What Is Athlete’s Foot?

Athlete's foot, also known as tinea pedis, is a contagious fungal infection that causes inflamed, itchy, and scaly skin between your toes. Symptoms can also affect the bottom of your feet and cause blistering. People often get athlete's foot from wearing sweaty, tight shoes for long periods of time or stepping barefoot on contaminated wet floors. 

If left untreated, you may get a bacterial infection in addition to a fungal infection. Luckily, athlete's foot is usually easy to treat with antifungal creams, sprays, powders, or an oral medication. 

Types of Athlete's Foot  

Athlete's foot is a type of ringworm that affects the feet. Itchy, red skin between your toes is the most common symptom. However, athlete's foot can look and act differently depending on the type.

Interdigital infection 

Interdigital infection is the most common type of athlete's foot. It targets the skin between the toes. The infection often starts between the pinkie and the neighboring toe, making your skin appear red or scaly. Your skin may also burn or itch.

Moccasin Infection

Moccasin infection covers the sole of the foot and can spread to the heel and edge of the foot. As a result, your feet often feel dry and itchy. Your skin will likely appear scaley and might thicken and crack over time.

This type of athlete's foot is sometimes misdiagnosed as eczema because these two skin conditions highly resemble each other.

Vesicular Infection

Vesicular infection occurs when athlete's foot causes blisters, also known as vesicles, that fill with pus and burst into open sores. These can appear on the soles of your feet or between your toes. They might feel sore and itchy. You're at a greater risk of developing a bacterial infection after the sores open. 

Ulcerative Infection

You might also develop open, oozing sores called ulcers between your toes. This is known as an ulcerative infection. It's the most painful type of athlete's foot. Like a vesicular infection, it can make you more susceptible to bacterial infections.

Athlete's Foot Symptoms 

Athlete's foot typically breaks down the skin between the toes, but it can also affect the soles, heels, and sides of the feet. The most common athlete's foot symptoms include:

• Red, inflamed skin between your toes
• Itchiness
• Flaky, scaly, or peeling skin between your toes or on the soles of your feet
• Thickened skin 
• Dry feet
  

More severe athlete's foot infections can also cause:

• Tiny, red blisters between your toes or on the soles of your feet (a vesicular infection)
• Inflamed ulcers that ooze fluid and may smell (an ulcerative infection)

Causes

Athlete's foot is one of the most common skin infections because it's highly contagious. It affects about 3% to 15% of the population. People assigned male at birth are more likely to get athlete's foot, as are older adults.

Athlete's foot is caused by fungi called dermatophytes, which thrive in warm and humid environments. You contract it when your feet come into contact with these fungi on contaminated wet surfaces or by sharing infected clothing and towels. Public showers, pools, and gym locker rooms are common places to contract athlete's foot. Keeping your feet in sweaty, warm environments—for example, wearing sweaty sneakers often and for long periods of time—can also increase your risk of infection. 

Once the fungus starts growing, it releases enzymes to break down proteins that form the top layer of your skin. Dermatophytes also suppress your immune system and prevent it from stopping the infection. This results in irritated, broken skin that cracks and itches. 

Risk factors for athlete's foot include:

• A family history of athlete's foot
• Allergies or eczema
• Very sweaty feet
• A weak immune system—for example, due to a chronic medical condition or long-term medication use
• Decreased circulation in your legs—for example, due to diabetes
• Consistently wearing sturdy shoes, like rubber boots or military boots
• Playing sports, especially running and swimming
  

Diagnosis

Healthcare providers typically diagnose athlete's foot by examining your skin and asking about your symptoms. It might be diagnosed by a dermatologist, a doctor who specializes in the skin, hair, and nails or a podiatrist who specialize in foot care.

A skin lesion potassium hydroxide exam (Skin KOH exam) is the most common test for athlete's foot. If your healthcare provider is unsure of the diagnosis, they may scrape off some skin using a curette or scalpel. The skin sample is added to a microscope slide along with a few drops of a potassium hydroxide (KOH) solution. This solution dissolves any non-fungal cells, revealing fungi.

Athlete's Foot Treatments

Athlete's foot is typically treated with antifungal medications that kill fungus and prevent more fungus growth. These antifungals are often available over-the-counter (OTC) in cream, spray, and powder forms. 

The most common athlete's foot treatments are topical antifungals called imidazoles. These treatments include:

• Lotrimin (clotrimazole)
• Spectrazole (econazole)
• Nizoral (ketoconazole)
• Monistat (miconazole)
• Terazol (isoconazole)
• Trosyd or Gyno-Trosyd (tioconazole)
• Exelderm (sulconazole)
• Ciclopirox (hydroxypyridine)
  

People with blisters or infections affecting the heel or sole of the foot may need oral medications to stop the infection. These include antifungals like:

• Lamisil (terbinafine)
• Sporanox (itraconazole)
• Difuclan (fluconazole)
• Grifulvin V or Gris-PEG (griseofulvin)
  

You can also try home remedies like tea tree oil to treat athlete's foot. Tea tree oil may have antifungal properties that can kill dermatophytes. However, there isn't enough research to prove tea tree oil is an effective athlete's foot treatment.

Prevention

You can contract athlete's foot even after successfully treating it. Again, the fungus that causes athlete's foot thrives in warm, moist environments.

Here are some recommendations for preventing athlete's foot:

• Wear clean socks made of breathable materials like cotton, nylon, polyester, and rayon
• Alternate the shoes you wear each day, especially if your shoes get wet
• Clean your feet daily with soap and water 
• Dry your feet after they get wet
• Wear sandals or flip-flops in locker rooms, public showers, and swimming pools
• Avoid walking barefoot in public areas
• Clip your toenails short and keep them clean

If you have athlete's foot, avoid going barefoot in public areas and don't share shoes, towels, or socks with others. This can prevent you from spreading the infection to someone else.

Related Conditions 

People with a more severe type of athlete's foot infection may get a toenail or bacterial skin infection. Other possible complications of athlete's foot include:

• Cellulitis: A bacterial skin infection that causes symptoms like red and swollen skin
• Pyoderma: A skin infection with small blisters that open into large painful ulcers
• Lymphangitis: An infection of the lymph vessels (tubes that carry lymph fluid from tissues)
• Osteomyelitis: An inflammatory bone infection that typically occurs from secondary cellulitis
  

These infections are more likely if you have a weaker immune system or cannot walk.

Living With Athlete's Foot

Athlete's foot can be very uncomfortable. Fortunately, it is usually easy to treat with OTC antifungal creams and sprays. Reach out to a healthcare provider if you notice red, itchy, or scaly skin between your toes. They may recommend OTC treatments or prescribe a more potent antifungal if you contract athlete's foot multiple times.

Avoid environments that let fungus thrive, especially if you're more susceptible to athlete's foot. This might include removing your sweaty shoes and socks right after a workout, keeping your feet clean, and wearing sandals in public locker rooms and pools.