Footsteps
 

Fungal Infections

Athletes foot
What is it? Athlete's foot is a intense itching, cracked, blistered or peeling areas of skin, redness and scaling. It can occur on moist, waterlogged skin especially between the fourth and fifth toes, or on dry, flaky skin around the heels or elsewhere on the foot. 
What causes it? It's caused by a number of fungal species which you can pick up from anywhere (typically communal areas such as pools, showers and changing rooms) or anywhere where you may walk around barefooted, "The fungus on each bit of skin that falls away from someone else's feet can be picked up by you if you're prone." Once your feet have been contaminated, the warm, dark and sweaty environment of feet cramped in shoes or trainers provides the ideal breeding ground for the fungus. However, athlete's foot also occurs in dry, flaky areas. It's quite common in summer sandal-wearers. The sun makes your skin dry out, so it loses its natural protective oils; this combined with the constant trauma from sandals makes them more prone to infection. 
Who gets it? Well, it's not called athlete's foot for nothing. Walking barefoot around swimming pools and spending your life in trainers make you more likely to suffer. But obviously, you don't need to be an athlete to suffer. 
Is it serious? "If left untreated, the fungus can spread to the toe nails, causing thickening and yellowing of the nail, which is much harder to treat," says Shuja. "Fungal infections are highly contagious and can spread to anywhere on your skin - to your scalp, hands and even your groin, especially if you use the same towel for your feet as for the rest of your body." 
What can I do? There are many things you can do to make your feet less hospitable to fungal infections: 
Re-think your footwear Firstly, change your footwear on a regular basis. There's no point sorting your feet out if you constantly re-infect them by putting them into damp, fungally infected shoes. It takes 24-48 hours for shoes to dry out properly, so alternate your shoes daily. "If you really have to wear the same pair day after day (say, if you're on holiday), dry them out by using the hairdryer on a cold setting," says Qureshi. "This will get rid of perspiration quickly without creating more heat." To help shoes dry out more quickly, take any insoles out. Also, loosen any laces and open your shoes out fully so that air can circulate. Go for trainers with ventilation holes. If your shoes are so tight that they squeeze your toes together, this encourages moisture to gather between your toes and encourages fungus. Let air circulate between the toes by going for a wider, deeper toebox instead and choose shoes made from natural materials. Of course, you should also change your socks every day too. Wear flip-flops in the bathroom and in public showers. This will not only ensure that you don't leave your dead skin around for others to pick up, but will stop you picking up another species of fungus! And never wear anyone else's shoes, trainers or slippers. 
Re-think your footcare Treatment depends on what type of athlete's foot you have: 
For athlete's foot where the skin conditions are dry If your athlete's foot occurs on a dry area such as your heel, you need to restore moisture by rubbing in an anti-fungal cream or ointment. However, don't forget to wash your hands thoroughly afterwards. Even better, use disposable gloves so you don't get the fungus on your hands at all. 
For athlete's foot where the skin conditions have been moist This requires altogether different treatment. Wash your feet in as cold water as you can bear, as hot water only makes your feet fungus-friendly. Then dry them thoroughly after washing - preferably with a separate towel or even kitchen roll. Dab dry, don't rub as rubbing tends to take away any healing skin. As the aim is to get rid of the moisture - although the skin may appear flaky and dry - never use moisturiser between your toes. Avoid powder too as it can cake up and irritate the skin. A spirit-based preparation can help, such as surgical spirit (it's cooling, soothing and antiseptic). "It might sting a bit," says Shuja, "but it evaporates the moisture and allows the skin to heal." If your athlete's foot is mild or you've only just started to suffer, rethinking your foot hygiene may help. Surgical spirit may be enough to see it off. However if an antifungal medication is required, your pharmacist can recommend one. "The mistake most people make is to stop the hygiene regime, shoe rotation and/or medication once their symptoms have gone," says Shuja. "Even though your symptoms may disappear after several days or weeks, the fungus can lie dormant and could eventually reappear if the environment is right. Some products require continued treatment for many weeks - always follow the instructions. Also, be alert to symptoms so that you can deal with any problems straight away. Though you should avoid using anti-fungal powders between the toes, they're good for dusting inside shoes and trainers. What can a podiatrist do?You should be able to get rid of athlete's foot on your own, but a podiatrist may help you pinpoint the best treatment for your particular type of athlete's foot. Your podiatrist can also help if the fungal infection has spread to your nails, by reducing the thickness and cutting back the nails, thereby exposing the infected nailbed to a lighter, cooler environment. "If the fungus is only in the nail and not elsewhere, it is probably caused by an injury. An injury allows the fungus to creep in and multiply under the nail. This can affect the substance of the nail which may become crusty, discoloured and deformed. 
At Footsteps we can carry out Pathology tests to identify the type of infection you have at our own laboratory facilities. We can then advise on the best form of treatment targeting the specific type of infection.
See our Pathology service. 
What your GP can do Your GP can prescribe a broad-spectrum anti-fungal medication to eliminate the fungus if local treatment or your prevention regime has failed