Treatment Overview
How you treat
athlete's foot (tinea pedis) depends on its type and
severity. Most cases of athlete's foot can be treated at home using an
antifungal medicine to slow the growth of
fungi.
- Non-prescription antifungals usually
are used first. These include miconazole (Micatin, Monistat Derm), clotrimazole
(Canesten), naftifine (Naftin), butenafine (Dr. Scholl's Athlete's Foot Cream),
and tolnaftate (Tinactin). Non-prescription antifungals are applied to the skin
(topical medicines).
- Prescription antifungals may be tried if
non-prescription medicines are not successful or if you have a severe
infection. Some of these medicines are
topical antifungals, which are put directly on the
skin. Examples include econazole (Ecostatin Cream), ketoconazole (Nizoral
Cream), and terbinafine (Lamisil). Prescription antifungals can also be taken
as a pill, which are called
oral
antifungals. Examples of oral antifungals include terbinafine
hydrochloride (Lamisil), itraconazole (Sporanox), and fluconazole
(Diflucan).
For severe athlete's foot that doesn't improve, your health
professional may suggest prescription oral antifungal medicine (pills). Oral
antifungal pills are used only for severe cases because they are expensive and
require periodic testing for dangerous
side
effects. Athlete's foot can return even after antifungal pill
treatment.
Although your symptoms may decrease or stop shortly after you begin
using antifungal medicine, it is important to complete the full course of
medicine. This increases the chance that athlete's foot will not return.
Reinfection is common, and athlete's foot needs to be fully treated each time
symptoms develop.
Toe web infections
Toe web
(interdigital) infections occur between the
toes, especially between the fourth and fifth toes. This is the most common
type of athlete's foot infection.
- Treat mild to moderate toe web infections by
keeping your feet clean and dry and using non-prescription antifungal creams or
lotions.
- If a severe infection develops, your health professional
may prescribe a combination of topical antifungal creams plus either oral or
topical
antibiotic medicines.
Moccasin-type athlete's foot infection
Moccasin-type
athlete's foot causes scaly, thickened
skin on the sole and heel of the foot. Often the toenails become infected
(onychomycosis). A moccasin-type infection is difficult
to treat because the skin on the sole of the foot is very thick.
- Non-prescription medicines may not
penetrate the thick skin of the sole well enough to cure moccasin-type
athlete's foot. In this case, a prescription topical antifungal medicine that
penetrates the sole, such as ketoconazole, may be
used.
- Prescription oral antifungal medicines are sometimes
necessary to cure moccasin-type athlete's foot.
Vesicular infections
Vesicular
infections, or blisters,
usually appear on the foot instep but can also develop between the toes, on the
sole of the foot, on the top of the foot, or on the heel. This type of fungal
infection may be accompanied by a bacterial infection. This is the least common
type of infection.
- Your health professional may remove the
tops of the blisters and soak your foot until the blister area is dried
out.
- You can dry out the blisters at home by soaking your foot in
non-prescription
Bur-in-Sol solution several times a day for 3 or more
days until the blister area is dried out. After the area is dried out, use a
topical antifungal cream as directed. You can also apply compresses using
Burow's solution.
- If you also have a bacterial infection, you will
most likely need an oral
antibiotic.
- If you have a severe
infection, your health professional may prescribe
corticosteroid pills. After improvement,
corticosteroid pills are gradually stopped, and antifungal creams and/or pills
are used until the infection is gone.
Even when treated, athlete's foot often returns. This is likely
to happen if:
- You don't take preventive measures and are
again exposed to the fungi that cause athlete's foot.
- You don't use
antifungal medicine for the specified length of time and the fungi are not
completely killed.
- The fungi are not completely killed even after
the full course of medicine.
You can prevent athlete's foot by:
- Keeping your feet clean and dry.
- Dry between your toes after swimming or
bathing.
- Wear leather shoes or sandals that allow your feet to
breathe.
- When indoors, wear socks without shoes.
- Wear
cotton socks to absorb sweat. Change your socks twice a day. (White socks do
not prevent athlete's foot, as some people believe.)
- Use talcum or
antifungal powder on your feet.
- Allow your shoes to air for at
least 24 hours before you wear them again.
- Wearing shower sandals in public pools and
showers.
What To Think About
You may choose not to treat athlete's foot if your symptoms don't
bother you and you have no health problems that increase your chance of severe
foot infection, such as
diabetes. However, untreated athlete's foot that
causes skin blisters or cracks can lead to severe bacterial infection. Also, if
you don't treat athlete's foot, you can spread it to other people.
Severe infections that appear suddenly (acute) usually respond
well to treatment. Long-lasting (chronic) infections can be more difficult to
cure.
Toenail infections (onychomycosis) that can develop with
athlete's foot tend to be more difficult to cure than fungal skin infections.
For more information, see the topic
Fungal Nail Infections.