MayoClinic.com reprints
This single copy is for your personal, noncommercial use only. For permission to reprint multiple copies or to order presentation-ready copies for distribution, use the reprints link below.
· Order reprints of this article now.
Athlete's foot
By Mayo Clinic staffMayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Definition
Athlete's foot is a fungal infection that develops in the moist areas between your toes and sometimes on other parts of your foot. Athlete's foot usually causes itching, stinging and burning.
Also called tinea pedis, athlete's foot is closely related to other fungal infections with similar names, which include:
- Ringworm of the body (tinea corporis). This form causes a red, scaly ring or circle of rash on the top layer of your skin.
- Jock itch (tinea cruris). This form affects your genitals, inner upper thighs and buttocks.
- Ringworm of the scalp (tinea capitis). This form is most common in children and involves red, itchy patches on the scalp, leaving bald patches.
Symptoms
The signs and symptoms of athlete's foot can be numerous, although you probably won't have all of them:
- Itching, stinging and burning between your toes
- Itching, stinging and burning on the soles of your feet
- Itchy blisters
- Cracking and peeling skin, especially between your toes and on the soles of your feet
- Excessive dryness of the skin on the bottoms or sides of the feet
- Toenails that are thick, crumbly, ragged, discolored or pulling away from the nail bed
Onychomycosis — a fungal infection of the nail — may develop with or without other signs and symptoms of athlete's foot.
When to see a doctor
If you have a rash on your foot that doesn't improve or worsens after you've followed home and lifestyle remedies, see your doctor. See someone sooner if you notice excessive redness, swelling, drainage or fever. In addition, if you have diabetes and suspect you have athlete's foot, see your doctor.
Causes
A group of mold-like fungi called dermatophytes causes athlete's foot. These organisms sprout tendril-like microscopic extensions that infect the superficial layer of the skin. In response to this fungal growth, the basal layer of the skin produces more skin cells than usual. As these cells push to the surface, the skin becomes thick and scaly. Most often, the more the fungi spread, the more scales your skin produces, causing the ring of advancing infection to form.
The organisms that cause athlete's foot thrive in damp, close environments created by thick, tight shoes that squeeze the toes together and create warm, moist areas between them. Damp socks and shoes and warm, humid conditions also favor the organisms' growth. Plastic shoes in particular provide a welcoming environment for fungal growth and infection.
Athlete's foot is contagious and can be spread in the following ways:
- Human to human. Athlete's foot often spreads by direct, skin-to-skin contact with an infected person. Not everyone who carries the fungus develops signs and symptoms of athlete's foot.
- Object to human. The fungus is carried on fragments of skin or other particles that contaminate floors, mats, rugs, bed linens, clothes, shoes and other surfaces. Although transmission can occur within a household, the infection is more commonly passed along in public areas — locker rooms, saunas, swimming pools, communal baths and showers.
- Animal to human. Household pets can pass along fungal infections to humans.
Risk factors
You are at higher risk of athlete's foot if you:
- Are a man
- Frequently wear damp socks or tightfitting shoes
- Share mats, rugs, bed linens, clothes or shoes with someone who has a fungal infection
- Frequently visit public areas where the infection can spread, such as locker rooms, saunas, swimming pools, communal baths and showers
- Have a weakened immune system
Complications
Athlete's foot can lead to complications. These include:
- Secondary infections. Athlete's foot, a fungal infection, can create an environment that invites a secondary bacterial infection. By producing an antibiotic substance, the fungus can kill off vulnerable bacteria and favor the overgrowth of hardier, resistant bacteria. In turn, the bacteria release substances that can cause tissue breakdown — soggy skin and painful eroded areas between the toes.
- An allergic response. After an episode of athlete's foot, proteins might enter your bloodstream, leading to an allergic reaction that may cause an eruption of blisters on your fingers, toes or hands (dermatophytid or "id" reaction).
Preparing for your appointment
Your family doctor or a skin specialist (dermatologist) can diagnose athlete's foot. Because appointments can be brief and there's often a lot of ground to cover, it can help to be well prepared. Here are some tips to help you get ready for your appointment and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your appointment. List your questions from most important to least important in case time runs out. For athlete's foot, some basic questions to ask your doctor include:
- What might be causing the signs and symptoms?
- Are tests needed to confirm the diagnosis?
- What is the best course of action?
- Is this condition temporary or chronic?
- Is there a generic alternative to the medicine you're prescribing?
- Can I wait to see if the condition goes away on its own?
- What can I do to prevent the infection from spreading?
- What skin care routines do you recommend while the condition heals?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did you first notice your symptoms?
- What did the rash look like when it first started?
- Is the rash painful or itchy?
- What, if anything, makes it better?
- What, if anything, makes it worse?
- Does a family member also have athlete's foot?
Tests and diagnosis
Your doctor will want to determine if your signs and symptoms are caused by athlete's foot or by another skin disorder, such as dermatitis or psoriasis. You'll probably be asked about exposure to contaminated areas or contact with people who have athlete's foot.
Your doctor may take skin scrapings or fluid samples from your foot to view under a microscope to identify a fungus. If the sample shows a fungus, an antifungal medication is the usual treatment. If the test is negative but your doctor still suspects that you have athlete's foot, a sample may be sent to a laboratory to determine whether it will grow fungus under the right conditions. This test is known as a culture. Your doctor may also order a culture if your condition doesn't respond to treatment.
Treatments and drugs
If athlete's foot is severe or doesn't respond to over-the-counter medicine, you may need a prescription-strength topical medication (lotion, powder, spray or ointment) or an oral medication (pill, capsule or tablet). Many options are available, including:
- Terbinafine (Lamisil)
- Clotrimazole (Lotrimin)
- Miconazole (Monistat-Derm)
If your fungal infection is severe or doesn't respond to topical medicine, your doctor may give you a prescription oral medication. Oral medications include:
- Itraconazole (Sporanox)
- Fluconazole (Diflucan)
- Terbinafine (Lamisil)
Side effects from oral medications include gastrointestinal upset, rash and abnormal liver function. Taking other medications, such as antacid therapies for ulcer disease or gastroesophageal reflux disease (GERD), may interfere with the absorption of these drugs. Oral medications for athlete's foot may alter the effectiveness of warfarin, an anticoagulant drug that decreases the clotting ability of your blood.
Your doctor may prescribe an oral antibiotic if you have an accompanying bacterial infection. In addition, your doctor may recommend wet dressings, steroid ointments, compresses or vinegar soaks to help clear up blisters or soggy skin.
Lifestyle and home remedies
For a mild case of athlete's foot, you can apply an over-the-counter antifungal cream, spray, powder or ointment. Most fungal infections respond well to these topical agents, which include:
- Clotrimazole (Lotrimin AF, Mycelex)
- Miconazole (Micatin)
- Terbinafine (Lamisil AT)
- Tolnaftate (Tinactin)
Wash and dry the affected area. Then, apply a thin layer of the topical agent once or twice a day for at least two weeks, or according to package directions. If you don't see an improvement after four weeks, see your doctor.
Prevention
These tips can help you avoid athlete's foot or ease the symptoms if infection occurs:
- Keep your feet dry, especially between your toes. Go barefoot to let your feet air out as much as possible when you're home.
- Go with natural materials. Wear socks that are made of natural material, such as cotton or wool, or a synthetic fiber designed to draw moisture away from your feet.
- Change socks and stockings regularly. If your feet sweat a lot, change your socks twice a day.
- Wear light, well-ventilated shoes. Avoid shoes made of synthetic material, such as vinyl or rubber.
- Alternate pairs of shoes. This allows time for your shoes to dry.
- Protect your feet in public places. Wear waterproof sandals or shower shoes in communal showers, pools, fitness centers and other public areas.
- Treat your feet. Use an antifungal powder daily.
- Don't borrow shoes. Borrowing risks spreading a fungal infection.
- Goldstein AO, et al. Dermatophyte (tinea) infections. http://www.uptodate.com/home/index.html. Accessed Sept. 22, 2008.
- Habif TP. Superficial fungal infections. In: Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. Philadelphia, Pa.: Mosby Inc.; 2004. http://www.mdconsult.com/das/book/body/104355536-2/742469442/1195/81.html?printing=true. Accessed Sept. 22, 2008.
- Drugs@FDA. Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm. Accessed Sept. 22, 2008.
- Andrews MD, et al. Common tinea infections in children. American Family Physician. 2008;77(10):1415-1420.
- Gibson LE (expert opinion). Mayo Clinic Rochester, Minn. Oct. 16, 2008.
