Athlete's foot

Page last reviewed: 13/07/2011

Athlete's foot is a very common condition. It is caused by a fungal infection that affects the skin on the feet.

Athlete's foot is usually mild and often affects the skin between the toes, causing it to become red, flaky and itchy. The medical name for athlete's foot is tinea pedis. Athlete's foot is usually easy to treat with antifungal medication.

How common is athlete's foot?

Anyone can develop athlete's foot, but it is more common in men and teenagers. The condition is relatively rare in children under 12 years old.

It is not fully understood why some people are more prone to developing athlete's foot than others. However, as the name suggests, people who play a lot of sport are often affected. This is because the infection is commonly spread in places such as communal showers and changing rooms.

Sport and exercise also tend to make your feet warmer and more moist than usual, which provides an ideal environment for the fungi to grow. Tight-fitting trainers can also encourage the fungi to grow.

Outlook

If it is treated effectively, an athlete's foot infection will usually only last for a few days or weeks. However, if left untreated, the condition can last for several months or, in some cases, years.

Not all cases of athlete's foot can be prevented, but practising good foot hygiene can greatly reduce your risk of developing the condition. See Preventing athlete's foot for more information about foot hygiene. 

Page last reviewed: 13/07/2011

Athlete's foot causes you to develop a rash, usually in the spaces between your toes. The rash can cause your skin to become:

  • itchy
  • scaly 
  • flaky
  • dry
  • red

As well as a rash in between your toes, you may notice other symptoms, including:

  • cracked skin
  • blisters (which may be oozing or crusting)
  • swelling of the skin
  • a burning or stinging sensation in your skin
  • scaling patterns around your sole and on the side of your foot

If the rash is very severe, your skin may start to crack, which can sometimes expose the raw tissue underneath. This can be particularly painful and increases your risk of developing a secondary bacterial infection. See Complications of athlete's foot for more information.

Spread of infection

The athlete's foot rash often begins in the spaces between your fourth and fifth toes. If the infection is not treated, a rash may form on the bottom and sides of your feet. Sometimes, the infection spreads to the toenails, causing them to become dry and crumbly.

If you scratch the infected skin then touch other parts of your body, you may spread the infection. It is important to treat the infection (see Treating athlete's foot) and always wash your hands thoroughly after touching the rash.

Tinea manuum

In some cases, the fungal infection that causes athlete's foot can spread to your hands. This is known as tinea manuum. The fungal infection is most likely to spread to your hands if you touch the infected skin on your feet and do not wash your hands afterwards.

The symptoms of tinea manuum are very similar to athlete's foot. Tinea manuum usually affects the palm of one of your hands, which can become dry, red and itchy. It can also cause areas of peeling skin on your hand.

The creases in the palms of your hands and the sides of your fingers are most commonly affected. A symptom of tinea manuum is increased markings on your skin, with similar symptoms occurring on both feet. 

How long will my symptoms last?

If your athlete's foot is treated, you usually only have symptoms for 1-10 days. If the infection is not treated or it does not respond to treatment, your symptoms may last for much longer (several months or even years).

See your GP if your athlete's foot does not improve after two weeks of treatment. Also see your GP if the infection causes significant pain or discomfort. Your GP should be able to prescribe a stronger antifungal medicine, which will often be in tablet form.  

Page last reviewed: 13/07/2011

Fungal infection

Athlete's foot is caused by a fungal infection of one or both feet. Everyone has bacteria and fungi on their skin, most of which are harmless. However, in some conditions, these organisms can multiply and cause your skin to become infected.

What are fungi?

Fungi are organisms that are similar to plants. They survive by feeding off broken-down tissue, including human tissue. Unlike plants, they cannot produce food using energy from sunlight (photosynthesis).

Athlete's foot is caused by a group of fungi called dermatophytes. These fungi are parasitic, which means they feed off other organisms to stay alive. Your feet provide a warm, dark and humid environment, which is the ideal condition for dermatophytes to grow.

Dermatophytes can cause fungal infections in areas such as the outer layers of the skin, nails, scalp and hair. Many other types of fungi cause various infections. However, the main groups of fungi that cause fungal infections such as athlete's foot are:

  • dermatophytes (tinea)
  • yeasts (candida)
  • moulds

Is athlete's foot contagious?

Athlete's foot is contagious, but you can take steps to prevent the spread of infection (see Preventing athletes foot for more details).

Athlete's foot can spread through direct and indirect contact.

  • Direct contact involves skin-to-skin contact. For example, someone may develop the infection if they touch your affected skin and do not wash their hands afterwards.
  • Indirect contact. For example, the fungi can be passed on through contaminated towels, bedsheets and clothing.

Showers, swimming pools and changing rooms are common places where infection can be passed on. This is because, like your feet, these places are usually warm and humid, which encourages bacteria and fungi to multiply. 

Page last reviewed: 13/07/2011

Athlete's foot is often a very mild infection that you can usually diagnose and treat yourself.

See your GP if you have athlete's foot and it does not respond to treatment, or if it causes significant pain or discomfort. Your GP may take a small sample of your affected skin cells.

The sample will be sent to a laboratory to be tested in order to identify the exact type of fungi that is causing your infection. This will enable them to prescribe the most appropriate treatment.

Page last reviewed: 13/07/2011

Most people can treat athlete's foot at home. This type of fungal infection is usually mild and responds quickly to treatment.

Most cases of athlete's foot can be treated through self care and an antifungal medicine. If your infection is more severe, your GP may prescribe some stronger medication, such as oral antifungal medication.

If the infection is not treated, it can sometimes spread to your toenails and other parts of your body, such as the palms of your hands. Untreated cases of athlete's foot can also lead to complications such as bacterial infection. See Complications of athlete's foot.

Self care

The following steps can help you treat athlete's foot:

  • Wash your feet frequently and thoroughly with soap and water. 
  • After washing, dry your feet, paying particular attention to the areas between your toes.
  • Wear clean cotton socks.
  • Change your shoes and socks regularly to help keep your feet dry, particularly after exercising.
  • Do not share towels, and ensure that they are washed regularly.

Antifungal treatment

Antifungal medication will help kill the fungi causing your infection. This type of medicine is available in several different forms, including:

  • creams
  • sprays
  • liquids 
  • powders
  • tablets

Topical antifungal medications for athlete's foot are widely available over-the-counter (OTC). 'Topical' means medication that is applied directly to the area being treated. Which form of antifungal medicine you use is usually a matter of personal preference. Ask your pharmacist which antifungal medicine would be most suitable.

Types of antifungal medicine available include:

  • terbinafine
  • clotrimazole
  • econazole
  • ketoconazole
  • miconazole
  • sulconazole

Different types of oral antifungal medicines are also available. These need to be prescribed by your GP. They include:

  • itraconazole
  • griseofulvin
  • terbinafine

Oral antifungal treatment is only recommended for severe cases of infection and when topical antifungal treatment has not worked. Oral medication is suitable for adults but not for children under 16 years old.

Risks

There are some risks involved with taking antifungal medication:

  • Some oral antifungal treatments are not suitable for children or elderly people.
  • Some oral antifungal treatments can interfere with pregnancy and the reproductive system in men and women.
  • Although the self-care steps above can be followed to treat athlete's foot, the use of tea tree oil is not recommended.

Your GP can give you more information and advice about oral antifungal medicines.

How to use antifungal medicines

Apply antifungal medication directly to the rash and surrounding area (4-6cm) of normal healthy skin. Make sure that the area is dry before you apply the treatment.

Sometimes, your skin may be infected with the fungus without showing any symptoms. Therefore, it is important to treat the surrounding 4-6cm of skin to help prevent re-infection. Always wash your hands before and after you apply the treatment. 

Apply your antifungal treatment for as long as recommended in the instructions that come with the medicine. Some antifungal medicines have to be used for longer than others to be effective.

Although your rash may disappear quickly, this does not necessarily mean that the infection has been completely treated. You may have to use your medication for one or two weeks after your symptoms have gone to ensure that the infection has been successfully treated.

Hydrocortisone treatment

If your rash is making your skin particularly sore and swollen, you can use an antifungal treatment that contains an ingredient called hydrocortisone.

Treatments with low doses of hydrocortisone are available over-the-counter (OTC). However, if your athlete's foot is more severe, your GP may prescribe a stronger hydrocortisone treatment. 

Hydrocortisone reduces inflammation, as well as easing irritation and itching. Follow the instructions that come with the treatment.

Hydrocortisone cannot be used for longer than seven days. If necessary, you will have to use an alternative antifungal treatment (one that does not contain hydrocortisone) until your infection is completely treated.

Always ask your GP or pharmacist for advice before using hydrocortisone if you are pregnant or breastfeeding.

When to see your GP

If you have developed a secondary infection as a result of your athlete's foot, you may be prescribed antibiotics to treat it, and you will need to see your GP. 

Page last reviewed: 13/07/2011

As athlete's foot is usually a mild infection, it rarely causes complications. It is usually quick and easy to treat.

However, it is always best to use the appropriate treatment as soon as you begin to develop symptoms. This will help to minimise your risk of developing complications.

Although they are rare, athlete's foot can cause some complications, which are outlined below.

Bacterial infection

If you have severe athlete's foot, you may have cracked skin, which exposes the raw tissue underneath. It is unlikely that your fungal infection will spread to any exposed tissue because fungi usually only grow on the surface of your skin. Bacteria, however, can thrive inside the body and may cause infection if they enter your body through cracked skin.

Cellulitis

Bacteria can release substances that break down skin and tissue. Once inside your body, bacteria can cause the infection to spread. If left untreated, a bacterial infection can potentially be very serious.

Cellulitis caused by a bacterial infection of the deep layers of skin, fat and soft tissue. If it is not treated, cellulitis can cause serious complications, such as blood poisoning (septicaemia), or the infection may spread to the bone.

Symptoms of cellulitis include a sore, red area of skin that is hot and tender to touch.

Although cellulitis is a rare complication of athlete's foot, it is important to treat it quickly. Most cases of cellulitis can be effectively treated using antibiotics.

Fungal nail infection

If athlete's foot is not treated, the infection may spread to your toenails. A fungal nail infection causes your nail to become thick, discoloured and crumbly. The skin beneath the nail (the nailbed) may also become painful and inflamed.

Most fungal nail infections can easily be treated using antifungal medication. This is taken either orally or it is painted onto your nail using a special antifungal nail paint. If left untreated, a fungal nail infection can cause significant pain and discomfort, which may make it difficult to wear shoes or walk around.

Page last reviewed: 13/07/2011

Good foot hygiene

The best way to prevent athlete's foot is to practise good foot hygiene. The following steps can keep your feet clean and hygienic:

  • Wash your feet daily, particularly between your toes.
  • Reduce foot perspiration by using talcum powder on your feet.
  • Avoid tight-fitting footwear, particularly during the summer.
  • Wash your towels and bedding frequently.
  • Do not put on socks, tights or stockings before your feet are completely dry.
  • Where possible, wear flip-flops or plastic sandals in communal changing rooms or shower areas.
  • Change your socks, stockings or tights regularly.
  • Alternating footwear can ensure that shoes are dry at all times.
  • Avoid borrowing shoes to lower the risk of spreading the infection.

Do I need to keep my child off school?

It is not recommended that children with athlete's foot should be kept off school.

Instead, take precautions to ensure that your child does not walk barefoot while at school - for example, during physical education classes. This will help to stop the infection from spreading. It is also advisable to let their teacher know so they can make sure that your child is wearing the appropriate footwear.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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