Treat early to stop the spread and prevent serious complications
The itching and burning caused by athlete’s foot is a common nuisance often encountered in gym locker rooms. However, this condition can develop even if you never visit a gym. Fungal infections of the feet include two distinct but often co-existing conditions: one that affects the skin of the feet (classic athlete’s foot) and another that affects the toenails, known as nail fungus (onychomycosis).
Both of these infections are very common because they are caused by fungi that spread easily. Dermatologist Dr. Pamela Ng explains what is important to know about these widespread fungal infections and how to effectively control and stop them.
Athlete’s foot is a highly contagious fungal infection that belongs to a broader group of fungal diseases affecting the skin and nails. Fungi thrive particularly well in warm, moist environments such as gym locker rooms, shared showers, swimming pools, and bathrooms. Infection most often occurs through direct contact with contaminated surfaces or by wearing tight, sweat-trapping footwear for prolonged periods.
Symptoms of athlete’s foot typically include an itchy, scaly rash on the feet and between the toes. Nail fungus, on the other hand, alters the appearance of the nails: they may become yellowish-brown, thickened, brittle, cracked, or even separate from the nail bed.
It is important to understand that this is not merely a cosmetic issue. “If you have diabetes or a weakened immune system, controlling foot and nail fungal infections is essential,” emphasizes Dr. Ng. According to her, untreated fungal infections can lead to skin cracking, allowing bacteria to enter the body and cause serious complications such as cellulitis or foot ulcers.
Foot or nail fungus does not go away on its own. “If you suspect you have a fungal infection of the feet or toenails, it is important to see a dermatologist,” says Dr. Ng. A specialist can perform several tests to determine exactly what is causing the problem.
“It’s important to know that not all nail changes are fungal in origin,” she notes. In some cases, similar symptoms may be caused by other conditions, such as squamous cell carcinoma of the nail bed or even melanoma, which can appear as brown or black discoloration under the nail. Therefore, an accurate diagnosis is crucial before starting treatment.
The most effective treatment for nail fungus is usually prescription oral antifungal medication, which a dermatologist may prescribe for daily use over two to three months. However, this treatment is not suitable for everyone, as oral antifungals can interact with other medications and may affect liver function.
If oral medications are not suitable or are not preferred, other treatment options are available. Topical antifungal medications are attractive due to their lower risk of side effects and drug interactions, but they generally require a longer treatment period and may be less effective.
“Newer topical antifungal medications, such as efinaconazole and tavaborole, penetrate the nail plate more effectively and therefore work better than older topical treatments,” explains Dr. Ng. These medications are most effective when the fungal infection has not yet deeply penetrated the nail.
The U.S. Food and Drug Administration (FDA) has also approved laser therapy as a temporary option to improve the appearance of affected nails. However, cure rates with laser treatment are lower than those achieved with oral or topical medications.
Photodynamic therapy, which involves applying a photosensitizing agent followed by exposure to a light source, is considered only moderately effective for treating nail fungus. In addition, this procedure is often not covered by insurance, and further research is needed to determine its long-term effectiveness.
“Unfortunately, even after successful treatment, fungal nail infections tend to recur, especially in individuals who are prone to these infections,” notes Dr. Ng. Regular use of topical antifungal creams after treatment, as well as spraying shoes with antifungal sprays or powders, can help reduce the risk of recurrence.
If the fungal infection affects only the skin of the feet and not the nails, Dr. Ng recommends starting treatment with an over-the-counter antifungal cream. “I prefer creams over sprays or powders because creams provide more complete coverage of the foot and treat the entire skin surface,” she explains.
It is especially important to apply the cream thoroughly between the toes, as fungi spread most easily in these warm, moist areas.
The best way to fight fungal infections is to reduce the risk of their development and spread. The following simple but effective measures can help:
Wash and thoroughly dry your feet after physical activity, paying special attention to the spaces between the toes.
Wear waterproof sandals or flip-flops in shared areas such as gym showers and swimming pool facilities.
At the first signs of athlete’s foot, begin treatment immediately with over-the-counter antifungal creams.
Choose breathable footwear that does not trap moisture and change socks frequently.
Consider using moisture-wicking socks.
If someone in your household has a foot fungal infection, make sure your feet are protected from direct contact.
The greatest risk of leaving foot or nail fungus untreated is that the infection may spread to other parts of the body, such as the hands or the groin. If, for any reason, you are unable to begin full treatment immediately, at least apply a topical antifungal cream to the surrounding skin. This can help prevent the spread of infection and protect healthy skin.
