What is foot fungus?
Tinea pedis is the medical term for foot fungus and the layman’s term is athlete’s foot. The most common organisms causing foot fungus are Tricahophyton rubrum and Trichophyton mentagrophytes. People generally pick up fungus in public showering areas, pools and spas, and shared bathing facilities.
What does foot fungus look like?
The common presentation of foot fungus is scaling, flaking, redness, and peeling between the toes or on the bottom of the foot. The fungus commonly affects the bottom of the foot and the sides of the foot, without extending to the top of the foot. This common pattern is called a moccasin distribution.
Fungus between the toes is called interdigital tinea pedisFoot fungus can affect the top of the foot, appearing in patches extending from the toe area, but this is not as common. Tiny blisters can occur between the toes and redness and inflammation can surround the scaly skin. Intense itching and cracked skin are common with foot fungus. Peeling between the toes is very common as seen in the fungus picture here to the right.
The most common treatment is over the counter antifungal creams. For mild cases of foot fungus, the cream should be used once to twice a day for two to four weeks. Don’t place the cream between the toes, as it will increase the moisture in the area. Place the cream around the toes and use an anti-fungal spray or powder between the toes.
For cases with associated redness, inflammation, or intense itching, a topical steroid can be added. A 1% hydrocortisone cream can be purchased at the drug store and used once daily for two weeks. (Do not use topical steroids for extended periods of time without consulting your doctor; the steroids can mask the symptoms of the fungus and cause damage to the skin).
Antifungal sprays and powders should be added to all shoes on a daily basis. Shoes should be aired out after each use. For recurrent foot fungus, remove all shoe liners and throw them out. Replace with a new pair of shoe liners or insoles and consider buying the antifungal liners at the drug store. Do not wear the same shoes two days in a row and make sure to remove your shoes at the end of the day and place them in a well-ventilated area (not in the closet).
Put on another pair of shoes, preferably open toed shoes, slippers, or sandals so your feet are not in the same pair of shoes all day. Enclosed leather shoes or plastic shoes and cotton socks are the worst combinations for foot fungus. Cotton socks absorb moisture and do not allow for wicking of the moisture to the outside environment. Leather shoes do not have much breathability, minimizing the wicking of moisture and heat. This creates a moist, warm environment in which fungus can thrive.
In the summer, it is best to wear sandals and open-toed shoes to minimize the amount of moisture and warmth surrounding the feet. If you do wear shoes and socks, wear shoes with some mesh-type fabric which allows the shoes to breathe. The socks should be a small fiber wool fabric or acrylic blend that allows for the wicking of moisture. Do not wear cotton socks. If your feet sweat extensively, change your socks once during the day. Try using an antiperspirant spray on your feet in the morning.
When bathing, wash the bottom of your feet and clean between your toes. If you have cracks or breaks in the skin, be careful not to be too aggressive with the wash cloth, as this can cause more openings and irritation. After showering, clean the shower or tub with a small amount of bleach or hydrogen peroxide. Showers are moist and warm and wonderful places for fungus to grow.
Step out of the shower onto a towel that you can wash after use. Wash socks and towels used on the feet in hot water. Dry your feet completely after showering, especially between the toes. Apply the antifungal cream and let the cream dry before putting on a sock or a shoe.
Vesicular tinea is a foot fungus with small blistersVesicular Tinea is a type of foot fungus which results in clusters of tiny blisters with surrounding scales. This type of foot fungus can be more severe and may not respond to topical treatments. In the picture to the left the black, splotchy areas represent scabs from scratching. Controlling excess perspiration with the preventive measure mentioned below is very important.
It is common for foot fungus to recur after treatment. Many people struggle with chronic foot fungus that does not seem to respond to any treatment. This is generally because the most important part of the treatment is ignored, prevention. Preventing the recurrence of foot fungus is the key to treating foot fungus successfully.
Even though the fungus appears to be resolved, many times the infection is still there. If the shower isn’t cleaned regularly, the towels and socks are not washed in hot water, the shoe liners are not changed, the shoes are not aired out, the chances of re-infection are very high. Even if the foot fungus has been treated completely if the fungus is still in the shower and the shoes, re-infection is likely.
Other Treatments & Home Remedies
One associated problem with the development of foot fungus is sweaty feet or hyperhidrosis. As mentioned above, use an antiperspirant spray (yes, the same antiperspirant in your drawer) each morning to minimize sweating. Another option to reduce sweating is to soak in Burrows® Soaks, 1:40 dilution, for 20 minutes twice a day. Use a foot powder with tannic acid or talcum powder to further reduce sweating.
Soaking in cider vinegar for 45 to 60 minutes once a day may create an inhospitable environment for the fungus. Most soaks help dry out the skin, which is also an advantage for those with sweaty feet.
Tea tree oil may help treat the fungus or at the very least soothe the itching and redness associated with foot fungus. Many products today are made with tea tree oil and washing daily with tea tree soap may be beneficial.
Your doctor may prescribe antifungal medication for you if the over the counter treatments are not helping. This is necessary in resistant cases not responsive to over the counter creams. A visit to your doctor may also help rule out other causes, as some types of dermatitis and eczema look exactly like foot fungus.
Prescription steroids may be necessary if there is severe redness, inflammation, and itching associated with the fungus. In very resistant cases, prescription oral antifungal medication may be necessary. Although these medications are taken in short courses, they still have side effects and should be used as a last resort.
Tips for Fungus Treatment and Prevention
- Air out shoes on a daily basis
- Rotate shoes. Don’t wear the same pair two days in a row.
- Replace shoe liners.
- Try to wear open-toed shoes or sandals when possible.
- Place anti-fungal powder or spray in closed-toed shoes.
- Wash socks and towels used on the feet in hot water.
- Don’t use creams between the toes.
- Wash feet daily with anti-fungal / tea tree soap
- Use an antiperspirant spray on sweaty feet
- Change socks during the day.
- Avoid cotton socks. Use wicking socks.
- Wear sandals or flip-flops in the gym changing room or around pool and spa areas.
- Wash and dry feet completely
- Bleach out the shower after use (or use hydrogen peroxide)
- Step out onto a towel after showering, and wash the towel after use.