Athletes Foot

Can a couch potato get athlete's foot? You bet your remote control! This fungus is an equal opportunity affliction. It doesn't care whether you're a jock or a janitor—or even a Jane. (Although men are more likely to catch this pesky infection, women are by no means immune.)

Athlete's foot is caused by an organism that lives on the skin and breeds best under warm, moist conditions. Although balmy climates probably encourage its growth, sweaty footwear is more often the culprit. Once you've got it, you'll need at least four weeks to make headway against a savage case. Worse, it will return unless you stamp out the conditions that caused it in the first place. So here are some tips on dealing with an active infection and some ways to guard against an encore.

Baby your foot. Athlete's foot can come on suddenly and be accompanied by cracked skin, oozing blisters, and an intermittent burning sensation, says Frederick Hass, M.D., a general practitioner in San Rafael, California. "When you're suffering through this acute stage, baby your foot. Keep it uncovered and at constant rest, even if you have to stay home from work or ignore your household duties to do so. Although the inflammation itself is not dangerous, it can worsen and lead to bacterial infection if you're not careful."

Soothe the sores. Use soothing compresses to cool the inflammation, ease the pain, lessen the itching, and dry the sores, says Dr. Hass. Dissolve one packet of Domeboro powder or 2 tablespoons Burow's Solution (both available without a prescription) in 1 pint of cold water. Soak an untreated, white cotton cloth in the liquid and apply three or four times daily for 15 to 20 minutes.

Look for a (salty) solution. Soak your foot in a mixture of 2 teaspoons salt per pint of warm water, says Toronto podiatrist Glenn Copeland, D.P.M. Do this for 5 to 10 minutes at a time, and repeat until the problem clears up. The saline solution helps provide an unappealing atmosphere for the fungus and lessens excess perspiration. What's more, it softens the affected skin, so antifungal medications can penetrate deeper and act more effectively.

Medicate your foot. Now's the time to apply an over-the-counter antifungal medication. According to dermatologist Thomas Goodman, Jr., M.D., an assistant professor at the University of Tennessee Center for Health Sciences in Memphis, the three main types contain either miconazole nitrate (found in Micatin products, for example), tolnaftate (Aftate or Tinactin), or fatty acids (Desenex). Two or three times a day, lightly apply one of them to the whole area involved and rub in gently. Continue for four weeks (or for two weeks after the problem seems gone).

Treat your little piggies. For athlete's foot between your toes, says Dr. Goodman, apply an aluminum-chloride solution. This clear liquid not only kills fungus but also helps to dry the area and discourage regrowth. Ask your pharmacist to make up a solution of 25 percent aluminum chloride in water. Use a cotton swab to apply the liquid between your toes two or three times a day. Continue for two weeks after the infection clears up.

One caution, says Dr. Goodman, don't use aluminum chloride on skin that is cracked or raw—it will sting like crazy. Heal the cracks first with an antifungal agent.

Rub in baking soda. For fungus on your feet, especially between the toes, apply a baking-soda paste, says Suzanne M. Levine, D.P.M., a clinical assistant podiatrist at Mount Sinai Hospital in New York City. Take 1 tablespoon of baking soda and add a little lukewarm water. Rub that on the site of your fungus, then rinse and dry thoroughly. Finish off the treatment by dusting on cornstarch or powder.

Remove dead skin. When the acute phase of the attack has settled down, says Dr. Hass, you need to remove any dead skin. "It houses living fungi that can reinfect you. At bath time, work the entire foot lightly but vigorously with a bristle scrub brush. Pay extra attention to spaces between toes—use a small bottle brush or test-tube brush there." If you scrub your feet in the bathtub, shower afterward to wash away any bits of skin that could attack themselves to other parts of the body and start an infection there.

Pay attention to toenails. Toenails are favorite breeding spots for the fungus, says Dr. Hass. He advises that you scrape the undersides clean at least every second or third day. Be sure to use an orange stick, toothpick, or wooden match rather than a metal nail file, which could scratch the nails and provide niches for the fungus to collect in.

Keep applying cream. Once your infection has cleared up, says Dr. Goodman, you can help guard against its return by continuing to use (less often) the antifungal cream or lotion that cured your problem. This is especially prudent during warm weather. Use your own judgment in working up a schedule—anywhere from once a day to once a week.

Choose proper shoes. Avoid both plastic shoes and footwear that has been treated to keep water out, says Dr. Copeland. They trap perspiration and create a warm, moist spot for the fungus to grow.

Dermatologist Diana Bihova, M.D., a clinical instructor of dermatology at New York University Medical Center in New York City, recommends that you steer clear of any tight, snug, or unventilated footwear and that you never wear boots all day. "Natural materials such as cotton and leather create the best environment for feet, while rubber and even wool may induce sweating and hold moisture. Whenever possible, such as during the summer, wear airy shoes such as sandals," she says.

Change them often. Don't wear the same shoes two days in a row, says Dean S. Stern, D.P.M., a podiatrist at Rush-Presbyterian-St. Luke's Medical Center in Chicago, Illinois. It takes at least 24 hours for shoes to dry out thoroughly. If your feet perspire heavily, change shoes twice a day.

Keep them dry—and clean. Dust the insides of your shoes frequently with antifungal powder or spray. Another good idea, says Bethlehem, Pennsylvania, podiatrist Neal Kramer, D.P.M., is to spray some disinfectant (such as Lysol) on a rag and use it to wipe out the insides of your shoes. That will kill off any fungus spores living there. Do this every time you take off your shoes, he says.

And air them out! Dr. Hass recommends giving your shoes a little time in the sun to air out. "Remove the laces and prop open the throat of each shoe. You should even leave sandals outdoors to dry between wearings. And wipe the undersides of their straps clean after every wearing to remove any fungi-carrying dead skin. The idea is to reduce even the slightest possibility of reinfection."

Sock the infection. If your feet perspire heavily, says Dr. Hass, change your socks three or four times a day. And wear only clean cotton socks, not those made with synthetic yarns. Be sure to rinse them thoroughly during laundering, because detergent residue can aggravate your skin problem. And to help kill fungus spores, says Dr. Kramer, wash your socks twice in extra-hot water.

Powder your toes. To further keep your feet dry, allow them to air-dry for 5 or 10 minutes after a shower before putting on your shoes and socks, says Dr. Bihova. To speed complete drying, hold a hair dryer about 6 inches from your foot, wiggle your toes, and dry between them. Then apply powder. To avoid the mess of loose powder, place it in a plastic or paper bag, then put your foot into the bag and shake it well.

And your footgear. Dr. Levine further recommends applying medicated powder—such as Tinactin, Halotex, or Desenex—to your shoes before you put them on.

Cover up in public places. You can decrease your exposure to the fungus, says Dr. Goodman, by wearing slippers and shower shoes in areas where lots of other people go barefoot. That includes gyms, spas, health clubs, locker rooms, and even around swimming pools. If you're prone to fungal infections, you can pick them up almost any place that is damp—so be prudent.

PANEL OF ADVISERS

Diana Bihova, M.D., is a dermatologist in private practice and clinical instructor of dermatology at New York University Medical Center in New York City. She is coauthor of Beauty from the Inside Out.

Glenn Copeland, D.P.M., is a podiatrist with a private practice at Toronto's Women's College Hospital. He is also consulting podiatrist for the Canadian Back Institute, podiatrist for the Toronto Blue Jays baseball team, and author of The Foot Doctor.

Thomas Goodman, Jr., M.D., is a dermatologist in private practice and assistant professor of dermatology at the University of Tennessee Center for Health Sciences in Memphis. He's the author of Smart Face and The Skin Doctor's Skin Doctoring Book.

Frederick Hass, M.D., is a general practitioner in San Rafael, California. He's on the staff of Marin General Hospital in Greenbrae. He's also the author of The Foot Book and What You Can Do about Your Headaches.

Neal Kramer, D.P.M., is a podiatrist with a practice in Bethlehem, Pennsylvania.

Suzanne M. Levine, D.P.M., is a podiatrist in private practice and clinical assistant podiatrist at Mount Sinai Hospital in New York City. She is author of My Feet Are Killing Me and Walk It Off.

Dean S. Stern, D.P.M., is a podiatrist at Rush-Presbyterian-St. Luke's Medical Center in Chicago, Illinois.