Athlete's foot is a skin infection caused by a fungus known as dermatophytes.  The infection was common among athletes who frequently used public sporting facilities so the term "athlete's foot" became popular.

Causes: The fungus most commonly attacks the feet because shoes create a warm, dark, and moist environment which encourages the growth of the fungus.  In fact, athlete's foot was relatively uncommon in humans before we began wearing shoes.  It is now frequently seen in adolescents and adults.  This fungus can be contracted by sharing shoes with an infected person or walking bare foot in areas where the fungus is.  The warmth and dampness of areas around swimming pools, public showers, and locker rooms are breeding grounds for fungi.  The fungus can also be transmitted by contact with pets who carry it on their fur.  

Athlete's foot may spread to the soles of the feet and to the toenails.  It can also spread to other parts of the body if the person scratches the infected area and then touches themselves elsewhere.  The fungus causing athlete's foot may last for a long time and can spread by contaminated bed sheets or clothing to other parts of the body.

Symptoms: The signs of athlete's foot are dry skin, itching, scaling, inflammation, and blisters.  Blisters often lead to cracking of the skin.  When blisters break, small raw areas of tissue are exposed, causing pain and swelling.  Itching and burning may increase as the infection spreads.  Athlete's foot can also be present in a number of different ways such as with moist, white, scaly lesions or sores between the toes and a reddish "moccasin-like" area over the soles of the feet.  This type often affects both feet.  Less frequently, this infection may involve painful blistery lesions, which can be oozing and may have a strong odor.

When to seek medical care: A simple fungal infection such as athlete's foot can become "super-infected" with bacteria.  If this should happen, the rash will become increasingly painful and red.  Your foot may become swollen, and you may develop blisters and even open sores in the infected area.  These are indications that you may need oral antibiotics and will need to call your doctor.

It is unlikely that athlete's foot would ever become severe enough to require hospitalization.  However, if you have diabetes or any other type of illness that will make it hard for your body to fight off an infection, athlete's foot may become more severe.  If you develop severe pain, redness, or swelling, fever, notice a pusslike drainage, see large blisters or ulcers on your foot, you should be seen as soon as possible by your doctor.  Most fungal infections of the skin will heal in two weeks.  If the symptoms persist for more than a month you should be seen by a podiatrist.

Prevention: It is not easy to prevent athlete's foot because it is usually contracted in dressing rooms, showers, and swimming pool locker rooms where bare feet come into contact with the fungus.  However, you can do much to prevent infection by practicing good foot hygiene.  Daily washing of the feet with soap and water and drying carefully, especially between the toes.  Changing shoes and sock/hose regularly to decrease moisture, help prevent the fungus from infecting the feet.  Also helpful is the daily use of a quality foot powder.  Wear sandals in public locker rooms and swimming areas.  Do not wear someone else's shoes, especially if that person has athlete's foot.  Thoroughly clean home showers and floors where family members walk barefooted to avoid spreading the fungus.

Self-care at home: If you have athlete's feet there are a number of things you can do to treat the fungus.  Many over-the-counter antifungal medications can be applied to the affected area.  These creams should be used sparingly, but regularly, at least twice a day.  It is important to keep your feet clean and dry.  Wear clean absorbent socks made of natural fibers, such as cotton, and change them during the day if your feet become moist or sweaty.  If possible, remove the insoles from shoes and sneakers to allow them to dry out over night.  Dusting talcum powder or any antifungal powder inside of your shoes and socks helps decrease the moisture level.  Alternate between wearing different pairs of shoes to allow them to dry out for a day or two between wearing.  Avoid walking barefoot.  Use shower shoes.  Reduce perspiration by using talcum powder.  Wear light and airy shoes and wear socks that keep your feet dry, and change them frequently if you perspire heavily.

Treatment: Over-the-counter antifungal creams are sufficient for treating most cases of athlete's foot.  Apply them as directed to the toes and foot.  Common brands include clotrimazole (Lotrimin) and tolnaftate (Tinactin). If the topical antifungal medications do not clear up the infection, your doctor may prescribe an oral antifungal medication.  Antifungal medications are used to treat athlete's foot.  Topical or oral antifungal medications are prescribed by the podiatrist.  Remember, it is important to keep the feet dry by dusting foot powder in shoes and hose.  Feet should be bathed frequently and all areas dried thoroughly.

Consult your podiatrist: If an apparent fungus condition does not respond to proper foot hygiene and self care, and there is no improvement within two weeks, consult your podiatrist.  The podiatrist will perform tests such as cultures to determine if a fungus is the cause of the infection.  If it is a specific treatment plan, including the prescription of antifungal medications, applied topically or taken by mouth, will usually be ordered.  This type of treatment has shown better resolution of the fungus, however if persons do not complete the entire course of treatment the infection can return.
 
For more information or to see a podiatrist visit Bahamas Foot Centre Rosetta Street 325-2996, Bahamas Surgical Associates, Albury Lane 394-5820 or email at foothealth242@hotmail.com or visit www.apma.org.

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