Athlete's Foot (cont.)

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Is athlete's foot contagious?

If athlete's foot is caused by a fungus, it is potentially contagious. Some people do not develop infection of the skin after exposure to the fungus. The exact cause of resistance or susceptibility to fungal infections is frequently unknown.

What else causes foot rashes?

There are many possible causes of foot rashes. Additional causes include irritant or contact dermatitis, allergic rashes from shoes or other creams, dyshidrotic eczema (skin allergy rash), psoriasis, yeast infections, and bacterial infections. Since they can be visually indistinguishable, it is important for your doctor to do his best to identify the precise cause. Since fungal infections are potentially curable, it is important not to miss this diagnosis.

Your physician can perform a simple test called a potassium hydroxide (KOH) preparation for microscopic fungal examination in the office or laboratory. This test can be used to confirm the presence of a fungal infection. This test is performed by using a microscope to examine small flakes of skin from the rash. Many dermatologists perform this test in their office with results available within minutes. Rarely, a small piece of skin may be removed and sent for biopsy to help confirm the diagnosis.

What is the treatment for fungal athlete's foot?

The treatment of athlete's foot can be divided into two parts. The first, and most important part, is to make the infected area less suitable for the athlete's foot fungus to grow. This means keeping the area clean and dry.

Occlusive shoe materials, such as vinyl, cause the feet to remain moist, providing an excellent area for the fungus to breed. Likewise, absorbent socks like cotton that wick water away from your feet may help.

Powders, especially medicated powders (such as with miconazole [Lotrimin] or tolnaftate [Tinactin]), can help keep your feet dry. Finally, your feet can be soaked in a drying solution of aluminum acetate (Burow's solution or Domeboro solution). A homemade remedy of dilute white vinegar soaks, using one part vinegar and roughly four parts water, once or twice a day as 10-minute foot soaks may aid in treatment.

The second part of treatment is the use of antifungal creams and washes. Many medications are available, including miconazole, econazole nitrate (Spectazole), clotrimazole (Lotrimin), terbinafine (Lamisil) sprays and creams, and ketoconazole shampoo and cream (Nizoral), etc. Ask your health-care professional or pharmacist for a recommendation. Treatment for athlete's foot should generally be continued for four weeks or at least one week after all of the skin symptoms have cleared.

More advanced or resistant cases of athlete's foot may require a course of an oral (pill) antifungal like terbinafine (Lamisil), itraconazole (Sporanox), or fluconazole (Diflucan). Laboratory blood tests to make sure there is no liver disease may be required before taking these pills.

Topical corticosteroid creams can act as a fertilizer for fungus and may actually worsen fungal skin infections. These topical steroid medications have no role in treating fungal foot infections.

If the fungal infection has spread to the toenails, the nails must also be treated to avoid reinfection of the feet. Often, the nails are initially ignored only to find the athlete's foot keeps recurring. It is important to treat all the visible fungus at the same time. Effective nail fungus treatment may be more intensive and require prolonged courses (three to four months) of oral antifungal medications.

Medically Reviewed by a Doctor on 12/19/2013

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