Athlete's Foot
Athlete's foot is the common term applied to a number of different fungal infections of the foot. The medical term for this condition is tinea pedis; tinea referring to the causative organism and pedis referring to the location of the infection. The two fungal organisms we see most often are tinea rubrum and tinea mentagrophytes. Tinea rubrum is often mistaken for dry skin and is the most common fungal organism found in low-grade chronic fungal infections. Acute athlete's foot, on the other hand, is characterized by bubbles, blisters and itching. T. mentagrophytes is the organism most often seen in acute infections. Both organisms cause inflammation in the skin that leads to itching.
Fungus, or the plural, fungi, are non-flowering plants that lack chlorophyll. Lacking chlorophyll, fungi can't synthesize their own food and therefore have to live off other organic material. In the case of athlete's foot, the tinea organism is actually living off of the dead skin cells of our foot.
As plants, fungi is very sensitive to its' environment. Fungus thrives in a warm, damp and dark environment.
Treatment of athlete's
foot infections
When working with patients, the first thing I always stress is the difference between fungal infections and bacterial infections. Bacterial infections are a finite problem, meaning to say that you can cure most bacterial infections with an antibiotic in a brief period of time. Fungal infections, like athlete's foot cannot be cured, and subsequently needs to be treated a bit differently. As an example, I often draw parallels between fungal infections and crabgrass. Both are nuisance plants. Both will reoccur without ongoing treatment. My point is that you wouldn't expect crabgrass to disappear with a 10 day course of penicillin. Nor can you expect a fungal infection to clear with a short course of oral medicine. You need an ongoing plan if you intend to control athlete's foot.
Oral medications used to treat fungal infections of the skin and nail have become popular over the past several years. Medications such as Lamisil and Sporanox can be used successfully to treat an acute fungal infection, but these medications will not provide long term coverage. They simply can't be looked upon as a cure for athlete's foot infections. Therefore, if you choose to use an oral medication, remember that you will need to continue using a topical medication once the oral medicine is discontinued.
Some of the traditional methods used to treat fungal infections are really quite simple and effective. We spoke of dark, warm and damp-well change that. Create and environment in the shoe that is cool, dry and accessible to UV light.
Following these simple suggestions can dramatically change the course of a fungal infection:
1. Rotate your shoes every other day to allow them to dry thoroughly.
2. Avoid synthetic materials like rubber or vinyl, wear leather or cloth that can absorb moisture.
3. Frequent changes of socks to wick away moisture.
4. Use talc or baby powder daily to wick away moisture.
One thing to remember is that for many patients, 'curing' a fungal infection of the foot may never happen. Those patients who are susceptible to re-infection will, in all likelihood, be managing this condition for life. One of the best tools we can offer is an education in how to decrease the tendency to re-infect. We've already discussed the steps we can use to change the environment in the shoe. I can't stress how important these steps are in decreasing re-infection and managing recurrence. Also, the daily use of a mild antifungal cream or soap is essential.
When managing an acute case of athlete's foot, we need to fall back on a prescription strength topical creams or ointments. There are a number of different prescription strength creams and lotions available from your doctor. There are also many other effective topical medications that are OTC and can help manage the acute phase of these infections. In limited cases where a fungal infection is quite severe, we may even use an oral antifungal but these cases are few and far between.
So how is athlete's foot best managed? There's no single best method. Change the environment in the shoe to be cool, dry and open to the light. And remember the crabgrass analogy. If you're sincere about a having a healthy lawn, you'll have an ongoing treatment plan. So when treating athlete's foot, you'll need an ongoing plan and a commitment to treat your feet on a regular basis.
Dr. Oster is a board certified podiatrist and pedorthist. Dr. Oster practices in Granville, Ohio and is medical director of Myfootshop.com, an on-line resource for foot care information and products