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Athlete's Foot

Causes and Treatment of an Itchy, Scaly Rash

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Updated May 10, 2012

Athlete's Foot

One form of athlete's foot- red rash with peeling skin

Image © A.D.A.M

Tinea pedis is the medical term for athlete's foot, one of the most well-known fungal foot conditions. Tinea pedis got its nickname because of its tendency to infect athletes, who often wear hot, sweaty athletic shoes that provide a good breeding ground for the fungus that causes the condition. In reality, athlete's foot can affect anyone, young or old, regardless of shoe style.

Characteristics of athlete's foot include an itchy or burning rash that may have such symptoms as: redness, odor, scaling or peeling skin, or small blisters that may resemble pimples. When athlete's foot occurs between the toes it often appears as pale-looking skin that has been over-exposed to moisture from sweat.

Chronic athlete's foot has a "moccasin" appearance, where the rash covers the soles and sides of the feet. This type of rash has fine, scaling skin that gives it a powdery appearance. Sometimes this chronic infection can spread to a hand due to contact with the foot from scratching. Acute tinea pedis has characteristic blisters or peeling skin with more intense redness.

Tinea pedis is caused by dermatophytes, which are fungi that infect skin, hair and nails. Sometimes yeast can cause foot infections and rashes, often between the toes. People who are prone to tinea pedis are also susceptible to fungal toenail infections (onychomycosis). This is because both conditions are caused by the same types of fungi.

Factors that Increase the Chance of Getting Athlete's Foot

Some people are prone to athlete's foot because of a genetic predisposition or because of factors that cause a compromised immune system. Examples of this include steroid medications or chronic diseases such as diabetes and cancer.

One of the most important factors contributing to athlete's foot is sweat. Sweat is a normal response to the hot environment inside a shoe. Some people may have hyperhidrosis, or excess sweating, which can increase the chance of fungal infection even further. The heat and humidity inside shoes create an ideal environment for dermatophytes and other fungi to thrive.

Tips for Prevention and Treatment of Athlete's Foot

  • Use synthetic socks made with acrylic or polypropylene. These materials wick away moisture better than cotton, which holds moisture close to the skin.

  • Wear sneakers with good ventilation, such as those that have breathable mesh tops.

  • Wear sandals or other shoes when in areas where fungi thrive, such as around public pools or in locker rooms.

  • When choosing over-the-counter (OTC) anti-fungal creams, look for brands that have either butenefine or terbinafine as active ingredients. These medications have good potency against most of the organisms that cause tinea pedis.

  • Always follow the anti-fungal medication's instructions, whether prescription or non-prescription.

  • Use anti-fungal sneaker sprays or powders in boots and shoes.

If OTC medicines have not resolved your athlete's foot, it is best to seek medical treatment to rule out other possible causes. It is also best to seek treatment if the symptoms include intense redness, blistering, peeling or cracked skin or pain. Lab tests such as a KOH prep or culture may be used to determine if the cause of symptoms is a fungal infection.

Some cases of tinea pedis can cause an id reaction. An id reaction is where the rash spreads to other parts of the body, often the hands and chest. This type of rash is also itchy and produces bumps and blisters, but is not caused by the spread of fungus. Rather, it's an allergic response to the original foot rash. An id reaction will clear on its own once the original athlete's foot resolves.

Conditions That Can Look Similar to Athlete's Foot

Sources

Joseph, DPM, FIDSA, Warren S.,(2009) A Closer Look at Topicals for Tinea Pedis. Podiatry Today, 22(9),48-56.

Morse, DPM, Joel M., When a Patient Presents with Malodorous, Macerated Feet. Podiatry Today,21(12), 26-32.

Hall MD, John C. (2000) Sauer's Manual of Skin Diseases(eighth ed.) Philadelphia: Lippincott Williams and Wilkins, p 216.

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