• Dr. Jennifer Nicole Falk

Not All Athlete’s Foot Is Created Equal



It has been shown that athlete’s foot (aka tinea pedis) can affect up to 70% of people at some point in their life, making it one of the most common skin conditions (1,3). But not all cases of athlete’s foot are the same. There are multiple species of fungi that result in different presentations of athlete’s foot. Continue reading below to learn why athlete’s foot occurs, how the different types present, and how it is treated.

CAUSES OF ATHLETE’S FOOT

There are several risk factors for developing athlete’s foot, including creating areas of increased moisture on your body (e.g. sweating in occlusive socks and shoes), using public areas and pools, and sharing personal items with others that have athlete’s foot. Those with a compromised immune system (e.g. those with the flu, the elderly, etc) are also at higher risk for contracting athlete’s foot.

TYPES OF ATHLETE’S FOOT


Interdigital Form​​

This is the most common form of athlete’s foot, with the fungus Trichophyton rubrum (T. rubrum) being responsible for a majority of the cases. It occurs within the toe web spaces (and sometimes underneath them), most often between the smaller, more lateral toes, as these are the ones that tend to overlap or are squeezed together in shoes. Interdigital tinea pedis can present as either dry scaling skin or as wet and macerated skin, which can lead to fissuring and, potentially, a bacterial infection. Itchiness and burning can also occur with this type of athlete’s foot, along with malodor (1,3).


Moccasin Distribution​​​​

Moccasin tinea pedis is a more chronic form of athlete’s foot, most often caused by the same fungus as the interdigital form, T. rubrum. It usually presents as scaly skin with an underlying redness along the bottom and, potentially, outside regions of the affected foot/feet (1). Patients often present to the doctor because of the scaling nature of their skin and/or the itchiness.


Acute Vesiculobullous ​

This type of athlete’s foot is commonly caused by the fungus Trichophyton mentagrophytes and involves vesicles or blisters (small, fluid-filled sacs) along the inside arch region or plantar side of the foot (1,2,3). If the fluid inside the vesicles is not clear, there could be an additional bacterial infection involved (1,3). Itching, burning, and pain can occur with this type of athlete’s foot (3).

DIAGNOSING ATHLETE’S FOOT

Although their clinical presentation may give good insight into diagnosing athlete’s foot, as you can tell from above, there are many different presentations of athlete's foot, some of which may also have a bacterial infection associated with it. If not treated appropriately, the fungal infection can actually worsen. Therefore, the best way to determine whether or not there is a fungus present, and which type, would be to do additional testing. Skin scrapings can be taken and looked at under a microscope for evaluation of specific fungal characteristics. If fluid is present, it can be cultured sent for bacterial testing.

ATHLETE’S FOOT TREATMENT

Most cases of athlete foot can be treated with topical antifungal medications. In severe, or difficult cases, oral medication can be prescribed. It is also good to treat the nail fungus, if it is present, as well as to use anti-fungal powder in your shoes.

ATHLETE’S FOOT PREVENTION

  • Keep your feet dry, especially between the toes

  • Avoid barefoot walking in public places

  • Avoid sharing personal items with others that have athlete’s foot or nail fungus

DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. Please consult the doctor, or your own healthcare professional, should you have questions or concerns related to your health.

References:

1. Al Hasan, M., Fitzgerald, S. M., Saoudian, M., & Krishnaswamy, G. (2004). Dermatology for the practicing allergist: Tinea pedis and its complications. Clinical and Molecular Allergy, 2(1), 5.

2. Brannon, H. Athlete's Foot Types and Treatments. VeryWellHealth. Retrieved from https://www.verywellhealth.com/athletes-foot-1068771.

3.Ilkit, M., & Durdu, M. (2015). Tinea pedis: the etiology and global epidemiology of a common fungal infection. Critical reviews in microbiology, 41(3), 374-388.

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