Athlete's foot is a fungal skin infection that occurs in warm, moist areas such as the feet and between the toes. It’s very common, affecting up to a quarter of people at some time in their life. Known medically as tinea pedis, it produces symptoms of a rash that is usually red, sore and itchy, with clear edges that can form a ring-like pattern, giving it its other name of ringworm. It can be passed on from person to person, often from walking barefoot in gym showers or around swimming pools for example.
The typical presentation of athlete’s foot is that the skin between the little toes is often affected first, with a very itchy rash that can split or crack the skin there. Larger splits can then occur between other toes which can be painful and the rash can progressively spread along the toes if it isn’t treated. Sometimes it can spread to the soles of the feet and even the sides of them in severe cases.
Anti-fungal medicines are used to treat athlete’s foot. You can buy them from your pharmacy without a prescription. There are lots of different products available and formulations include creams, powders, gels, and sprays. There is no evidence to suggest that one anti-fungal medicine is better than the others, so it comes down to personal preference. You should only use one anti-fungal medicine at a time. Anti-fungal medicines work by killing the fungus (dermatophytes) that cause athlete’s foot. They usually do this by disrupting the production of important components needed for the fungal cell membrane.
For children, it’s best to use clotrimazole, miconazole or econazole based treatments.
Apply the treatment as directed, and because this varies between different treatments always read the instructions carefully. You may need to use them for a fortnight after the rash has cleared to stop it returning. Typical treatments include:
Clotrimazole: apply 2-3 times a day for at least a month.
Miconazole: apply twice a day and continue for 10 days after your skin is back to normal.
Econazole: use twice a day until your skin is back to normal.
Ketoconazole: apply twice a day for seven days but don’t use on children.
Terbinafine: apply once or twice a day for seven days but again, don’t use on children.
Always try to avoid any creams or products that have steroids in them (such as hydrocortisone). Although these may initially seem to help by relieving itching and soreness, they can actually make the spread of the fungus worse.
To prevent and manage athlete’s foot, you need to stop your feet from becoming hot and sweaty. Therefore, you should avoid wearing tight-fitting shoes, avoid wearing shoes in the house, try to rotate between the shoes you wear, dry your feet well after washing them, and wear clean socks every day.
Fungal spores can spread from person to person when your body naturally sheds skin, so if you have athlete’s foot, you should avoid sharing towels, socks, and shoes and wear flip flops in communal changing rooms and showers. These measures can also stop you from getting athlete’s foot again in the future. Fungal spores can also spread to other parts of your body. Therefore, if you have athlete’s foot, you should avoid scratching affected areas of skin and use a separate towel for your feet.
You should make an appointment to see your doctor if medicines from your pharmacy have not been effective. They may decide to take a small scraping of skin from your feet to send to a laboratory to check you have athlete’s foot. If your infection is severe or widespread, your doctor may recommend an antifungal tablet. You should also make an appointment to see your doctor if you have diabetes or a weakened immune system or if your rash has spread to other parts of your body, such as your hands.
You should seek urgent medical advice if your foot is hot or very painful. This may indicate that you also have a bacterial infection that will require antibiotic treatment.
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