ALL YOU NEED TO KNOW ABOUT ATHLETE’S FOOT
Athlete’s foot is a fungal infection affecting the upper layer of the skin of the foot or any part of the foot commonly between the toes, especially when it is warm, moist, and irritated. It is medically known as tinea pedis. The fungus that causes athlete’s foot is called trichophyton and is commonly found on floors and in clothing. The same fungus may also affect the nails or the hands. It is a member of the group of diseases known as tinea.
Athlete’s foot was first medically described in 1908. Globally, athlete’s foot affects about 15% of the population. Males are more often affected than females. It occurs most frequently in older children or younger adults.
SIGNS AND SYMPTOMS
Athlete’s foot is divided into four presentations:
Chronic inter-digital: Inter-digital simply means between the toes. Cases of inter-digital athlete’s foot caused by trichophyton rubrum may itch, or the skin between the toes may appear red or ulcerative (scaly, flaky, with soft and white if skin has been kept wet), with or without itching.
Plantar (chronic scaly; aka “moccasin foot”): Plantar here refers to the sole of the foot. This is also caused by trichophyton rubrum which typically causes erythematous plaques (areas of redness of the skin) to form on the plantar surface (sole) of the foot that are often covered by fine, powdery hyperkeratotic scales
Acute ulcerative: The ulcerative condition includes macerated lesions with scaly borders. Maceration is the softening and breaking down of skin due to extensive exposure to moisture. An acute ulcerative variant of inter-digital athlete’s foot caused by trichophyton mentagrophytes and it is characterized by pain, maceration of the skin, erosions and fissuring of the skin, crusting, and an odor due to secondary bacterial infection
Vesiculobullous: A vesiculobullous disease is a type of mucocutaneous disease characterized by vesicles and bullae (blisters). Both vesicles and bullae are fluid-filled lesions, and they are distinguished by size. The vesiculobullous type of athlete’s foot is less common and is usually caused by trichophyton mentagrophytes and it is characterized by a sudden outbreak of itchy blisters and vesicles on an erythematous base, usually appearing on the sole of the foot. This subtype of athlete’s foot is often complicated by secondary bacterial infection by streptococcus pyogenes or staphylococcus aureus.
CAUSES
Athlete’s foot is a form of dermatophytosis (fungal infection of the skin), caused by dermatophytes, fungi (most of which are mold) which inhabit dead layers of skin and digest keratin. These fungi exist harmlessly on human skin. As long as the skin is dry and clean, their reproduction is limited. However, under damp and warm conditions, they multiply rapidly. It is often commonly caused by the molds known as trichophyton rubrum and trichophyton mentagrophytes it may also be caused by epidermophyton floccosum
DIAGNOSIS
When visiting a doctor, the basic diagnosis procedure applies. This includes checking the patient’s medical history and medical record for risk factors. This is a medical interview during which the doctor asks questions (such as about itching and scratching), and a physical examination. If the diagnosis is uncertain, direct microscopy of a potassium hydroxide preparation of a skin scraping (known as a KOH test) can confirm the diagnosis of athlete’s foot.
PREVENTION
There are several preventive foot hygiene measures that can prevent athlete’s foot and reduce recurrence. Some of these include:
- Keeping the feet dry
- Clipping toenails short
- Using a separate nail clipper for infected toenails
- Using socks made from well-ventilated cotton or synthetic moisture wicking materials (to soak moisture away from the skin to help keep it dry)
- Avoiding tight-fitting footwear
- Changing socks frequently
- Wearing sandals while walking through communal areas such as gym showers and locker rooms
- Keeping socks and shoes clean (using bleach in the wash)
- Avoiding the sharing of boots and shoes
Experts advise the following:
- Wear loose-fitting, well-ventilated shoes, especially during the warmer months. The best materials for shoes are leather or canvas.
- Wash the feet twice a day with water and soap and always clean between the toes
- Remove shoes as soon as exercise or sports has ended
- Make sure feet are dry before putting on socks, stockings, or tights
- Change shoes regularly so that footwear is relatively dry
- Wash sheets and towels regularly.
TRANSMISSION
- Athlete’s foot can be transmitted by sharing footwear with an infected person
- Hand-me-downs
- Purchasing and wearing used shoes are other forms of shoe-sharing.
TREATMENT
Athlete’s foot resolves without medication (resolves by itself) in 30–40% of cases. Topical antifungal medication consistently produces much higher rates of cure.
Conventional treatment typically involves thoroughly washing the feet daily or twice daily, followed by the application of a topical medication. This is because the outer skin layers are damaged and susceptible to re-infection, topical treatment generally continues until all layers of the skin are replaced, about 2–6 weeks after symptoms disappear. Keeping feet dry and practicing good hygiene is crucial for killing the fungus and preventing re-infection.
