Athlete's Foot

What Happens

How athlete's foot (tinea pedis) develops and how well it responds to treatment depends on the type of athlete's foot you have.

Toe web infection (interdigital)

Toe web infections (interdigital) often begin with skin that seems moist and pale white. You may notice itching, burning, and a slight odor. As the infection gets worse, the skin between the toes becomes scaly, peels, and cracks. If the fungal infection becomes severe, a bacterial infection also may develop. This can cause further skin breakdown. The bacterial infection may also infect the lower leg (cellulitis of the lower leg). Toe web infections often result in a sudden vesicular (blister) infection.

Toe web infections respond well to treatment.

Moccasin-type infection

Moccasin-type infections may begin with minor irritation, dryness, itching, burning, or scaly skin and progress to thickened, cracked skin on the sole or heel. In severe cases, the toenails become infected and can thicken, crumble, and even fall out. If you do not take preventive measures, this infection often returns. You may also develop an infection on the palm of the hand (symptoms commonly affect one hand and both feet).

Moccasin-type infections may be long-lasting (chronic) and are very difficult to treat.

Vesicular infection

Vesicular infections (blisters) usually begin with a sudden outbreak of blisters that become red and inflamed. Blisters occasionally erupt again after the initial infection. A bacterial infection may also be present. A vesicular infection often develops from a long-lasting toe web infection. Blisters may also appear on palms, the side of the fingers, and other areas (dermatophytid or id reaction).

Vesicular infections usually respond well to treatment.

Complications

If untreated, skin blisters and cracks caused by athlete's foot can lead to severe bacterial infections. In some types of athlete's foot, the toenails may be infected. For more information, see the topic Fungal Nail Infections.

All types of athlete's foot can be treated, but symptoms often return after treatment. Athlete's foot is most likely to return if:

• You don't take preventive measures and are again exposed to fungi that cause athlete's foot.
• You don't use antifungal medicine for the prescribed length of time and the fungi are not completely killed.
• The fungi are not completely killed even after the full course of medicine.

Severe infections that appear suddenly, and keep returning, can lead to long-lasting infection.

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Author:	Maria G. Essig, MS, ELS	Last Updated: July 2, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Anne C. Poinier, MD - Internal Medicine
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