Athlete’s Foot (Tinea Pedis) Symptoms, Causes & Treatment Options

Athlete’s foot (tinea pedis) is an itchy fungal infection of the foot that is generally curable with over-the-counter medications.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Athlete’s Foot (Tinea Pedis)?

Summary

Athlete’s foot, also known as tinea pedis, is a common, curable, fungal infection of the skin on the foot, that most commonly occurs in between the toes. It can cause itching, redness, thickening, and flaking of the skin. Often athlete’s foot occurs when feet are damp or sweaty for long periods of time. The infection can usually be cured with over the counter topical antifungal medications, though stronger treatments may be required in some cases. Preventative measures like keeping feet clean and dry may help to avoid infection.

Recommended care

Athlete’s Foot (Tinea Pedis) Symptoms

Main symptoms

You should suspect athlete’s foot if you have the following symptoms. Most commonly, athlete’s foot will affect the spaces in between the toes, with the space between the 4th and 5th toes being the very most common.

  • Itching
  • Burning
  • New foot odor
  • Erosions: Erosions are areas where the skin has become thin or worn away, that do not extend through the entire skin.
  • Scale: You may notice extra, pale, dead skin flaking or peeling away from the sites of infection.
  • Blistering: It is possible that athlete’s foot will cause small blisters to form in the spaces between the toes (called vesiculobullous type infection) [1].

Other symptoms

Less common symptoms of athlete’s foot include the following:

  • Ulceration: Ulcers are areas where the full thickness of the skin has worn away revealing beefy red tissue below. Oozing ulcerations may occur in certain types of tinea pedis.
  • Pustules: Pustules are puss-filled inflamed bumps, often with a white head, resembling common acne. Pustules occur rarely in certain types of athlete’s foot [1].
  • Hyperkeratosis: Similar to scaling (above) – thickening and flaking of skin on the foot.
  • Extension to other areas of the foot: Though it most commonly affects the spaces between the toes (interdigital spaces), athlete’s foot may extend to cover the entire bottom or top of the foot.

Complications

In severe or advanced cases of athlete’s foot, the following complications may occur. These are more likely to occur if an athlete’s foot infection is untreated for a long period of time, or in patients with other conditions like diabetes, non-walking patients, and patients with compromised immune systems.

  • Cellulitis: A red, hot, swollen foot may mean that a deeper infection has occurred in addition to athlete’s foot.
  • Lymphadenopathy: swollen lymph nodes around the foot or leg
  • Osteomyelitis: a painful infection of the bones of the feet [2]

Athlete’s Foot (Tinea Pedis) Causes

Athlete’s foot is caused by a group of fungi called the dermatophytes, which also cause common itchy infections known as “ringworm” and “jock itch.” The names of these fungi are listed below. The fungi that cause athlete’s foot tend to thrive in damp environments, like locker rooms or showers – these are also listed below. Anyone can get athlete’s foot and, not surprisingly, it is most common among teenagers, who are active and spend time in locker rooms and at pools.

Fungi that cause athlete’s foot

These are the specific names of the fungi that cause athlete’s foot. Collectively they are called “dermatophytes.” Some of the species have special characteristics, listed below. Their treatments are mostly the same.

  • Trichophyton rubrum: This is the most common species, responsible for about 70% of cases.
  • Trichophyton interdigitale: This species is most susceptible to tolnaftate (Tinactin) medication.
  • Epidermophyton floccosum
  • Tricholosporum violaceum
  • Trichophyton mentagrophytes: This species is more likely to cause the vesiculobullous form of athlete’s foot.

Environmental causes

Many factors can lead to infection with the fungi listed above. Some of the most common ones are listed below:

  • Sweat: Athlete’s foot fungi thrive in damp environments. This means that sweaty socks, non-breathable shoes, hot weather, and those predisposed to sweat more (hyperhidrosis) will be more susceptible to infection.
  • Shared, wet spaces: Spaces like pool sides, shared showers, and locker rooms are damp and have many people walking around barefoot in them. This makes them ideal places for fungi to be exchanged.

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Treatment Options, Relief, and Prevention for Athlete’s Foot (Tinea Pedis)

Treatment

Fortunately, many treatment options exist for athlete’s foot. The most common ones are listed below:

  • Improve hygiene: Tinea pedis is more likely to occur in users of shared pools and bathing areas. Keeping these areas clean, frequent washing of the feet, and use of shower shoes may help to control infection and prevent re-infection, hastening cure.
  • Topical antifungal medications: Clotrimazole (Lotrimin) is perhaps the best known topical antifungal medication for athlete’s foot. Other closely related medications (called imidazoles) are also effective against athlete's foot (for example, econazole, ketoconazole, miconazole, isoconazole, tioconazole, sulconazole). Most of these medications will be available over the counter.
  • Alternative topical medications: Terbinafine (Lamisil) is another topical antifungal medication that is known to work quickly. It is also available over the counter.
  • Tolnaftate powder: Also known as Tinactin, it is a topical antifungal available over the counter that may help to treat or prevent athlete’s foot.
  • Magenta (Castellani’s) paint: This topical treatment is applied directly to the foot and may be especially helpful in cases with a coexisting bacterial infection.
  • Oral medications: Systemic treatment with medications taken by mouth may be necessary when larger areas of the foot are involved (beyond just the interdigital spaces). A prescription will be required for these treatments. Some examples of systemic antifungal medications include Terbinafine (oral), itraconazole, fluconazole, and griseofulvin. These medications are more likely than topical treatments to cause side effects.

Prevention

In cases of repeated infection, prevention may be the best medicine. Here are some ways to minimize the chance of infection:

  • Cleanliness: The fungi that cause athlete’s foot are environmental contaminants most commonly encountered in and around swimming pools, shared bathing areas, locker rooms, and other damp environments where people are barefoot. Frequent hosing and cleaning of the floors of such spaces will help to control infections.
  • Hygiene: Proper washing of feet will help to prevent infection.
  • Proper drying: Keeping feet dry is another important way to prevent athlete’s foot. Dry thoroughly after showering before putting on shoes and socks.
  • Plain talc: Plain talc applied to feet after showering may help feet stay dry.
  • Proper footwear: Wearing shower shoes and sandals around pool sides is one way to prevent athlete’s foot. Because athlete’s foot fungus thrives in damp environments, shoes or socks that cause feet to sweat should be avoided in favor of dry, breathable footwear. Shoes and socks may also become contaminated with the fungus, so after curing athlete’s foot, old shoes and socks may need to be discarded.
  • Antiseptic powders: Medicated foot powders like tolnaftate (Tinactin powder) or clotrimazole (Lotrimin powder) may be dusted or sprayed onto feet to protect against athlete’s foot. This may be especially important if athlete’s foot is a recurrent problem.

When to Seek Further Consultation for Athlete’s Foot (Tinea Pedis)

In general, athlete’s foot is a non-life threatening annoyance that can be treated at home, with over the counter medications as directed above; however, in certain cases, you should seek consultation with a physician. Internal medicine doctors and dermatologists are both capable of treating athlete’s foot. See your doctor in the following circumstances:

  • At-home treatment doesn’t work: Your doctor may be able to give you a stronger treatment to cure the infection definitively. It will also be important to ensure that the diagnosis of athlete’s foot is correct.
  • Athlete’s foot keeps coming back: In this case, it is important to ensure the diagnosis is correct, and your doctor may be able to come up with a good prevention plan.
  • Athlete’s foot has spread to cover parts of the foot: When athlete’s foot spreads beyond the interdigital spaces, more serious treatments may be required.
  • Special patients: Patients who are non-ambulatory (don’t walk), have diabetes with a history of foot problems or have compromised immune systems may want to see a doctor right away to ensure that the athlete’s foot infection does not progress to something more dangerous and to ensure the correct diagnosis.
  • Complications: If you have any of the complications listed above (cellulitis, lymphadenopathy, or osteomyelitis) see a doctor immediately. If your infection becomes painful, if your foot is hot or red, if you have a fever, or are otherwise concerned, see a doctor as soon as possible.