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Health Matters
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Week of 3 April 1998 |
Vol. I, No. 26 |
Health Matters
Athlete's Foot: Cures for a common affliction
I've been having recurrent problems with athlete's foot. Is there anything I can do beyond using over-the-counter medications to treat it?
Caused by a superficial fungal infection, athlete's foot, or tinea pedis, is one of the most common infections to afflict humans. As many as 70 percent of people harbor the fungus, although only 15 to 20 percent have the scaling and cracking associated with it. According to Jill Slater-Freedberg, M.D., assistant professor of dermatology at Boston University School of Medicine and chief of dermatology at Boston Veteran's Administration Medical Center, the condition often can be treated successfully by using over-the-counter products for two to four weeks. If the condition fails to improve during this time, Slater-Freedberg recommends visiting your physician, taking with you all the medications you have tried.
The types of fungus that cause tinea pedis, called dermatophytes, can pass to people from soil, animals, and other humans and manifests in three forms. Interdigital tinea pedis affects the area between the toes and can create painful fissures. The biggest problem with this infection is that people with very deep fissures can develop a secondary bacterial infection that may cause cellulitis. The most chronic and persistent kind of tinea pedis is called moccasin-type, which is itchy but not as painful as interdigital. The third type, known as vesicular, produces little raised bumps on the foot that contain fluid and often requires oral therapy.
A variety of medications are effective in treating the different types of athlete's foot. Treatment for interdigital tinea pedis requires a dry environment, since the fungus thrives with moisture. Thoroughly dry your feet when you finish showering, wear cotton socks, and use some type of antifungal powder. If the soles of your feet sweat significantly, check with your doctor about purchasing drying agents containing aluminum or aluminum chloride. Generally, topical treatments such as clotrimazole and miconazole are very effective for interdigital tinea pedis. A short course of topical steroids, lasting only a few days, can be used to help reduce inflammation, and antibiotics may be needed to treat a secondary bacterial infection.
Moccasin-type tinea pedis can cause the skin to be very dry, so antifungal creams are effective treatments. One commonly recommended medication is ketoconazole, but most antifungal creams will halt the infection.
Vesicular-type tinea pedis, like the interdigital type, may require a drying agent. "This kind of tinea pedis is difficult to eliminate, so if creams are not effective, doctors will often prescribe oral antifungal medications such as itraconazole, fluoconazole, and terbinafine," Slater-Freedberg says. Some patients may experience a hypersensitive reaction, where sterile fluid-filled bumps develop on the palms as well (this can also occur in patients with interdigital tinea pedis). The reaction should not interfere with the treatment of the fungal infection.
Finally, while the fungus is remarkably widespread, you can take some measures to prevent recurring infection. Wear shoes or thongs whenever you use public bath facilities, and avoid sharing towels with others in gyms. The drier your feet are, the less likely a fungus will gain a foothold on you.
"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information about athlete's foot or other health matters, call 617-638-6767.