Athlete’s foot

If athlete’s foot is your Achilles heel, you will be relieved to know that, with a little perseverance, there are several ways in which to treat the condition successfully.

Athlete's foot or tinea pedis is a fungal infection caused by yeasts and moulds. The term ‘athlete's foot' derives from the fact that the condition is prevalent among active people who go barefoot and use communal showers.

However, athlete’s foot is not limited to sports-people but can affect anybody who goes bare-footed in a communal area. Other exchange sites include swimming pools, moist sandy beaches, schools, hotel showers, hot working environments and even barefoot walking, because animals and soil carry fungal spores. According to dermatologist Dr Brian Sher, transmission to humans is by indirect contact with substrates such as carpets, mats, and communal showers. Transmission is usually via the feet and may remain subclinical until it spreads to other skin areas.

Many people are silent carriers who are able to disseminate fungal spores.

THE DEVELOPMENT OF ATHLETE’S FOOT

Sweating is a promoting factor, since it provokes maceration (softening and breaking up) of the epidermis and facilitates penetration of the fungi into the deeper layers of the skin. Heat and the wearing of synthetic footwear, socks and stockings play a significant role in the promotion of fungal infections. This explains why fungal infections are worse in the summer months or whenever feet are kept warm and enclosed for long periods.

With all fungal infections there is a risk of secondary infection developing via any crack in the skin. This can be due to poor foot hygiene or repeated scratching. Fungal infection also affects the toenails and is very resistant to treatment.

athlete's foot

TREATMENT

Because they spread easily, fungal infections are somewhat difficult, but not impossible, to control and eliminate. There are two categories of treatment, topical and systemic.

For an acute well-localised condition, topical treatment is usually successful, using natural or proprietary medication. Systemic treatment requires the prescription of oral antifungal drugs; these should only be used for severe or chronic infections and after consideration of their possible effects on the patient.

Treatment starts with good foot hygiene. Wash the feet with mild soap and dry them thoroughly every day, twice-daily if necessary. Try to identify the cause of the infection and always get an accurate diagnosis from skin scrapings.

Footwear plays a vital role, since sweating occurs in all shoes. Reduce the use of synthetic and closed footwear that does not breathe and remember that fungal spores multiply in damp leather. Allow shoes to air overnight and don't wear the same shoes on consecutive days. Wear clean socks of natural materials such as cotton or wool every day. Whenever possible, air the feet and expose them to sunlight: ultraviolet rays are a natural inhibiter of fungal organisms.

Potassium permanganate* solution is effective for maceration and secondary infection. This can be bought in crystal form and a pale pink solution may be made up for use as a daily footbath.

Spiritus pedibus spray, containing salicylic acid in alcohol, treats interdigital maceration.

Currently, tea tree products are proving successful. Various tea tree preparations are available including sprays, essential oil, tinctures and foot creams and gels.

Topical proprietary preparations include powders, creams, ointments, and sprays containing undecenoic acid or the imidazoles and terbinafine.

Successful treatment depends on the perseverance of the patient and practitioner, since reinfection is common. This is because the spores remain in footwear, clothes, carpets and floor surfaces. The normal treatment advice given to patients should be to continue treatment for at least one month after all signs and symptoms have subsided.

Editor's note: You may find this article interesting: Footology ‒ a dream come true.

* Potassium Permanganate can irritate the lungs causing coughing and/or shortness of breath and irritate the nose and throat. Contact can severely irritate and burn the skin and eyes.

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