet is recommended, as humans can even catch the infection from pets.
• If a child has an athlete’s foot, they can still attend school, but teachers should be informed so necessary precautions can be taken during physical education classes. The child should avoid walking barefoot at school.

What is the Outlook (Prognosis) for an Athlete’s Foot?

Athlete’s foot usually responds well to self-care and treatment, but it may return. In some cases, long-term medication and preventive steps may be required to keep the infection from coming back. If left untreated, the infection can also spread to the toenails.

FAQs About Athlete’s Foot

1.   What does an athlete’s foot look like?

An athletes foot can appear on different parts of the foot, including between the toes, the tops, the soles, the heels, and the edges. The affected skin may look irritated, with redness, grey, purple, or white discolouration. It can also become flaky or scaly.

2. How common is an athlete’s foot?

An athlete’s foot is a common condition. It is estimated that between 3% and 15% of people have it at any given time, and around 70% of the population experience it at some point in their lives.

3. Who is at risk of an athlete’s foot?

Athlete’s foot can affect anyone, but it is more common in men and people over 60. The risk is higher for individuals who have:

• Diabetes.
• Obesity.
• A weakened immune system.
• Cuts, wounds, or other damage to the skin on their feet.

4. Is an athlete’s foot contagious?

Yes, an athlete’s foot is contagious. It is caused by a fungus that grows on or inside the skin. Fungi thrive in moist and warm conditions, making feet an ideal place for infection, especially when wearing socks and tight shoes for long periods.

5. How soon does an athlete’s foot improve with treatment?

With the right treatment, an athlete foot disease usually heals up within one to eight weeks. It is important to follow medical advice and complete the course of treatment. 

Symptoms such as irritation or itching may improve early, but stopping treatment too soon can cause the infection to return and become harder to treat.

Conclusion

The athlete’s foot is uncomfortable, causing burning, itching, and, at times, a bad smell. Antifungal treatments or home remedies can help treat the infection. Scratching should be avoided, as it can spread the fungus to other areas.

Following the complete course of treatment is essential to prevent it from returning. A healthcare provider can offer advice on stopping the infection from spreading to other parts of the body or others.

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