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Foot health

Updated 13 February 2013

Athlete's foot

Athlete's foot refers to a dermatophyte infection of the spaces between the toes, usually between the fourth and fifth toes.

Summary

  • Athlete's foot is an umbrella term describing common fungal infections of the feet.
  • Athlete's foot refers to a dermatophyte infection of the spaces between the toes, usually between the fourth and fifth toes, but not limited to that space.
  • Although it is most often described as the infection between the toes, it may also affect the sole of the foot, the whole foot, and the nails.
  • It may occur in association with other fungal skin infections, such as fungal infection of the toenails, feet or groin.
  • The condition usually responds to self-care, provided that care is applied for long enough.
  • If the infection persists, long-term medication and preventive measures may be needed.

Alternative names

Definition

Athlete’s foot is caused by one of three different groups of organism, Dermatophytes, yeasts and moulds. Of these, Dermatophytes are by far and away the most common. Yeasts are usually secondary invaders, and moulds extremely rare.

Causes

Symptoms

  • interdigital athlete’s foot: this appears as moist, pink, white flaking skin between the toes with a reddened area in the splits in the skin. This is usually very itchy. There is a bacterial condition that looks similar, but does not itch. So the appearance of this presentation with the itch is usually athlete’s foot
  • vesiculo-pustular presentation: this presents as small blisters, usually in the arch area under the foot. The blisters have a small red halo, with a grey blister and a dark peak to the blister. They are very itchy, and burst easily when scratched. The itch soon abates when the blister is burst, but this just spreads the infection and causes more blisters to appear. Soon there will be a large area that will be peeling, with new blisters forming.
  • the dry scaly type: this appears as dry skin over the surface of the foot, and often it covers the entire foot. This is called a moccasin infection as it resembles the shape of a moccasin. The edges of the dry skin are slightly reddened with small flakes of skin around the edges of the infected areas. This is often not symptomatic at all and patients will just treat it with moisturizing creams, thinking it is dry skin.

Diagnosis

  • Skin or nail scrapings are sent for fungal culture (fungi from flecks of skin or nail are allowed to grow on special material).
  • Skin lesion biopsy (examination may show dermatophyte).
  • Skin lesion KOH exam (skin or nail scrapings in potassium hydroxide show dermatophytes when examined under a microscope).

Treatment

Prognosis

  • Recurrence of athlete's foot
  • Secondary bacterial skin infections such as impetigo, ecthyma and cellulitis
  • Lymphangitis, lymphadenitis
  • Systemic side effects of medications (see specific medication)
  • Do not use cortisone as a treatment, unless prescribed by a healthcare provider.

When to call your doctor

Prevention

 

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