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Managing Athlete's Foot
Edited by Olivia McPherson
Athlete’s foot – also referred to as tinea pedis – is a fungal infection of the skin on the feet often observed between the toes. Athlete’s foot can affect anyone – not just athletes. In fact, 70% of all fungal foot infections are determined to be athlete’s foot, affecting about 8.5% of the general population. Fortunately, most cases can be treated with self-care using over the counter (OTC) medications and good hygiene practices.
What causes tinea pedis?
Tinea pedis is transmitted through direct contact with the fungus. This typically occurs in shared areas such as locker rooms and pools. Tinea pedis can occur due to a few distinct species of fungi; the most common species are of Trichophyton and Epidermophyton.
Risk factors for developing an athlete’s foot infection include:
Excessive sweating around the feet
Being barefoot in public places
Autoimmune disease (e.g., diabetes)
Poor blood circulation in feet (Peripheral Vascular Disease)
Trauma/injury to the foot
Poorly ventilated, tight-fitting shoes
Poor hygiene
Obesity
How does athlete’s foot present?
Tinea pedis infections most commonly occur between the toes and may spread to the sole or the top arch of the foot. The skin of the affected area can become red, itchy, and may burn or blister. The skin will also often become thin, white, and flake or peel (as seen in the photo above). Untreated tinea pedis can progress into a bacterial infection. It can also spread to other parts of the body by touching another area of the skin after touching your infected foot without washing your hands. Jock itch is an example of a fungal infection that is caused by the same organisms as athlete’s foot but affects the pubic area instead of the feet.
How can you decrease your chances of contracting athlete’s foot?
Practicing good foot care and hygiene is essential to prevent infection. This includes washing your feet with mild soap daily and drying thoroughly afterwards (especially between the toes), wearing comfortable footwear with good ventilation such as canvas shoes, and changing socks daily or more frequently if your feet get sweaty. It is also important to wear shoes in shared areas (ie. flip-flops in change rooms) and avoid sharing footwear with others. Continue to ensure you are participating in basic foot hygiene to minimize your chances of getting an athlete’s foot infection.
How do you treat athlete’s foot?
There are many products that can be used to self-treat athlete’s foot that do not require a prescription. In addition to using drug products, good foot hygiene (as discussed above) should always be a part of the treatment for tinea pedis.
Antiperspirants
When applied to the feet, absorbent powders such as talcum or aluminum chloride can reduce sweating and moisture around the area, thus preventing the infection from getting worse.
Topical Antifungal Agents
Topical antifungal agents are the most common treatment for fungal infection of the feet including athlete’s foot. These should be applied to the affected areas of the feet twice daily for four weeks. Topical antifungals come in creams, sprays, and powders. If you have a history athlete’s foot or other fungal foot infections, you may consider applying antifungal powder directly to your feet once or twice daily to prevent infections from re-occurring.
Some over-the-counter options to treat athlete’s foot include:
Clotrimazole 1% (Canesten Topical) – available as cream
Miconazole 2% (Micatin, Monistat) – available as cream, spray powder
Tolnaftate 1% (Tinactin) - available as cream, topical powder, spray
Topical antifungals are well-tolerated. Side effects that may occur are usually limited to the skin, with the most common being local skin irritation (e.g., burning sensation, dryness, redness, and stinging).
Oral Antifungal Agents
Oral antifungal agents such as fluconazole, terbinafine and itraconazole can be used to treat tinea pedis if the infection is resistant to topical treatment or if the infection has spread to the toenails (another condition called “onychomycosis”). These agents will require prescriptions from a doctor.
When should you see a doctor?
You should see a doctor if you do not see any symptom improvement or if your symptoms continue to worsen after two weeks of treatment. You should also see a doctor if your symptoms are not completely gone after six weeks of treatment or if the infection is also affecting your toenails. Untreated or persistent infections can spread to other body parts and other individuals.
Athlete’s foot is a common fungal foot infection that can usually be treated with over-the-counter antifungal products. If you have questions or concerns about your foot health, have a discussion with your family doctor, nurse practitioner, or local community pharmacist.
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Reference
Mallin A. Athlete’s Foot. In: Compendium of Therapeutics for Minor Ailments. Canadian Pharmacists Association. Updated July 5, 2021. Accessed May 8, 2022. https://www.myrxtx.ca/
Goldstein, A. et al. Dermatophyte (tinea) infections. In: Post T, ed. UpToDate. UpToDate; 2022. Accessed May 30, 2022. www.uptodate.com
