Athlete’s foot, also called tinea pedis and ringworm of the foot, is a contagious fungal infection of the foot that can spread to hands and nails. It typically presents with itching, redness, scaling, or bumps.
To prevent the worsening and spread of athlete’s foot to other parts of the body, it is important to identify and treat it in the early stages.
Table of Contents
What is athlete’s foot?
Athlete’s foot is a fungal foot infection, meaning it’s caused by a fungus. It can lead to an itchy foot rash accompanied by burning, scaliness, and peeling of the skin. It may also result in red spots or patches, blisters, or sometimes sores on the feet.
It usually affects the area between the 4th and the 5th toe (also known as the little toe, or sometimes called the pinky toe), but it can involve any other area of the foot.
This infection is often acquired by walking barefoot in public places like swimming pools, gyms, and showers. Since it is commonly seen in athletes who use these facilities, that’s the reason it is called “athlete’s foot.”
Medical term
The medical term for athlete’s foot is tinea pedis or ringworm of the foot. “Tinea” refers to the fungal infection, while “pedis” refers to the foot.
Pictures
Athlete’s foot most often looks like scaly, peeling, or cracking skin between the toes. The affected skin may appear red, white, or purple.
The pictures below show athlete’s foot affecting various parts of the foot.
The picture below shows the hyperkeratotic or moccasin type of athlete’s foot.
Causes
Athlete’s foot is an infection caused by a fungus, primarily Trichophyton, which belongs to the group of dermatophytes. These dermatophytes can infect skin, hair, and nails and are the same organisms that cause ringworm of the body and jock itch.
These fungi need warmth and moisture to grow and flourish. Our feet can provide the perfect environment for their growth, especially if we wear socks all day and our feet sweat a lot.
Who is at risk of getting it?
Athlete’s foot can affect anyone. There are certain factors that increase one’s chances of getting it. These include:
- Diabetes
- Weak immune system due to immunosuppressive drugs or other underlying medical conditions
- Injury or trauma to feet
- Sweaty feet
- Prone to eczema
- Wearing socks for an extended time period
- Wearing synthetic/ rubber boots
Spread
If you are wondering, “How contagious is athlete’s foot?” the answer is “very contagious.” This is the reason you can get athlete’s foot very easily from an infected individual.
It can spread through direct contact with infected areas of the foot or through contaminated surfaces or clothing, such as floors, towels, socks, or shoes. This is why it can easily spread in public areas where people walk barefoot, like swimming pools, saunas, and gyms.
One can also spread it to other parts of the body. For example, touching the infected areas with your hands and not washing them can lead to the spread of athlete’s foot to the hands, resulting in a condition known as tinea manuum or ringworm of the hands.
Similarly, if you touch any other area of your body like your face or groin without washing your hands, it can lead to the spread of athlete’s foot there as well.
Symptoms
Athlete’s foot can involve one or both feet and can present with various symptoms.
Athlete’s foot very commonly affects the area between the toes, especially the fourth and fifth toes, or the little toe. It can also affect the top of the feet, soles, sides, or heels.
The symptoms of athlete’s foot include:
- Red spots or patches, especially on the top of the feet or between the toes
- White peeling skin between the toes
- Splitting or cracking of the skin, especially between the toes
- Dry, scaly skin on the bottom of the feet, sides, or heels
- Blisters
- Itchiness
- Burning sensation
- Change in color
- Open sores
There are different types of athlete’s foot, and depending on the type, the symptoms and areas affected may vary.
Different types
Athlete’s foot can be divided into four main types, and appearance varies depending on the type.
1. Toe-web infection (Chronic interdigital)
Toe-web infection is the most common type of athlete’s foot. It mostly affects the area between the smallest two toes, namely the 4th and 5th toes (pinky toe). The skin may appear red or white and may peel, split, or crack.
2. Moccasin-type infection (Chronic hyperkeratotic)
Moccasin-type usually affects the bottoms or soles and may extend to the heels and sides of the feet. The skin appears red and scaly and may become thick. The feet may feel sore or tender. Hands and nails may also become infected.
3. Vesiculobullous-type infection
The vesiculobullous type most commonly affects the bottom of the feet and the area between the toes. It results in the formation of vesicles or fluid-filled bumps, also called athlete’s foot bumps or blisters. It may be painful. The blisters may burst open, leading to red and peeling skin or sores.
4. Ulcerative infection
The ulcerative type is an uncommon form that results in pus-filled bumps (pustules), open sores, or ulcers between the toes or on the bottom of the feet. A superimposed bacterial infection may also be present. This type is usually very painful.
Read more: Itchy blisters on feet, but not athlete’s foot
Complications
1. Recurrence
Athlete’s foot can recur, especially if the treatment is stopped before complete clearance.
If you keep getting athlete’s foot, make sure you complete the full treatment plan as recommended by your doctor.
2. Spread to other parts of the body
If athlete’s foot is not treated, it can spread to other parts of the body.
- Adjacent toes: The infection can spread to adjacent toes through direct contact.
- Nails: The infection can spread to the nails, a condition known as onychomycosis. Nails may appear discolored and brittle, and the nail plate can thicken. Treatment can be challenging; topicals may help but often take a long time to show improvement. Oral antifungals may be necessary in some cases.
- Hands: If hands are not thoroughly washed with soap and water after touching an infected foot, they can also become infected. This condition is known as tinea manuum.
- Groin: The infection can spread to the groin area either by direct contact or by using the same towel. This condition is termed jock itch or tinea cruris.
3. Allergic reaction to fungus
Some people can have an allergic reaction to the fungus resulting in a blistering skin rash.
4. Secondary bacterial infection
If athlete’s foot is not treated for long, the skin can become raw and develop open wounds. This can serve as a breeding ground for bacteria, leading to a secondary bacterial infection. As a result, the foot can become swollen, painful, and hot to the touch. One may also develop a fever.
5. Involvement of the lymphatic system
The secondary bacterial infection can get severe and can involve lymphatic vessels and lymph nodes.
Diagnosis
Athlete’s foot can be diagnosed clinically by a doctor based on the appearance of skin lesions. Your doctor may perform some tests to confirm the diagnosis or to rule out other causes.
1. KOH preparation
The most common skin test is a KOH preparation. In this test, the specialist will take skin scrapings and place them in potassium hydroxide.
The potassium hydroxide dissolves the human skin cells, leaving behind only the fungal cells. These can then be viewed under a microscope to aid in making a diagnosis.
2. Culture
In some cases, a sample may be sent to a lab for culture. The results take longer to arrive, but culture is more specific and can identify the type of dermatophyte or fungus causing the infection.
3. Skin biopsy
Sometimes, to rule out other skin conditions like eczema and psoriasis, a skin biopsy may be taken and sent to a pathologist for a definitive diagnosis.
Treatment
Most minor or mild athlete’s foot infections can be treated at home with over-the-counter treatment options. However, severe athlete’s foot infections require prescription medications. If it becomes secondarily infected by bacteria, one will require antibiotics.
Treating athlete’s foot in the early stages can prevent the spread of the infection to other parts of the body and to other individuals.
Whatever treatment you choose for treating your athlete’s foot, it’s important to complete the full course or continue using the medication until the infection is completely cleared.
Home remedies
There are many treatments that you can get over the counter to treat mild athlete’s foot.
1. Keep your feet dry
The fungus that causes athlete’s foot loves a warm and moist environment. So, it is important to keep the feet dry. Do not wear socks for an extended time and make sure to air out your feet in between.
2. Disinfect shoes
It is important to disinfect shoes to prevent the spread of infection and reinfection. You can use sprays to disinfect shoes. Alternatively, you can wash your shoes in hot water.
3. Socks
Always wear clean socks and avoid sharing them with anyone. Opt for socks made of material that doesn’t retain moisture.
4. Absorbent powder
The feet can be kept dry by using powders that absorb excess moisture like corn starch. Some powders also come with antifungal ingredients and can help in treating athlete’s foot (tinea pedis).
5. Over-the-counter topical medications
Over-the-counter (OTC) antifungal medications can treat mild athlete’s foot effectively. These can be in the form of creams, gels, sprays, lotions, or powders. The most commonly used antifungal ingredients are miconazole, clotrimazole, terbinafine, and tolnaftate.
- Lotrimin AF Antifungal Liquid Spray (2% miconazole nitrate)
- Lotrimin AF cream (1% clotrimazole)
- Lamisil AT spray (1% terbinafine)
- Lotrimin AF Athlete’s Foot Antifungal Powder (2% miconazole nitrate)
Note: Some home remedies like tea tree oil and bitter orange oil have limited evidence supporting their effectiveness in the treatment of athlete’s foot/tinea pedis. Natural remedies if used incorrectly can damage skin so be cautious in choosing over-the-counter treatments. It’s best to discuss these with your doctor.
6. Tea tree oil
Tea tree oil is known for its antibacterial and antifungal properties. It should never be used undiluted as it can lead to contact dermatitis or other skin reactions.
A 2002 study suggests that using tea tree oil at 25 to 50% concentration twice daily for a few weeks (4 weeks in this study) can treat athlete’s foot. However, few patients in this study had to discontinue treatment due to contact dermatitis.
In an older study from 1992, tea tree oil cream (10%) improved the symptoms of athlete’s foot but it did not get rid of the fungus.
So, be cautious in using it due to its side effects. In addition, it may or may not eradicate the fungus completely.
7. Garlic extract – Ajoene
Garlic extract, ajoene, has been found to be effective for athlete’s foot. An older study from 1996, found that ajoene (0.4% cream) completely cleared athlete’s foot in 1-2 weeks.
8. Sosa
Sosa (Solanum chrysotrichum) is commonly used in Mexico as a remedy for fungal skin infections. In one study, it was compared to 2% ketoconazole. Both were effective in clearing the athlete’s foot. The data supporting its benefit is limited and it may be hard to get.
9. Bitter orange oil
Bitter orange oil has antifungal properties. One study from 1996 found that using 25% emulsion of bitter orange oil can clear athlete’s foot in 1-2 weeks.
Be cautious though, in pure form, it can irritate skin. In addition, bitter orange oil is phototoxic so can make skin more sensitive to the sun.
Prescription medications
In resistant and extreme cases of athlete’s foot, it’s best to see a doctor to get prescription medications. These can either be in the form of topical or oral medication.
Terbinafine, itraconazole, or fluconazole are some of the commonly prescribed oral drugs.
Prevention
The following measures may reduce the chances of getting it:
- Give time for your feet to air out.
- Wash your feet every day with soap and water, especially between the toes.
- Antifungal powder can be used, which will help in absorbing excess moisture.
- Make sure to dry your feet thoroughly before putting on socks.
- Wear socks made of moisture-absorbing material.
- Wear shoes made of breathable material.
- Keep a few pairs of shoes in rotation so that your shoes get time to dry in between.
- Disinfect your shoes with spray or wipes. Alternatively, wash your shoes in hot water and soap and dry them thoroughly.
- Wear flip-flops or slides in public bathrooms, lockers, or swimming pools.
- Don’t share your shoes and socks with others.
- Wash your towels, socks, and linen in hot water.
- Always wear clean socks.
- Keep your nails clipped and clean.
When to see a doctor
One should see a doctor if:
- Diabetic
- Immunosuppressed
- Experiencing pain
- Notice pus or foul-smelling discharge
- Have a fever
- The infection does not improve or gets worse
FAQs
- How can you get rid of athlete’s foot fast? The fastest way to get rid of athlete’s foot is to consult a doctor for a proper diagnosis and treatment. Home remedies may or may not be effective for everyone.
- How long does athlete’s foot take to heal? The healing time for athlete’s foot can range from 1 to 8 weeks, depending on the severity and the treatment used.
- Should I wash my shoes if I have athlete’s foot? Yes, it’s important to clean your shoes to prevent reinfection. You can either use disinfectant sprays or wash them in hot water, provided they are made of washable material. Make sure to dry them thoroughly before wearing them again.
- Can athlete’s foot be cured? Completing the full course of medication can help in completely clearing the athlete’s foot infection. However, if the treatment is not completed, the condition can recur. Preventative measures can help reduce the likelihood of recurrence.
- Can athlete’s foot go away without treatment? It usually doesn’t go away without treatment. If left untreated, it can spread to other parts of the body like the nails and hands. Therefore, it’s important to seek treatment for this skin condition.
Key points
Athlete’s foot, also known as tinea pedis, is a highly contagious fungal infection affecting the skin on the feet.
Common symptoms of athlete’s foot include red patches, white peeling skin between the toes, cracking or splitting skin, and itchiness. The symptoms may vary depending on the type of athlete’s foot.
Treatment options range from over-the-counter antifungal creams for mild athlete’s foot to prescription medications for severe cases, and in some cases, antibiotics for secondary bacterial infections. It’s important to complete the full treatment course to prevent recurrence.
Further reading
- Stages of Ringworm Healing
- Ringworm: Facts and FAQs
- How Ringworm Spreads and What Causes It?
- How Long is Ringworm Contagious? Treated vs Untreated
- How Long does Ringworm Last?
- Treatment for Ringworm: How to Get Rid of It?
- Home Remedies for Ringworm: How to treat it at home naturally?
- 8 Rashes That Look Like Ringworm But Aren’t (With Pictures)
References
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- Crawford F, Hollis S. Topical treatments for fungal infections of the skin and nails of the foot. Cochrane Database Syst Rev. 2007 Jul 18;2007(3):CD001434. doi: 10.1002/14651858.CD001434.pub2. PMID: 17636672; PMCID: PMC7073424.
- Ilkit M, Durdu M. Tinea pedis: The etiology and global epidemiology of a common fungal infection. Crit Rev Microbiol. 2015;41(3):374-88.
- M. Aaron D. Tinea Pedis (Athlete’s Foot). (2012)
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- Tong MM, Altman PM, Barnetson RS. Tea tree oil in the treatment of tinea pedis. Australas J Dermatol. 1992;33(3):145-9. doi: 10.1111/j.1440-0960.1992.tb00103.x. PMID: 1303075.
- Ledezma E, DeSousa L, Jorquera A, Sanchez J, Lander A, Rodriguez E, Jain MK, Apitz-Castro R. Efficacy of ajoene, an organosulphur derived from garlic, in the short-term therapy of tinea pedis. Mycoses. 1996 Sep-Oct;39(9-10):393-5. doi: 10.1111/j.1439-0507.1996.tb00160.x. PMID: 9009665.
- Herrera-Arellano A, Rodríguez-Soberanes A, de los Angeles Martínez-Rivera M, et al. Effectiveness and tolerability of a standardized phytodrug derived from Solanum chrysotrichum on Tinea pedis: a controlled and randomized clinical trial. Planta Med. 2003 May;69(5):390-5.
- Ramadan W, Mourad B, Ibrahim S, Sonbol F. Oil of bitter orange: new topical antifungal agent. Int J Dermatol. 1996 Jun;35(6):448-9. doi: 10.1111/j.1365-4362.1996.tb03032.x. PMID: 8737885.
- Burnett CL, Fiume MM, Bergfeld WF, et al. Safety Assessment of Citrus-Derived Peel Oils as Used in Cosmetics. International Journal of Toxicology. 2019;38(2_suppl):33S-59S.
Disclaimer: This blog post is for information purposes only and does not replace medical advice.