Athlete’s foot is a fungal infection of one or both feet.

Everyone has bacteria and fungi on their skin. Most of the time they’re harmless and don’t cause problems.

However, at certain times – for example in moist, warm conditions – the fungi can grow and multiply, causing your skin to become infected.

What are fungi?

Fungi are plant-like organisms that don’t have leaves or flowers. They live on other organisms and feed off broken-down tissue, including human tissue. Unlike plants, fungi can’t produce food using energy from sunlight (photosynthesis).

Athlete’s foot is caused by a group of fungi called dermatophytes. Dermatophytes are parasitic, which means they feed off other organisms to survive. Your feet provide a warm, dark and humid environment, ideal conditions for dermatophytes to live and grow.

Dermatophytes can cause fungal infections to develop in areas such as the outer layers of the skin, nails, scalp and hair. 

How athlete’s foot spreads

Athlete’s foot is very contagious and can be spread through direct and indirect contact:

• Direct contact, involving skin-to-skin contact. For example, someone may become infected if they touch the affected area of your skin and don’t wash their hands afterwards.
• Indirect contact, where the fungi are passed on to others through touching contaminated objects, such as towels, bed sheets and clothing.

Public swimming pools, communal showers and changing rooms are common places where athlete’s foot is spread. Like your feet, these places are often warm and humid, which encourages bacteria and fungi to multiply.

There are a number of simple measures you can take to prevent athlete’s foot spreading, including washing your feet regularly, drying them thoroughly and not wearing tight-fitting shoes for long periods.  

As athlete’s foot is usually a mild infection, it rarely causes complications.

However, it’s best to treat the infection as soon as you develop symptoms. This will minimise your risk of developing complications.

Some of the complications related to athlete’s foot are described below.

Fungal nail infection

If an athlete’s foot infection isn’t treated, it may spread to your toenails. A fungal nail infection causes your nail to become thick, discoloured and crumbly. The skin beneath the nail may also be painful and inflamed.

Most fungal nail infections can be easily treated using antifungal medication. This is either taken orally or painted on to your nail using special antifungal nail paint. If it’s not treated, a fungal nail infection can cause significant pain and discomfort, which may make it difficult to wear shoes or walk around.

Bacterial infection

If you have severe athlete’s foot, your skin may also be cracked, exposing the raw tissue underneath.

It’s fairly rare for a fungal infection to affect exposed tissue because fungi usually only grow on the surface of the skin. However, as bacteria can thrive inside the body, they could cause a bacterial infection if they enter your body through cracked skin.

Cellulitis

Bacteria release substances that break down skin and tissue. Once inside your body, bacteria can spread quickly and cause widespread infection. Left untreated, a bacterial infection can be very serious.

Cellulitis is caused by a bacterial infection of the deep layers of skin, fat and soft tissue. If it’s not treated, cellulitis can lead to serious complications, such as blood poisoning (septicaemia), or the infection can spread to the bone.

The symptoms of cellulitis include a sore, red area of skin that’s hot and tender to touch.

Cellulitis is a rare complication of athlete’s foot, but it should be treated quickly if it occurs. Most cases can be effectively treated using antibiotics.

Athlete’s foot is a common fungal infection of the foot.

An itchy red rash develops in the spaces between your toes. The affected skin may also be scaly, flaky and dry.

The medical name for athlete’s foot is tinea pedis.

Read more about the symptoms of athlete’s foot. 

When to see your GP

Athlete’s foot is usually mild and can be easily treated using antifungal medication, available from your pharmacy (see below).

You only need to see your GP if the infection doesn’t clear up, although pharmacists often prefer a diagnosis to be confirmed in children.

What causes athlete’s foot?

Harmless bacteria and fungi live naturally on your skin, but if these organisms multiply, your skin can become infected.

A group of fungi called dermatophytes is responsible for athlete’s foot. Dermatophytes live in and feed off dead skin tissue.

Your feet provide a warm, dark and humid environment – ideal conditions for the fungi to live and multiply.

Athlete’s foot spreads very easily. It can be passed from person to person through contaminated towels, clothing and surfaces.

The fungi can survive and multiply in warm and humid places, such as swimming pools, showers and changing rooms. 

Read more about the causes of athlete’s foot.

Treating athlete’s foot

Most cases of athlete’s foot are mild and can be treated at home using self-care techniques (see below) and antifungal medication.

With effective treatment, athlete’s foot usually only lasts for a few days or weeks. Antifungal medication clears the fungi that cause the infection. It’s available as:

• creams
• sprays
• liquids
• powders
• tablets

Read more about treating athlete’s foot.

Complications of athlete’s foot

If athlete’s foot isn’t treated, the infection may spread to your toenails, causing a fungal nail infection, or to other areas of your body, such as the palms of your hands.

The fungi that cause athlete’s foot usually only grow on the surface of the skin. However, if your skin is cracked, other germs can enter it, leading to a more serious bacterial infection.

Read about the complications of athlete’s foot.

Preventing athlete’s foot

It’s not always possible to prevent athlete’s foot. However, good foot hygiene can reduce your risk of developing the condition.

Follow the advice below to help treat and prevent athlete’s foot.

• Wash your feet regularly using soap and water.
• After washing your feet, dry them thoroughly, paying particular attention to the areas between your toes.
• Wear clean cotton socks.
• Change your socks and shoes regularly to help keep your feet dry, particularly after exercising.
• Don’t share towels and wash your towels regularly.

Read more about preventing athlete’s foot.

The best way to prevent athlete’s foot is to always practise good foot hygiene.

Follow the advice listed below to help keep your feet clean and hygienic.

• Wash your feet thoroughly every day, particularly between your toes.
• Reduce foot perspiration by using talcum powder on your feet.
• Avoid wearing tight-fitting footwear, particularly during the summer.
• Don’t put on socks, tights or stockings before your feet are completely dry.
• Change your socks, stockings or tights regularly.
• Wear pool slippers or flip-flops in communal changing rooms or shower areas.
• Alternate your footwear, particularly running shoes and trainers, so that you wear dry shoes at all times.
• Avoid borrowing shoes to lower the risk of spreading the infection.
• Wash towels and bedding frequently.

Should I keep my child off school?

It’s uncommon for children under 12 years of age to develop athlete’s foot. If your child does develop it, it’s not necessary to keep them off school.

However, it’s important to ensure that they don’t walk barefoot while at school – for example, during physical education (PE). This will help prevent the infection being spread to others.

Tell your child’s teacher that your child has athlete’s foot so that the teacher can make sure they wear appropriate footwear during PE lessons.

Athlete’s foot causes an itchy rash to develop between your toes.

As well as being itchy, the affected skin may also be red, scaly, flaky and dry.

In some cases, the bottom of the feet may be inflamed and have small blisters. The blisters can cause the skin to become cracked, which can be sore and painful.

The infection can spread to the sole and side of your foot, producing redness and scaling in these areas. 

If you have severe athlete’s foot that causes your skin to become cracked, it may lead to the raw tissue underneath being exposed. As well as being very painful, it increases your risk of developing a bacterial infection.

Read more about the complications of athlete’s foot.

Spread of infection

Athlete’s foot often develops between the little toe and the one next to it. If the infection isn’t treated, a rash can form on the bottom and sides of your feet. The infection can also spread to your toenails, causing them to become dry and crumbly.

Scratching the infected skin and then touching other parts of your body can spread the infection. Therefore, it’s important to treat the infection promptly. Always wash your hands thoroughly after touching the rash.

Read more about treating athlete’s foot.

Tinea manuum

The fungal infection that causes athlete’s foot can sometimes be spread to the hands. This is known as tinea manuum and it can occur if you touch the infected skin on your feet and don’t wash your hands afterwards.

However, it’s quite rare for athlete’s foot to be passed to the hands. If it does occur, it usually affects the palm of one hand, which can become dry, red and itchy.

Most cases of athlete’s foot are mild and can be treated at home using self-care methods and antifungal medication.

This type of fungal infection usually responds quickly to treatment.

If you have a more severe infection, your GP may prescribe a stronger antifungal medication, which will usually be in tablet form.

If athlete’s foot isn’t treated, the infection may spread to your toenails, causing a fungal nail infection, or to other areas of your body such as the palms of your hands.

Self care

The following measures can help treat athlete’s foot:

• Wash your feet regularly and thoroughly using soap and water.
• After washing, dry your feet, paying particular attention to the areas between your toes.
• Wear clean cotton socks.
• Change your shoes and socks regularly to help keep your feet dry.
• Don’t share towels and wash your towels regularly.

Antifungal medication

Antifungal medication works by killing the fungi that are causing your infection. This type of medicine is available in several different forms, including:

• creams
• sprays
• liquids 
• powders
• tablets

Topical antifungal medicines, which are applied directly to the affected area, are widely available from pharmacies without a prescription.

The type of antifungal medicine you use is usually down to personal preference. Your pharmacist can recommend the most suitable antifungal for you.

Specific types of antifungal medicine include:

• terbinafine 
• clotrimazole 
• econazole 
• ketoconazole 
• miconazole 
• sulconazole

Oral antifungal medicines include:

• itraconazole 
• griseofulvin 
• terbinafine 

In rare cases, antifungal medicines can cause liver inflammation in people who are susceptible.

Antifungal treatments in tablet form are usually only recommended to treat severe cases of athlete’s foot or when topical antifungals haven’t worked. They’re also usually needed to clear toenail infections.

Risks

Some antifungal tablets aren’t suitable for children or elderly people. Check the patient information leaflet that comes with your medicine to see if it’s suitable for children. Different doses may be needed for children of different ages.

Some antifungal treatments can interfere with pregnancy and the reproductive system in both men and women. Your GP will be able to give you more information and advice about using antifungal medicines.

How to use antifungal medication

Apply antifungal medication directly to the rash and surrounding area (4-6cm) of normal, healthy skin. Make sure that the area is dry before applying the treatment.

Sometimes, skin can be infected with the fungus without showing any symptoms. Therefore, it’s important to treat the surrounding area of skin to help prevent re-infection. Always wash your hands before and after applying the treatment. 

Continue to apply the antifungal treatment for as long as recommended in the instructions that come with the medicine. Some antifungals need to be used for longer than others.

Your rash may clear up quickly, but it doesn’t necessarily mean that the infection has gone. Therefore, you may need to continue using the medication for one to two weeks after your symptoms have disappeared to ensure the infection has been successfully treated.

Hydrocortisone treatment

If athlete’s foot is making your skin particularly sore and inflamed, you can use an antifungal treatment containing an ingredient called hydrocortisone.

Treatments with low doses of hydrocortisone are available over the counter from pharmacies. However, if you have a severe infection, your GP may prescribe a stronger hydrocortisone treatment. 

Hydrocortisone reduces inflammation and eases irritation and itching. Again, it’s important that you follow the instructions that come with the treatment.

Hydrocortisone can’t be used for longer than seven days. You may need to use an alternative antifungal treatment (that doesn’t contain hydrocortisone) until your infection has been effectively treated.