Treatment of Athlete’s foot
By Dr Ananya Mandal, MD
Athlete’s foot is a fungal infection affecting the skin over the feet and between toes.
Most cases are mild and can be treated at home. The infection often responds well to antifungal therapy.
Initially only local ointments and creams containing antifungal agents may be prescribed.
If the infection is severe or recurs oral antifungal agents may be needed.
Untreated the infection spreads to toenails, palms of the hands etc. and may lead to complications such as secondary bacterial infection.
Basic cleanliness and foot hygiene that prevent athlete’s foot from occurring as well as a recurring include –
- Maintaining cleanliness by regularly using soap and water. Drying the feet especially between the toes and keeping them dry using talcum powder.
- Wearing clean cotton socks and avoidance of tight, closed plastic lined shoes.
- Avoidance of sharing towels and socks that can carry the infection.
- Washing hands before and after applying medication or touching the infected foot.
Medications for Athlete’s foot
Medications for Athlete’s foot may be applied in the form of ointments, creams, lotions, sprays, powders etc.
They may be needed as tablets to be taken orally as well.
The locally applied preparations do not need to be prescribed by a doctor and are available over-the-counter.
Drugs include Terbinafine, Clotrimazole, Ketoconazole, Miconazole, Econazole and Sulconazole.
The topical agents are applied directly to the rash and 4 to 6 cm of the surrounding area of normal skin. The skin needs to be completely dry before the treatment is applied.
The surrounding area needs to be treated as well since fungal infection sometimes may occur without any symptoms. This wider application of the medication prevents re-infection.
Once the rash disappears the treatment needs to continue for one to two weeks to ensure that the infection has been completely treated. (1, 2, 3, 4)
Treatment for recurring infections
When uncontrolled or if the infection recurs physicians and dermatologists may prescribe Itraconazole, Griseofulvin and terbinafine orally as well.
Oral antifungal medications carry risks especially in the pregnant women and in elderly who are also taking other medications. These agents thus need to be prescribed only by a physician.
These drugs also have side effects like gastrointestinal upsets, nausea etc. Medications for bacterial infections may also be prescribed if there is a secondary infection.
Sometimes there may be soreness and inflammation over the skin of the foot.
Along with an antifungal an anti-inflammatory agent or steroid cream hydrocortisone may be advised.
This reduces the itching and inflammation to a great extent and aids in healing. However steroid creams cannot be used over seven days. (1)
Treatment for specific types of Athlete’s foot
For blisters, skin lesions, soggy skin dressing, local compresses, soaks etc. may be recommended. (2)
For Moccasin type of chronic infection long term therapy with oral drugs may be needed.
In Vescicular type of lesions the blisters in the instep may be removed by a health care provider and the bases dressed or soaked till they dry out. The soak commonly used is the Burow’s solution that is used several times a day for 3 days or more until the blister is dried out. Once dried the area is covered in topical antifungal creams.
Diabetics have a higher risk of foot infections. They often need aggressive therapy for athlete’s foot.
Toe nail infections are long term and need long term oral course of antifungals that may need to be administered over a year. (3)
Alternative therapies for Athlete’s foot
Alternative therapies with Tea tree oil or garlic may also be tried in the home therapies of athlete’s foot.
Tea tree oil has both antifungal and antibacterial properties and is derived from Australian Melaleuca alternifolia tree.
An antifungal compound called Ajoene is found in garlic. It may be used in therapy of athlete’s foot. (3)