Why athletes alone don’t get athlete’s foot

Skin peeling between the toes and turning red coupled with itching and burning sensation could put a damper on daily activities, especially in the monsoon. Athlete’s foot, medically called tinea pedis, is a contagious fungal infection that occurs specifically in the foot under moist, damp conditions, which is transmissible upon contact.

“The condition arises due to a fungal infection of the skin, and you get it in areas where there is excess moisture,” says Dr Dileep Jude, a Puducherry-based dermatologist.

The condition is so named since it is more commonly seen in athletes as their feet are more prone to be exposed to damp environments where the fungus finds its ideal breeding ground. “Athletes’ feet often come into contact with a lot of moisture due to excessive sweating as sportspersons are used to wearing closed footwear for long durations,” adds Dr Jude.

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Condition not limited to athletes

While the name of the infection could be misleading, the condition is not just limited to athletes but could affect anyone exposed to extreme moisture in their feet, more commonly in people who wear enclosed footwear for a prolonged period of time.

“People who work in conditions where their feet come into contact with excessive moisture, such as farmers and hospitality workers, are prone to developing this condition. Those with excessive sweating in their feet are predisposed to getting infected with athlete’s foot. However, the condition could also show up in other parts of the body, like armpits, even though it is more likely to appear in the feet,” clarifies Dr Jude, who runs Dr Jude’s Hair Transplant and Skin Clinic.

Riju Bora, a 54-year-old construction site engineer, has been working on a project in Assam for the past two years. About a year ago, the skin between the last two fingers on his feet started to itch quite a lot and seemed to appear white. So, he took the most obvious common route.

“I tried some home remedies to treat the infection but was unsuccessful. That is when I decided to go to a dermatologist,” recalls Bora. He was diagnosed with athlete’s foot immediately when he visited a doctor and was prescribed some antifungal medications, including oral medications, to minimise the impact of the infection and prevent it from spreading.

“Since my job requires me to wear safety shoes for about 15-16 hours a day in a humid climate, it led to excessive sweating in my feet and making me prone to the infection. My doctor has advised me to wear open footwear as much as I can,” Bora adds. Bora has seen some progress as he has been taking his medications for a month now, and he plans to continue it for another two months as prescribed by his doctor.

Nature and severity

Since athlete’s foot is a transmissible infection that spreads through direct contact, it can find its way to other parts of the body. “Washing hands before and after applying topical medications is a must to prevent the infection from spreading,” emphasises Dr Poonam Wadhwani, dermatologist, Mumbai.

Among athletes who run and swim, the rate of transmission is higher through water and locker rooms. According to American Centers for Disease Control & Prevention (CDC), the infection can spread from a person or an animal that has a ringworm infection. “To prevent the infection from spreading, people with ringworm shouldn’t share clothing, towels, combs, or other personal items with others,” says a CDC directive.

Public spaces such as public toilets, showers, and locker rooms in swimming pools and amusement parks are other common points that facilitate transmission of the disease.

Diagnosis

The little toe and the toe next to it are particularly prone to getting infected with athlete’s foot. The fungus could make the skin turn red. Additionally, the skin may become white, thicken, and swell in some situations. According to Dr Jude, the diagnosis is almost always based on observation, but if needed, a potassium hydroxide (KOH) test is done to diagnose the condition. Affected skin is scraped off and put in the KOH solution and further observed under the microscope for the presence of the fungus.

The presenting symptom is continuous itchiness and later prompting the skin to peel off. “In some rare cases, called the vesicular tinea pedis, the person affected develops fluid-filled blisters that tend to be painful,” says Dr Jude.

Treatment

Dr Jude’s advice for athletes having athlete’s foot would be to apply an antifungal powder before putting on their footwear to minimise sweating of the feet as well as eliminate the possibility of developing the infection. “In mild cases, apart from a few preventive measures, topical application of antifungal creams for two to three weeks helps in complete healing of the infection,” he says.

Dr Jude adds that the infection can spread to the sole and the nails and thus can become a chronic infection in severe cases, wherein it becomes necessary to take oral antifungal tablets to cure the condition.

Healing prolongs for some

The usual time taken for a mild infection to subside is about two weeks, say experts. But sometimes it can take more than the stipulated time to heal. Dr Wadhwani informs that it might take a longer time to heal for people who are:

• elderly
• immunocompromised
• not maintaining proper hygiene
• diabetic

Dr Wadhwani also cautions against taking over-the-counter medications to treat the condition. “If the infection is not treated properly with a prescribed course of antifungal medications, it takes longer to heal, along with chances of recurrence being higher,” she says.

How to prevent athlete’s foot

Doctors list the following dos and don’ts:

• Drying the skin between the fingers in the feet
• Wearing open footwear often
• Changing socks and shoes immediately if it’s damp
• Wearing clean socks, especially cotton ones
• Washing hands before and after applying medicines
• Washing and drying socks in the sun to eliminate fungal spores