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A fungus among us...
no one is exempt from athlete’s foot

A fungus among us. no one is exempt from athlete’s foot Last issue, I shared some information about the treatment of cracked heels. This time, I’m going to move to the other end of the foot—the toes. Tinea pedis is the term for a condition that is better known as athlete’s foot. Athlete’s foot is a fungal infection of the foot which typically starts between the toes. Early infection is commonly noticed in the area between the fourth and fifth toes. This may progress to include the bottom of the foot, the sides of the foot, and even to the toenails. The fungus that causes athlete’s foot can also cause fungal infections of other parts of the body such as the groin (referred to as “jock itch”) and also ringworm.

Athlete’s foot is contagious. It can be passed directly from person to person, as well as from infected surfaces to persons. This can occur by sharing towels, showering in the same shower as an infected person, or even just walking barefoot on infected surfaces i.e., airport security lines! Note: always wear socks to the airport!

This type of fungus thrives in warm, moist places. Athletes seem to be more prone to the fungal infection because they wear sweaty, athletic shoes for long periods of time and because the concentration of the fungus in locker rooms, gyms, and swimming areas (therefore the name “athlete’s foot”) is high, but the infection can occur in anyone.

Obviously, prevention is the key to avoiding athlete’s foot. All at-risk persons should wear breathable shoes when possible, always wear clean socks (sometimes change them during the day), dry their feet completely after bathing (including between the toes), and wear shower shoes when using public showers or gym locker rooms. Applying over-the-counter antifungal powders after showering can also help prevent tinea pedis.

Identification of athlete’s foot is typically confirmed by the appearance of the feet. Most commonly, skin appears scaly between the toes and on the bottom of the feet. Some people may even mistake it for dry skin (which is very unlikely between the toes). The affected area may also become red, irritated, itchy, and even blister based on the extent of the infection. If athlete’s foot progresses to this condition, some are at greater risk of secondary infections from scratching and opening blisters, which could lead to bacterial contamination. Diabetics should be especially cautious.

Treatment of athlete’s foot is convenient with the use of over-the-counter antifungals and following the preventative measures outlined above. However, if the infection is not better after two weeks use of the medications, a doctor should be contacted.

As stated above, topical antifungals are available without a prescription, over-the-counter. Clotrimazole (Lotrimin®), miconazole (Micatin®), and tolnaftate (Tinactin®) are products that have been available for many years. They are available in several different topical dosage forms such as creams, powders, and powder sprays.

Most recently, terbinafine (Lamisil AT®), and butenafine (Lotrimin Ultra®) have become available without a prescription, as well. These may be more effective in curing the infection in a shorter period of time because of their distinct mechanism of action.

Individuals will respond differently to different preparations. In other words, if one topical antifungal doesn’t work, try another. There have also been some suggestions that it may be even more effective to alternate one of the new preps with an older one (for example: Lotrimin® applied in the morning alternated with Lotrimin Ultra® applied in the evening). The rationale for this lies with the two different actions of the medications which work together to attack the infection, but the increased cost of two medications should also be a consideration.

Regardless of the medication chosen, diligence and compliance with application is necessary. Most preps are applied twice daily until the infection is cleared, and then continued for another seven days after symptoms have resolved.

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"A fungus among us...
no one is exempt from athlete’s foot"

   authored by:
Tamara Dulin, R.Ph., is a registered pharmacist with Nightingale Home Health Care in Carmel, Indiana. A 1991 graduate of Butler University College of Pharmacy, she has spent the majority of her career in consulting. She is a past president of the Ind...

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