Sunday, March 19, 2006

Athlete's Feet :Tinea Pedis

The activities associated with sport causes skin temperatures to raise and evaporation of sweat is a natural way for the body to keep its internal temperature at a constant. When the sweat cannot evaporate into the air increased water content on the skin devitalises the cells and leaves them prone to infections. Sports' people have in the past worn footgear which prevented evaporation of sweat. The increased hydration turned normal skin into moist, white and rubbery tissue particularly between the toes. The medium is perfect for fungal growth and hence fungal infection of the foot is often referred to as athlete’s foot.

Fungi are not always present however and most sweaty skins respond to sensible and regular foot hygiene. The fungus grows in warm, dark, sweaty areas of the skin such as the space between the toes. They are tough micro-organisms and survive in showers, swimming pools and spa areas. Infection passes from infected scales of skin dropped on the floors of changing areas. Very moist and dry skins are equally prone to fungal infections. Tinea pedis appears in three different forms.

Toe nail infections present as yellowish brown discoloured thickened nails which are often crumbling and separated from the nail bed. This may be accompanied by an unpleasant smell.

Infections in-between the toes usually appear as soft whitish skin with cracks. Puritis and foul smell is commonly reported.

Sole of the foot infections can present as small fluid filled blisters usually around the arch of the foot. Itching, burning and stinging pain can often add to the general discomfort of fungal infections. Things to avoid are walking barefoot in public areas such as showers; poor foot hygiene; not drying carefully between the toes; wearing socks made from synthetic fibres or plastic footwear or rubber shoes which restrict evaporation of natural sweat.

Young and old people suffer from fungal infections and those with low immune responses may be more prone, people suffering from diabetes mellitus often have higher risk as well as people taking antibiotics for prolonged periods. The good news is most fungal and yeast infections respond to treatment. Although this may take some time. Over the counter preparations will kill or inhibit both fungi and bacteria and the pharmacist should be able to help with general inquiries. In the case of reluctant strains consult your general practitioner or podiatrist. If in any doubt what to use or the condition does not show improvement after treatment. Individual strains of fungi can be identified under a microscope, the practitioner requires removing some cells from the skin surface. This is a painless process. Most skin infections clear quickly and provided general foot hygiene is maintained, the risk of reinfection is reduced. Treatment for infected nails was less successful and could take years to clear. New advances in treating nail infections have significantly improved outcomes

Fortunately cross infection rates in nails are low and the condition is quite painless. Treatment is usually with topical applications although for resistant conditions a prescribed medication may be required. Most over the counter antifungals are available as paints; powders and creams. The rule of thumb is, paints, like nail varnish, are used on nails, powders are particularly good for applying in-between the toes; and creams are useful for skin infections. Ask the pharmacist if in doubt. Outward signs of fungal infections usually respond very quickly to treatment but the fungus may still be on the skin surface. So it is important to keep treating the area regularly for at least one month after the initial symptoms disappear.

Good care should include washing the feet every day in warm water (hand hot, 43oC). Gently dry the skin with a soft towel, take time to dry carefully in-between the toes without forcing them apart and tearing the delicate skin. When the feet are completely dry apply an appropriate antifungal preparation twice a day. Until the infection has cleared you should avoid going barefoot in areas where others could be exposed to the fungi. Sharing footwear including socks should be avoided and communal shower mats should be regularly cleaned with domestic disinfectant. A good tip is to wear socks made from wool/nylon mix and change them daily. As a precautionary action lightly powder inside the socks with a wide spectrum antifungal powder and a pharmacist will be able to advise you here.

Reviewed 31/12/2016

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