Athlete's foot treatment: how does it work?

By Kathryn Senior on 18 July 2022

Athlete’s foot, which can also be called tinea pedis, is a fungal infection of the feet caused by Trichophyton and other fungi. It causes scaly, flaky patches on the skin that are often red, sore and unbearably itchy, giving people the incentive to find a quick and effective athlete’s foot treatment. The condition gets its name from the way the fungi transfer from person to person in changing room environments, where sportsmen and women walk around barefoot in warm, damp conditions. This is then exacerbated by the fact that active people tend to wear tight-fitting trainers of synthetic material, which keep their feet warm and moist, providing ideal conditions for the fungal spores and hyphae to thrive. Not surprisingly, teenagers and young adults are the most likely to suffer from athlete’s foot and are the biggest users of athlete’s foot treatments. This article on athlete's foot treatment is written by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

Practical treatment

The first stage of athlete’s foot treatment is to change the conditions in and around your feet, to make the environment less friendly to the fungi that cause the infection. There are several steps you can take to achieve this, including:

    Regular washing and thorough drying of the feet
    Choosing cotton socks and leather shoes
    Wearing sandals in summer or going barefoot outdoors
    Wearing flip flops in changing areas and showers
    Not sharing towels

Since the fungi prefer warm, damp conditions, these strategies work well as an athlete’s foot treatment as they make it more difficult for the fungi to survive.


Medical treatment

These simple can work well but often don’t clear the problem up completely. The next stage of athlete’s foot treatment is to kill the remaining fungi that have probably penetrated the skin, so are more difficult to get rid of. You should not need to visit your doctor for this, as there are many effective athlete’s foot treatments available over the counter at your local pharmacist.

These come in three forms – spray, cream and powder – each containing anti-fungal medicines. The most common are Miconazola (found in Daktarin) Tolnaftate (found in Mycil) and Terbinafine (found in Lamisil).


How the treatment works

Athlete’s foot treatments work by killing the fungal cells. For example, Tolnaftate (found in Mycil) creates holes in the cell membrane, allowing foreign material in and vital cell contents out. This quickly kills the fungal cell. Other anti-fungals work in slightly different ways, but all achieve the same end result.

Creams and sprays are convenient and easy to use, and are applied directly to the skin on and around the infected area. It is important to apply athlete’s foot treatment to skin up to 4cm beyond the main area of infection, as adjoining tissue may be infected might not show obvious symptoms. Athlete’s foot treatments should also be applied for up to two weeks after the symptoms have gone to ensure that the infection has completely cleared. Treatment may take up to two months.

Athlete’s foot treatment powder can be used to treat socks and shoes to kill any lingering fungus. Powder can also be used to treat the feet, and although this is messier than creams or sprays, it does have the advantage of drying the feet at the same time as killing the fungus.

Some athlete’s foot treatments also contain hydrocortisone. This is used to reduce swelling around the infected area, and also soothes the irritating itching. As hydrocortisone is a steroid, it can have adverse effects on the skin if used for a long time; ideally it should only be used for a maximum of seven days. After that, you should revert to a plain athlete’s foot treatment. Pregnant women and women who are breastfeeding should avoid athlete’s foot treatments containing hydrocortisone.


Does alternative treatment work?

There are many ‘home-made’ athlete’s foot treatments that people have come up with over the years. Many do result in the death of fungal hyphae and prevent further growth so they can be as effective as standard medications. These alternative athlete’s foot treatments include:

    Soaking feet in a weak bleach solution
    Soaking feet in a dilute mouthwash solution
    Soaking the feet in tea tree oil solution
    Direct application of neat tea tree oil.

It has also been suggested that urinating on the feet while showering is an effective athlete’s foot treatment, as urine contains urea, which has strong anti-fungal qualities. Teenage boys may be prepared to do this, but most people favour other athlete’s foot treatments.


What happens if athlete’s foot treatment fails?

In rare cases, over the counter medications are not sufficient as an athlete’s foot treatment. If you find that you don’t see any improvement after two weeks, do consult your GP. He or she will be able to prescribe a stronger, athlete’s foot treatment, often taken in tablet form. Commonly prescribed anti-fungal tablets include Itraconazole, Griseofilvin and Terbinafine. These stronger athlete’s foot treatments should only be used as a last resort, after all other avenues have been exhausted, as they can have side effects.

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