Athlete's foot

Athlete's foot, also called tinea pedis, is a skin infection caused by fungi. It usually starts between the toes. The condition can occur when feet get hot and sweaty inside closed shoes.

Signs and symptoms of athlete's foot include an itchy, scaly rash. The fungus can live on floors, bedding, towels and shoes, spreading easily to others.

Athlete's foot is closely related to other fungal infections such as ringworm and jock itch. It can be treated with antifungal medicines. But it often comes back.

Athlete's foot can affect one or both feet. Common symptoms are:

• Scaly, peeling or cracked skin between the toes.
• Itchy skin, especially right after taking off socks and shoes.
• Swollen skin that may look red, purple or gray, depending on your skin color.
• Burning or stinging.
• Blisters.
• Dry, scaly skin on the bottom and sides of the foot.

When to see a doctor

If you have a rash on your foot that doesn't improve after two weeks of using an antifungal cream that you can buy over the counter, see your healthcare professional.

If you have diabetes, see your healthcare professional if you think you have athlete's foot. Also see your healthcare professional if you have symptoms of an infection, such as swelling of the affected area, pus and fever.

Athlete's foot is caused by the same type of fungi, called dermatophytes, that cause jock itch and ringworm. They thrive in warm, damp places such as sweaty socks and shoes and wet towels.

The fungi that cause athlete's foot spread easily to other people because they can travel on hands, towels and other surfaces. You can get athlete's foot through contact with someone who has it and by touching surfaces that have the fungus on them. The fungi also can spread from the feet to other parts of the body. This may happen if you use a towel to dry your feet and then use the same towel to dry the rest of your body.

You have a higher risk of athlete's foot if you:

• Often wear enclosed footwear.
• Sweat a lot.
• Share towels, shoes, rugs or bed linens with someone who has athlete's foot.
• Walk barefoot in public showers, pools or locker rooms.

A complication of athlete's foot is the spread of fungi to other parts of the body. For example, if the fungi that cause athlete's foot spread to the groin, they can cause jock itch.

Athlete's foot sometimes can lead to a bacterial infection. People with weakened immune systems, such as those with diabetes, may develop a serious skin infection called cellulitis.

These tips can help you prevent athlete's foot or lower your risk of getting or spreading the fungus:

• Let your feet breathe. Wear sandals or open-toe shoes when possible.
• Wash your feet every day. Use warm, soapy water. Dry your feet well, especially between the toes.
• Use an antifungal powder, spray or ointment. After washing your feet, apply an antifungal medicine that you can buy over the counter.
• Change your socks regularly. Change them at least once a day or more often if your feet get very sweaty. Choose socks made from fabrics that absorb moisture, such as cotton. They help keep your feet drier than those made from artificial fabric, such as nylon.
• Rotate pairs of shoes. Wear different shoes from day to day. This gives your shoes time to dry after each use.
• Protect your feet in public places. Wear waterproof sandals or shoes around public pools, showers and locker rooms.
• Don't share shoes, towels or unwashed bedding with others. The fungi can live on these items.

Your healthcare professional may be able to diagnose athlete's foot simply by looking at it. Some types of athlete's foot look like dry skin or dermatitis. To help diagnose athlete's foot and rule out other conditions, your healthcare professional may take a small skin sample of the affected area for testing in a lab.

Your healthcare professional likely will suggest self-care and antifungal cream, spray or powder that you can buy without a prescription. The antifungal terbinafine (Lamisil AT) has been shown to be highly effective. Other options are miconazole (Zeasorb AF, Lotrimin AF), clotrimazole (Lotrimin AF) and tolnaftate (Tinactin). If these don't work, your healthcare professional may prescribe a stronger antifungal medicine that you apply to your skin. Examples are econazole or ciclopirox.

For more serious infections, your healthcare professional may prescribe antifungal medicines that you take by mouth. Examples include terbinafine or itraconazole. Sometimes you may need both medicines you put on your skin and those you take by mouth.

These tips can help you ease the symptoms of athlete's foot or lower your risk of the condition coming back:

• Keep your feet clean and dry. Wash your feet twice a day and gently towel-dry between the toes.

• Use an antifungal product. After washing and drying your feet, apply an antifungal cream, powder or spray.

  You may need to try various products to find the one that works best for you. Put the product on your skin twice a day. Keep using the product until a week after the rash clears up. It might take 2 to 4 weeks to see results. If the infection comes back, you may need to start treatment again.

• Change socks regularly. Change your socks at least once a day. Or change them more often if your feet get very sweaty.
• Wear lightweight, breathable footwear. Avoid shoes made of artificial materials, such as vinyl or rubber. Try shoes made with natural materials such as leather, cotton or linen. When possible, wear sandals or open-toe shoes to help your feet dry out.
• Rotate pairs of shoes. Use different shoes from day to day. This gives your shoes time to dry after each use.
• Protect your feet in public places. Wear waterproof sandals or shoes around public pools, showers and lockers rooms.
• Try not to scratch the rash. You can try soothing your itchy feet by soaking them in cool water.
• Don't share shoes. When you share shoes, it raises the risk of getting a fungal infection.

Your healthcare professional or a skin specialist, called a dermatologist, can diagnose athlete's foot. You don't need to do anything special before an appointment to diagnose athlete's foot.

What you can do

Before your appointment, you might want to write down a list of questions to ask your healthcare professional. Examples include:

• What's the most likely cause of my symptoms?
• Are tests needed to confirm the diagnosis?
• What treatments are available?
• Is this condition temporary or long lasting?
• Is there a generic alternative to the medicine you're prescribing?
• Can I wait to see if the condition goes away on its own?
• What can I do to prevent the fungus from spreading?
• What skin care routines do you recommend while the condition heals?

What to expect from your doctor

Your healthcare professional is likely to ask you a number of questions, such as:

• When did you first notice your symptoms?
• What did the rash look like when it first started?
• Is the rash painful or itchy?
• Does anything seem to make it better?
• What, if anything, makes it worse?
• Does a family member also have athlete's foot?
• Have you spent time at swimming pools, locker rooms, saunas or other places where athlete's foot might be spread?