Athlete's Foot

What is athlete’s foot? 

Athlete’s foot is a common infection, caused by a fungus (dermatophytes), that can affect either one or both of your feet[4]. The infection typically affects the skin between your toes, but it can also appear on the tops, soles and edges of your feet, as well as your heels.   

It causes[5]: 

• Red, purple, grey or white patches of skin 

• Sore, inflamed skin 

• Cracked, bleeding skin 

• Fluid-filled blisters 

• A rash 

• A burning or stinging sensation 

• Itchiness  

• Dry, flaky, scaly skin 

• An unpleasant smell 

However, the specific symptoms you experience will depend on the type of athlete’s foot that you have. There are four main types of athlete’s foot[6]: 

• Interdigital type – causes the skin between your fourth and fifth toe (pinkie) to change colour, crack and peel. This is the most common type of athlete’s foot 

• Moccasin-type infection – causes the skin on the soles of your feet, your heels, the edges of your feet, and sometimes your toenails, to thicken and crack 

• Vesiculobullous-type infection – causes bumps and blisters to appear, particularly on the soles of your feet 

• Ulcerative infection – causes open sores to appear between your toes and sometimes on the soles of your feet. This is the rarest type of athlete’s foot 

Is athlete’s foot contagious? 

Athlete’s foot is extremely contagious. It spreads through direct skin-to-skin contact or via contact with a flake of skin from an infected person.  

The fungi that cause athlete’s foot needs warm temperatures and moisture to grow. As a result, it tends to spread in areas used by large groups of people, like locker rooms, swimming pools and saunas, and grow quickly when you wear socks and tight shoes. It can also spread if you share towels, socks and shoes with an infected person.  

Once you have athlete’s foot, the infection can spread from the foot to other warm, moist parts of the body, such as your hands, groin and nails.   

How is athlete’s foot diagnosed?  

A visual inspection by your GP is normally all that’s needed to diagnose athlete’s foot[7]. They will ask you about your symptoms and whether any of your family or friends are affected by the condition[8].   

If this information isn’t enough to diagnose athlete’s foot, or your GP wants to confirm the type of fungal infection you have, they may take a small sample of your skin from the affected area to be tested in a lab under a microscope[9]. 

Athlete’s foot risk factors 

Athlete’s foot can affect anyone. However, it’s more common in people:  

• Born male 

• Over the age of 60 

• With diabetes 

• Who are at a higher weight 

• With a weakened immune system 

• With wounds on their feet 

In addition, athlete’s foot gets its name because it’s extremely common in those who regularly participate in sports. For example, if you: 

• Wear enclosed footwear a lot  

• Sweat heavily 

• Don’t dry your feet properly after showering 

• Walk barefoot in communal areas where the infection is commonly spread 

How can athlete’s foot be treated? 

If you have a fungal foot infection, chances are you’re wondering what kills athlete’s foot instantly. Unfortunately, it can take between one to eight weeks for the infection to clear completely. However, it’s very easy to treat using over-the-counter antifungal medicines containing the active ingredients terbinafine, clotrimazole, miconazole, or tolnaftate[10].  

These are available as:    

• Athlete’s foot creams 

• Athlete’s foot sprays 

• Athlete’s foot powders  

To ensure the infection doesn’t come back, you should:  

• Use the treatment until the symptoms have gone, and for two weeks afterwards 

• Wash your hands with soap and water every time you use the treatment 

• Wash your socks and bed sheets at 60°C until the symptoms have gone, and for 2 weeks afterwards 

• Not scratch your foot, as the fungus can travel via your hands to other parts of your body and cause it to spread   

When to see a GP for athlete’s foot 

In rare cases, over-the-counter medications may not be enough to treat athlete’s foot. You should see a GP if[11]:

• You’ve completed a full course of treatment from a pharmacy, and it hasn’t worked 

• You're in a lot of pain 

• The infection spreads to other parts of your body, such as your groin 

• Your foot or leg is hot, painful and red/dark brown/purple/grey (depending on your skin colour), as these signs indicate a more serious infection 

• You have diabetes, as high blood sugar levels can damage the nerves in your feet, making it easier to cause severe damage to your feet without noticing  

• You have a weakened immune system (e.g. if you are having chemotherapy), as this can make it harder for your body to fight off infections 

Prescription-only athlete’s foot treatments 

If treatments from a pharmacy have not worked, a GP may: 

• Prescribe antifungal tablets  

• Prescribe a steroid cream to use at the same time as antifungal cream 

• Refer you to a dermatologist (skin specialist) for more specialised care  

How to stop the spread of athlete’s foot  

Nobody wants to get athlete’s foot. You can help protect other people from contracting the infection by: 

• Not walking around barefoot in places like changing rooms and showers (wear flip-flops instead) 

• Not sharing towels, socks or shoes with other people 

• Not wearing the same pair of shoes for more than two to three days in a row 

• Avoiding wearing shoes that make your feet hot and sweaty, as this can encourage the bacteria to grow 

How to prevent athlete’s foot  

Thankfully, there are plenty of things you can do to prevent athlete’s foot from developing or coming back:  

• Wash your feet and the skin between your toes thoroughly with antibacterial soap 

• Dry your feet and between your toes after washing them 

• Apply talcum powder or antifungal powder to your feet to absorb moisture 

• Use a separate towel for your feet  

• Wear clean socks every day (and choose cotton, wool or synthetic materials that absorb moisture) 

• Wear shoes or sandals that allow your feet access to the air 

• If you do sports in a particular pair of shoes, allow them to dry out for 24 hours between uses  

• Avoid wearing rubber or synthetic shoes for long periods  

• Clean your shoes with a disinfectant spray 

• Wash your socks, towels and bedding in hot water 

Sources 

1. https://www.gatesheadhealth.nhs.uk/wp-content/uploads/2023/09/Fungal-Infections-Athletes-Foot-and-Toenail-Infections.pdf 
2. https://my.clevelandclinic.org/health/diseases/22139-athletes-foot-tinea-pedis 
3. https://www.nhs.uk/conditions/athletes-foot/  
4. https://www.mayoclinic.org/diseases-conditions/athletes-foot/symptoms-causes/syc-20353841  
5. https://dermnetnz.org/topics/athletes-foot  
6. https://cks.nice.org.uk/topics/fungal-skin-infection-foot/diagnosis/diagnosis/  
7. https://cks.nice.org.uk/topics/fungal-skin-infection-foot/diagnosis/assessment/ 
8. https://www.mayoclinic.org/diseases-conditions/athletes-foot/diagnosis-treatment/drc-20353847  
9. https://www.guysandstthomas.nhs.uk/health-information/athletes-foot  
10. https://cks.nice.org.uk/topics/fungal-skin-infection-foot/management/management/  
11. https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/complications/feet