Tinea pedis is a fungal infection that affects the skin on the feet. Despite its association with the term “ringworm”, it is not caused by a parasitic worm but by a fungus that thrives in warm, moist environments. Commonly referred to as athlete’s foot, this condition is also known by other names, including foot rot (Singapore) and “Hong Kong foot”. The latter term originated when early Western visitors observed a high prevalence of the infection in Hong Kong. During British colonial rule, many soldiers contracted the condition, and later, during the Japanese invasion of China, those fleeing south from Shanghai also experienced outbreaks. While this term has historical roots, such labels are no longer appropriate in today’s context.
Understanding tinea pedis begins with recognising its various types, with each type presenting different characteristics. By identifying the specific type early, individuals can take steps to prevent further complications and ensure proper care.
Types of Athlete’s Foot
As mentioned earlier, athlete’s foot can manifest in various forms. Here are the four types of tinea pedis infection:
- Toe Web Infection: This type affects the skin between the fourth and fifth toes, causing redness, scaling, and cracking.
- Moccasin-Type Infection: This type affects the soles of the feet, beginning with dry or sore skin that gradually thickens and cracks.
- Vesicular-Type Infection: This type features itchy blisters, usually found on the soles or between the toes, though they can appear elsewhere.
- Ulcerative Infection: The rarest type of athlete’s foot, this form involves painful open sores or ulcers between the toes or on the soles of the feet.
Common Causes of Athlete’s Foot
Athlete’s foot is caused by the overgrowth of dermatophyte fungi, such as Trichophyton rubrum and Trichophyton interdigitale. These fungi thrive on the skin’s surface, particularly in warm and moist environments, such as damp socks and enclosed shoes. In regions with higher humidity, like Singapore, the risk of infection increases as these conditions are frequently present.
This risk is especially heightened during Singapore’s south-west monsoon period, from June to September. The increased rain and humidity during this rainy season create an optimal environment for fungal infections like athlete’s foot to spread. When feet remain damp in enclosed footwear throughout this wet season, the fungi can easily multiply and cause infections. Although the general public can contract athlete’s foot through these factors, certain groups are at a higher risk due to their environments, including:
- Athletes: As the name implies, athletes are prone to athlete’s foot due to the sweat buildup in their shoes during physical activity, creating a moist environment that fosters fungal growth. They are also frequently exposed to communal showers and locker rooms, which increases the risk of coming into contact with fungi.
- Military Personnel: Military personnel often wear heavy, enclosed boots for long hours, which trap sweat and moisture. The lack of ventilation in the boots combined with the heat provides ideal conditions for fungi to thrive, especially during prolonged use.
- Workers in Humid or Wet Environments: Workers in construction or similar jobs are regularly exposed to wet or humid conditions, either from working in rain, mud, or sweat inside waterproof boots. This constant exposure to moisture keeps the feet damp, raising the risk of fungal infection.
- Swimmers and Gym-Goers: Walking barefoot in communal areas like swimming pools and gym showers exposes swimmers and gym-goers to contaminated surfaces where fungi can thrive. These shared spaces are often damp, making them high-risk areas for infection.
- Hyperhidrosis Sufferers or Those with Weakened Immunity: Individuals with hyperhidrosis, a condition that causes excessive sweating in the feet, or those with weakened immune systems are more susceptible. The constant moisture from sweating provides an ideal environment for fungi, while a weakened immune system makes it difficult to fight off infections.
For these groups, continuous exposure to moisture and contaminated surfaces makes vigilant foot care essential. Keeping feet dry, changing out of wet footwear promptly, and avoiding direct contact with shared surfaces are crucial steps in reducing the risk of athlete’s foot.
Symptoms of Athlete’s Foot
Athlete’s foot, if left unmanaged, can worsen, leading to what many describe as “foot rot”, where the skin begins to break down. Initial symptoms often include itching, burning, or stinging sensations, especially between the toes. Interestingly, one of the fungi involved in athlete’s foot is Trichophyton interdigitale. Its Latin name, interdigitale, directly refers to the spaces between the toes, which are commonly affected by the infection.
As the condition progresses, several noticeable symptoms can develop, such as:
- Redness, scaling, and cracked skin between the toes, particularly between the fourth and fifth toes. This is often accompanied by a burning sensation, and in advanced stages, the skin may emit an unpleasant odour or fluid discharge. These signs suggest the presence of a secondary bacterial infection.
- Dry, flaky skin on the soles of the feet that gradually thickens and cracks. As the infection spreads, discomfort increases, and if the condition affects the toenails, fungal toenails might develop. The nails can become thick, brittle, and prone to breaking or detaching from the nail bed.
- Unbearable itching on the infected areas, which can be difficult to resist scratching. Breaking the skin through scratching can lead to weeping or fluid discharge, which worsens the infection and spreads the fungi to other parts of the body. This also increases the risk of bacterial infections.
- Fluid-filled blisters that often appear on the soles or between the toes. These blisters, known as vesicles, can burst and leave the skin exposed to bacterial infections. This leads to what many describe as the “rotting effect”.
- Painful open sores or ulcers between the toes or on the soles of the feet. Without proper care, these sores can worsen over time, leading to serious complications, including deeper infections and further skin damage.
Addressing these symptoms early is key to preventing the progression of athlete’s foot and reducing the risk of further complications. Additionally, knowing how to manage and prevent the condition is crucial for keeping it under control.
Athlete’s Foot Management and Prevention
Managing athlete’s foot requires a combination of targeted care and preventive measures. As discussed earlier, tropical environments like Singapore are particularly favourable for fungal growth. Thus, addressing the infection early is crucial to stop its progression and reduce the chances of recurrence.
Management
For mild cases of athlete’s foot, topical antifungal creams or special paints are typically recommended to help eliminate the fungi while soothing the affected skin. To further enhance the results, your podiatrist will offer advice on proper footwear and foot care as well as recommend antifungal sprays or powders inside your shoes to control moisture, as damp environments encourage fungal growth. These helps reduce the risk of recurrence. If the infection persists, prescription strength antifungal medication might be required. These could include stronger topical applications or oral tablets. Maintaining proper foot hygiene throughout the recovery process is also essential.
Photodynamic Antimicrobial Therapy (PACT) is another option used for fungal infections. Since athlete’s foot is also caused by fungi, this advanced method, which utilises a photosensitive dye and light wavelengths to target fungal cells, may present a viable option. While topical applications and oral medications are commonly recommended, PACT offers a more innovative approach for stubborn cases. Although primarily designed for fungal toenails, discussing its potential use for athlete’s foot with your podiatrist can help determine if it is suitable for you.
Prevention
In addition to management, preventing athlete’s foot is crucial to stop it from recurring. Good hygiene habits and preventive measures significantly reduce the risk of future infections. Below are practical steps to lower your risk:
- Keep your feet clean and dry: Washing your feet daily with soap and water and ensuring they are thoroughly dry afterward, particularly between the toes, is vital. Since fungi thrive in warm, moist conditions, maintaining dryness is one of the most effective ways to prevent infection from developing.
- Wear protective footwear in communal areas: When walking around public spaces like pools, gyms, and showers, it is advisable to wear shower shoes or slippers/sandals. These surfaces often harbour fungi, and wearing protective footwear helps prevent direct contact with contaminated floors, reducing the chance of contracting an infection.
- Choose moisture-wicking socks: Socks made from natural fabrics or moisture-wicking materials help keep your feet dry by drawing moisture away from the skin. In humid environments, moisture can quickly accumulate inside shoes, so changing your socks regularly if they become damp can greatly reduce the chance of fungal growth.
- Rotate your shoes regularly: Alternating shoes each day allows them to fully dry before wearing them again. This practice helps prevent moisture buildup that can occur when shoes are worn on consecutive days. Additionally, wearing breathable shoes will further minimise moisture and reduce the risk of infection.
- Avoid sharing personal items: Sharing towels, linens, or shoes with others can increase the risk of spreading fungal infections. Maintaining good personal hygiene and keeping your own items separate from others’ is essential to prevent cross-contamination.
- Wear open footwear in warm weather: Wearing sandals or slippers during hot conditions allows your feet to breathe. This prevents the buildup of heat and moisture inside enclosed shoes, which can create a favourable environment for fungi to grow.
By following these preventive steps and consulting with your podiatrist for tailored advice, athlete’s foot can be better managed, and the risk of future infections can be significantly reduced.
Tackle Athlete’s Foot at East Coast Podiatry
If you are struggling with persistent itching, peeling, or cracked skin caused by athlete’s foot, you know how much it can interfere with your comfort and disrupt your daily life. The constant urge to scratch often results in painful open wounds, worsening the skin’s condition and making it vulnerable to infection. This breakdown in the skin increases the risk of secondary bacterial infections, which is often referred to locally as “foot rot”. Without routine nail and skin care, athlete’s foot can spread beyond the feet to areas like the toenails, leading to further complications.
At East Coast Podiatry, we take a proactive approach to manage athlete’s foot before it worsens. Our podiatrists target the infection at its source and provide personalised advice to help keep your feet dry and healthy. Whether athlete’s foot is disrupting your daily comfort or flaring up after activities that leave your feet moist, we’re here to help ensure it doesn’t interfere with your routine. Schedule a consultation today to protect your foot health and prevent further complications.
Frequently Asked Questions About Athlete’s Foot
Athlete’s foot, the medical term for which is tinea pedis, is a fungal infection that typically affects the skin between the toes, causing itching, burning, and peeling. It can also spread to other areas of the feet, such as the soles and heels, leading to cracked or blistered skin. The term “foot rot” is a local, informal expression often used to describe the same condition. While the names differ, they largely refer to the same fungal infection affecting the feet.
Athlete’s foot often starts with red, scaly skin between the toes, especially the fourth and fifth toes. The affected areas may become dry, flaky, or cracked, making the skin appear rough and irritated. In some cases, small blisters or sores can develop, which may ooze or become more painful if scratched. The infection can also cause the skin to look moist or soft in areas, particularly between the toes, where it may appear white and macerated. As the condition worsens, the skin on the soles and sides of the feet can thicken and become scaly in appearance. A common sign is persistent itching, often accompanied by an unpleasant odour.
Yes, athlete’s foot is contagious. It spreads through direct contact with an infected person’s skin or by touching contaminated surfaces, such as floors in communal areas like pools, gyms, and locker rooms. The fungi that cause athlete’s foot thrive in warm, moist environments, making tight shoes and damp floors ideal breeding grounds. Sharing personal items such as socks, shoes, or towels with someone who has the infection can also transmit it. To reduce the risk of spreading, it’s important to maintain good foot hygiene, avoid walking barefoot in communal spaces, and refrain from sharing personal items.
Yes, athlete’s foot can spread to other parts of the body if it comes into contact with other areas. It can spread to the hands, a condition known as tinea manuum, or to the groin, which is called jock itch (tinea cruris). It may also spread to the neck or other parts of the body as ringworm of the body (tinea corporis), or to the scalp, known as tinea capitis. When the infection reaches the fingernails or toenails, it can cause fungal nail infections, known as onychomycosis. To prevent this spread, it’s essential to maintain proper hygiene.
Yes, you can get athlete’s foot again. Athlete’s foot is highly contagious, and reinfection is possible, especially if you continue to expose your feet to warm, moist environments where the fungus thrives, such as communal showers, locker rooms, or sweaty shoes. Maintaining good foot hygiene, such as keeping your feet dry, changing socks regularly, and avoiding walking barefoot in public areas, is crucial in preventing recurrence. Even if the infection clears up, the fungus can still be present in your shoes or other surfaces, so ongoing care is important to avoid getting athlete’s foot again.
