Athlete's Foot: Symptoms, Treatment and Prevention

Athlete's foot is a contagious fungal skin infection that commonly causes itching, scaling and peeling between the toes or on the soles.

Also called tinea pedis, it develops when dermatophyte fungi grow in warm, damp areas of the outer skin. It can affect one foot or both, and it is not limited to people who play sport.

Very commonly, athlete's foot presents with itchy feet. Peeling skin is also a common presentation. Skin between the toes may look pale, softened, cracked or sore, while the sole may develop dry, powdery scale along its edges. Small fluid-filled blisters can occur in an inflamed pattern.

Seek prompt assessment if redness rapidly spreads, the foot becomes hot or swollen, pus appears, pain is marked, or fever develops. These changes can point to a bacterial infection rather than uncomplicated fungus.

Dermatophyte fungi feed on keratin in the outer skin. They can pass through direct skin contact or through contaminated floors, towels, footwear and nail tools. Damp socks and enclosed shoes create conditions that help the fungi persist; scratching can transfer them to other skin sites.

Untreated patches may enlarge, split or become more inflamed. Symptoms can settle before the fungus has cleared, so stopping treatment early may allow it to return. Infected toenails can act as a reservoir and repeatedly seed the surrounding skin.

Sweaty feet, tight or poorly ventilated footwear, shared changing areas and repeated exposure to damp floors increase opportunity for fungal growth or contact. Broken skin and reduced immune defence can make infection harder to control. Diabetes or poor circulation also raises the importance of early foot assessment.

A clinician examines the distribution and surface of the rash and checks the toenails. Eczema, contact irritation, psoriasis and bacterial infection can resemble fungal disease. If the appearance is uncertain or treatment has failed, a gentle skin scraping may be sent for fungal microscopy or culture.

A topical antifungal cream, spray or solution is commonly used for infection limited to the skin. Application needs to cover the affected area and a small margin, following the product or prescriber's directions. Keeping the foot dry supports treatment.

A clinician may consider oral antifungal medicine when disease is extensive, persistent, repeatedly recurrent or accompanied by significant nail infection. These medicines are not suitable for everyone and may require checks for health conditions and medicine interactions.

Wash gently, pat rather than rub, and dry between every toe. Use a separate towel for the feet and wash it regularly. Avoid picking loose skin, because tiny breaks can admit bacteria. Put socks on before underwear if another fungal rash is present, reducing transfer from feet to the groin.

Cracks can provide an entry point for bacteria, leading to increasing warmth, tenderness, swelling or spreading redness. Fungus may also involve the toenails or spread to the hands and groin. People with diabetes, impaired circulation or reduced immunity should not delay assessment of broken or infected foot skin.

Keep feet cool and dry, choose breathable shoes, change damp socks, and avoid sharing towels or footwear. Clean nail tools after use. Treating coexisting nail fungus and allowing shoes to dry can remove sources that otherwise reintroduce fungus to cleared skin.

Arrange a dermatology review when the diagnosis is unclear, the rash keeps returning, nails are involved, or correctly used non-prescription treatment has not helped. Urgent care is appropriate for rapidly spreading redness, fever, marked swelling or severe pain.