Last reviewed by Editorial Team on August 13th, 2018.
What is Athlete’s Foot?
Athlete’s foot is a fungal infection that usually occurs in the web of the toes and the soles of your feet. It is also called by other names such as ringworm of the foot and tinea pedis. It is a common fungal infection that causes flaking, scaling and itching of the affected foot.
Athlete’s foot usually affects the surface of the skin of the feet but can also spread to the groin and other areas of the body that is constantly warm and moist. It is a contagious fungal infection that can be spread through direct contact or sharing of the personal belongings of the affected person. Unaffected individual can acquire the fungal infection by walking barefoot and stepping on contaminated surfaces such as in the shower room. Sharing of footwear with an infected person is also another mode of acquiring the fungi that cause the infection.
Tinea pedis or athlete’s foot is regarded as the most common dermatophytic fungal infection in the world affecting almost all people worldwide. It has no racial predilection and can affect both men and women, although there is a slight prevalence among the male gender. Athlete’s foot is rare among children and commonly happens after the age of puberty. It is prone in people who often wear close fitting footwear and with feet that often sweat. Athlete’s foot is generally not a harmful disease that no mortality and morbidity can be associated with the disease.
Athlete’s foot or Tinea pedis was first described in 1888 by Pelizzari although the condition was believed to have afflicted humans for more than centuries before it was first described. The first report of athlete’s foot was made in the year 1908 by Whitfield, along with a colleague who believed that athlete’s foot is a rare skin condition caused by the pathogen that also causes tinea capitis. It was then believed to be a very rare infection. This type of skin condition, however, affects 1 in every 4 people and believed to affect people at one point in their life. It is not a serious or life threatening condition, but athlete’s foot can cause embarrassment as the infection can result to a foul smell of the foot aside from the scaly and itchy rash.
Athlete’s Foot Symptoms
Athlete’s foot usually develops in the sole of the foot and the digital spaces with the spaces between the fourth and fifth digit as the most area of infection. The onset is usually mild but severe degree is often the result of secondary infection.
The onset of athlete’s foot is marked by the development of red and scaly patches of skin on the sole of the foot or in the spaces between the toes most commonly between the fourth and fifth digits. It is also accompanied with varying degree of itchiness which is often made worse when footwear is removed.
The common symptoms of athlete’s foot are:
- Varying degree of itchiness in the affected foot particularly in the spaces between the toes
- Inflammation of the affected area
- Dry, cracking and flaking skin of the sole of the foot
- Burning sensation over the affected foot
- Blisters may develop
- Foul smell of the affected foot
The most common presentation of athlete’s foot is the interdigital tinea pedis. It is characterized by erythema, fissuring and scaling which often occurs in the space between the fourth and fifth digits of the toes but the dorsal surface is usually spared. It is also often accompanied with varying degree of itchiness and is often associated with both fungal and bacterial infection.
Inflammatory and vesicular tinea pedis is another clinical presentation of athlete’s foot and is characterized by the onset of pruritic vesicles and pain and is often found at the instep. Ulcerative tinea pedis is clinically presented by the development of vesicles and lesions that rapidly spread in the web spaces and often complicated by a bacterial infection.
The asymptomatic type of athlete’s foot is moccasin tinea pedis which is characterized by a distribution similar to the appearance of the moccasin. It is hyperkeratotic in nature accompanied by erythema and slight scaling. This clinical presentation of athlete’s foot often affects both feet.
Athlete’s foot is caused by fungi, the same fungi that cause jock itch and ringworm. There are several causes of athlete’s foot aside from infection with fungi and bacteria. The fungi that cause the athlete’s foot thrive in the human skin and usually do not cause any harm until the condition favors their proliferation and invasion of the skin leading to infection.
The most common fungi causing athlete’s foot are:
- Trichophyton rubrum is regarded as the most common cause of athlete’s foot, jock itch and ringworm. Trichophyton rubrum favors moist and humid environment.
- Trichophyton interdigitale is the second leading cause of tinea infections among humans. It is a keratinophylic fungus that inhabits the warm and moist area and can also be sourced out from the toe webs without causing relative lesion. Trichophyton interdigitale commonly causes the ulcerative tinea pedis and inflammatory and vesicular tinea pedis.
- Epidermophyton floccosum is a moccasin like fungi that prefers a human host. This fungus usually causes the chronic hyperkeratotic presentation of athlete’s foot.
Bacterial infection and mold infection are also causative agents of athlete’s foot.
Athlete’s foot is a contagious skin condition that can be passed on healthy individuals via direct or indirect contact. Direct contact means a skin-to-skin contact with an affected person such as in touch or holding the infected area without proper washing of hands afterwards. Indirect contact is via contact with contaminated surfaces.
The initial approach in treating athlete’s foot is through general measures of keeping the foot clean and dry and this can be achieved with the following:
- Wearing of footwear that absorbs water away from the feet such as with the use of highly absorbent socks
- Application of medicated powders such as miconazole and tolnaftate are both beneficial in keeping the feet dry and moist free
Over-the-counter antifungal cream and ointment are especially helpful in mild athlete’s foot. Severe cases or those that do not respond well to treatment may be prescribed with broad spectrum treatments which are to be taken orally. Terbinafine and Griseofulvin are antifungal tablets usually prescribed for the treatment of severe cases of athlete’s foot that remained unresponsive to topical medications.