Condition

Athlete's Foot

Athlete's foot is a fungal infection of the outer layer of skin on the feet. It causes itching, peeling and cracking, most often between the toes. It clears with antifungal creams from a pharmacy, and it comes back easily if the shoes, socks and toenails are not dealt with as well.
Dr. Schwarz, MD · Board-certified dermatologistLast reviewed September 8, 2026
16:9 hero for Athlete's Foot. Never cropped: the tone strip and the corner logo depend on the full frame.

Start here

You do not have to be an athlete or unclean - fungus needs warmth, moisture and keratin, and a closed shoe worn all day gives it all three. Keep treating for one to two weeks after the skin looks clear, because the itch goes long before the fungus does, and stopping early is why people tell me the cream did not work. Then I check the toenails, because thick, crumbly, yellow nails are the same infection where cream cannot reach and they reseed the skin for years. If four weeks of a proper antifungal has changed nothing, get it looked at rather than buying something stronger, and do not put a steroid on an undiagnosed foot rash - if it is fungus, a steroid lets it spread.

— Dr. Schwarz, Board Certified Dermatologist

Key Facts

−
How commonThe most common fungal skin infection there is. A large share of adults get it at some point, and it is especially common in people who wear closed shoes all day
Who gets itAdults far more than children, and men more than women. Common in athletes, in people who sweat heavily, in people who use communal showers, and in people with diabetes or poor circulation
Curable or managedCurable. Reinfection is common, so prevention continues after the cure
Prescription neededUsually not. Over-the-counter antifungal creams clear most cases. Infected toenails and the widespread dry-scaling pattern often need prescription tablets
Time to improveItching usually settles within a few days. The skin takes two to four weeks

What It Is

−

Athlete's foot is an infection of the outer skin of the feet by dermatophytes, fungi that feed on keratin - the tough protein in skin, hair and nails. They stay in the dead surface layer and never get into the body, which is why this is stubborn and uncomfortable rather than dangerous.

Three patterns, and you can have more than one at once.

Between the toes is the most common. The web spaces, usually the outer ones, turn white, soggy and peeling, often with a split at the base of the toes. It itches, stings when it cracks, and can smell.

The moccasin pattern covers the sole, heel and sides of the foot in fine dry scale, roughly the shape of a slipper. Often barely itchy, so it gets treated as dry skin for years.

The blistering pattern is less common - small deep blisters on the arch or instep, intensely itchy for a week or two, then drying into a peeling patch.

Two things travel with it. The toenails are often infected too - thick, crumbly, discolored - and they reinfect the skin every time you put a sock on. Some people also get an itchy blistering rash on the palms or sides of the fingers while the feet are flaring; that rash has no fungus in it, it is an allergic reaction to the fungus on the feet, and it settles once the feet are treated. There is also a recognized pattern of two infected feet and one infected hand, usually the hand that picks at the toes.

Symptoms

−
Soggy, peeling skin

Between the Toes

White, soft, peeling skin in the tight web spaces, usually between the fourth and fifth toes. It often itches or stings and can smell. This is the most common pattern and the one most likely to be passed on in shared showers.
Dry, scaly soles

Moccasin

Fine scale spreading across the sole and up the sides of the foot, in the shape a moccasin would cover. It is often mistaken for plain dry skin because it is not very itchy. It tends to be long-standing and needs longer treatment than the toe-web kind.
Sudden itchy blisters

Blistering

A crop of small, intensely itchy blisters, usually on the arch or instep. It can flare quickly in hot weather or heavy shoes. The blisters can get infected with bacteria if they are opened.

How It Looks by Skin Tone

−
The sole and inner border of one foot on light skin, covered in fine white scale over a faint pink base. The scale stops at a clean line along the side of the foot. The toenails are thickened and dull.The sole and inner border of one foot on medium tan skin, covered in fine gray-white scale over a muted pink base. The scale stops at a clean line along the side of the foot. The toenails are thickened and dull.The sole and inner border of one foot on brown skin, covered in fine gray scale that stops at a clean line along the side of the foot. There is no visible redness anywhere, and the toenails are thickened and dull.The sole and inner border of one foot on deep brown skin, covered in fine gray scale that stops at a clean line along the side of the foot. There is no visible redness anywhere, and the toenails are thickened and dull.
LightMediumBrownDeep

On deeper skin tones the pink or red base is often invisible, so the diagnosis rests on the fine scale, the white soggy skin in the web spaces, the cracks, and the raised scaling edge creeping onto the top of the foot. Redness is not reliable here, and infections get judged milder than they are because it looks absent.

The moccasin pattern is missed most often. Fine dry scale across the sole and sides of the foot reads as ordinary dry, ashy skin and gets moisturized for years. The clue is the edge. Dry skin fades out gradually; this stops at a line along the side of the foot, and the same scale is usually on the toenails. After the fungus clears, the skin often stays darker where it was inflamed. That is post-inflammatory hyperpigmentation - a flat dark mark left by inflammation, not remaining infection. It takes months to fade, and it is why people keep using antifungal cream long after the fungus has gone. Still scaling, itching or peeling means active infection. Flat, smooth and simply darker is a mark, and time plus daily sunscreen fixes that.

Where It Shows Up

−
Front view of a whole body with red marks on both feet and both ankles. The rest of the body is clear.
Feet, and one hand more often than two
It starts between the toes, most often in the tight web beside the little toe, and spreads to the sole, the heel and the sides of the foot. It can move to the toenails. If a hand is involved it is usually only one, from scratching the feet.

What Happens in the Skin

−

This is what is going wrong under the skin, in the order it happens. Click a step to see it.

How Athlete's Foot happens
Skin basics
BARRIEREPIDERMISDERMIS0NORMAL SKIN BETWEEN THE TOES1WARM, DAMP SKIN2THE FUNGUS GROWS IN THE OUTER LAYER3THE SKIN CRACKS AND ITCHES

Dry, intact skin between the toes. The outer layer is a poor place for anything to grow.

Shoes, socks and sweat keep the skin between the toes wet for hours. Softened skin is what the fungus needs.

Dermatophytes feed on keratin, so they live in the dead outer layer and go no deeper. That is why an antifungal cream reaches them.

The barrier breaks down into peeling, cracking and itching, and those cracks let bacteria in. Untreated it spreads to the soles and the nails, and the nails are what reinfect the skin later.

The outer film of dead cells and oil. It holds water in and keeps irritants out, and it is thinner than a sheet of paper. Almost every dry, itchy, stinging skin problem starts here.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

The fungi are dermatophytes, most often Trichophyton rubrum. They are not normal residents of skin the way some yeasts are, so they have to arrive from somewhere.

They arrive as flakes of skin and spores shed by someone who already has it. Those flakes survive a long time on wet floors - communal showers, changing rooms, pool surrounds, gyms, hotel bathrooms, any barefoot floor. They also travel on shared towels, shoes, nail clippers, bath mats and bedding, which is how it moves around a household.

Then they need keratin to feed on, warmth and moisture, and a closed shoe worn all day supplies all three. Sweat softens the skin surface, especially between the toes, and softened skin is far easier to get into. Splits, rubbing from footwear and skin damaged by damp all help it take hold.

The immune response decides who gets it repeatedly. Some people clear it easily. Others, apparently for inherited reasons, respond weakly to Trichophyton rubrum specifically and carry the dry, scaling version for decades.

Infected toenails change the picture. Fungus inside a nail is out of reach of creams, so the nail is a permanent reservoir that reseeds the skin. That is the main reason it returns in people treating it properly.

Risk Factors

−

These come down to how warm and damp your feet are, and how often they meet the fungus. None are about being unclean.

Shoes & floors
Wearing closed shoes all day
The biggest single factor. Boots, safety footwear, trainers and dress shoes all trap heat and moisture.
Shoes & floors
Walking barefoot on communal wet floors
Changing rooms, showers, pool surrounds, gyms, studios and shared bathrooms.
Shoes & floors
Living with someone who has it
Shared floors, bath mats and towels move it around.
Your skin
Sweaty feet
Heavy sweating makes the first infection and every recurrence more likely.
Your skin
Damaged skin between the toes
Splits, rubbing from tight shoes and damp-softened skin give it a way in.
Your skin
A previous episode
Some people are simply prone to it, and repeated episodes over years are normal rather than a sign of doing something wrong.
Age & sex
Age
Uncommon before puberty, then increasingly common through adult life.
Age & sex
Being male
Consistently more common in men - partly footwear and sport, probably partly hormonal.
Other health conditions
Fungal toenails
Both a consequence and a cause. Infected nails keep reinfecting the skin.
Other health conditions
Diabetes
More common, more persistent and more likely to cause complications, so treat it promptly.
Other health conditions
Poor circulation or swollen legs
Harder to clear, and the cracks are a well-recognized entry point for bacterial infection of the leg.
Other health conditions
A suppressed immune system
More extensive, more stubborn, more likely to spread to the nails and elsewhere.

Course

−

Athlete's foot does not clear on its own. Left alone it becomes a low-grade infection that flares in hot weather, and it spreads across the sole, onto the top of the foot, into the toenails, and sometimes to the groin or hands. Treated, it behaves well.

First few daysItching eases
The symptom goes before the skin does

The itch eases within a few days of starting an antifungal cream, well before the skin clears.

Two to four weeksSkin clears
The newest scale is the last to go

The skin takes two to four weeks with the common creams, newest scale last. The dry moccasin pattern is slower and often needs tablets, because cream struggles through thickened skin on the sole.

SoleTop of the foot
Most of a yearIf the toenails are involved
Nails run on a different clock

Nail infection is treated in months, not weeks. Successful treatment only shows as healthy nail growing from the base, so a big toenail takes most of a year to look normal.

Toenails
AfterwardsRecurrence
Common, and not a sign anything went wrong

Usually stopping as soon as the skin looked normal, an untreated toenail reinfecting the skin, or the same shoes and floors.

Any timeThe complication to know about
Cracks between the toes let bacteria in

Cracks between the toes are a recognized entry point for bacteria into the leg. With diabetes, poor circulation or swollen legs that can become cellulitis - hot, spreading, painful redness that needs antibiotics. That risk is why athlete's foot is treated promptly in those groups.

Between the toesLower leg

What Makes It Better & Worse

−

Athlete's foot is four problems — trapped moisture, a damaged barrier, the fungus growing, and reinfection from shoes, floors and nails. The fix depends on which step is failing.

What is driving yours?

FATBARRIEREPIDERMISDERMIS

Shoes, socks and sweat keep the skin between the toes wet for hours. Softened skin is what the fungus needs.

Dermatophytes feed on keratin, so they live in the dead outer layer and go no deeper. That is why an antifungal cream reaches them.

Dermatophytes feed on keratin, so they live in the dead outer layer and go no deeper. That is why an antifungal cream reaches them.

What helps

  • Dry between the toes deliberately A separate corner of the towel, or a cool hairdryer.
  • Change socks when they are damp The number of changes beats the fabric.
  • Alternate two pairs of shoes Drying time makes the inside less hospitable.
  • Antifungal powder in the shoes Prevention - it stops shoes reinfecting you.
  • Treat heavy foot sweating An antiperspirant made for feet treats the cause.

What makes it worse

  • Wearing the same shoes every day Shoes need about 24 hours to dry inside.
  • Closed, non-breathable footwear Boots and heavy trainers hold sweat against the skin.
  • Not drying between the toes Wet web spaces are what the fungus wants.
  • Leaving damp socks on Keeps the skin softened for hours.
  • Hot, humid weather Recurrences cluster in summer.

What helps

  • Soften thick sole skin first Urea or salicylic acid helps the antifungal through.

What makes it worse

  • Picking and peeling loose skin Tears the barrier open and spreads it.
  • Strong home soaks Bleach and vinegar damage skin more reliably than fungus.

What helps

  • Terbinafine cream The most effective over-the-counter option, shortest course.
  • Azole creams Clotrimazole, miconazole or ketoconazole for a few weeks.
  • Keep treating past the clear point Another one to two weeks prevents most recurrences.
  • Cover the whole foot The fungus extends past the itchy spot.
  • Antifungal tablets For widespread, nail or stubborn infections. If you are pregnant or breastfeeding, ask the doctor managing your pregnancy first.
  • Avoid steroid-antifungal creams A common route to a longer, harder infection.

What makes it worse

  • Using a steroid cream on it It spreads quietly while looking less angry.
  • Stopping the cream when itching stops The itch goes long before the fungus.

What helps

  • Wear sandals on communal floors Where most reinfection starts.
  • Deal with the toenails Treating skin and leaving nails is why some never clear.
  • Wash socks, towels and mats hot Cuts the fungus circulating at home.

What makes it worse

  • Walking barefoot on wet floors Where most people meet it.
  • Sharing towels, shoes and clippers How it spreads and reinfects a treated foot.
  • Treating the skin, not the nails Nails reseed the skin with every sock.
  • Putting underwear on before socks A known way of moving fungus to the groin.
  • Untreated feet in the household The shared bathroom floor keeps it going.

How These Treatments Work

−

Treatments for Athlete's Foot do not all work in the same place. Tap one to see where it acts.

Pick a treatment
Skin basics
BARRIEREPIDERMISDERMISKILLS THE FUNGUSKILLS THE FUNGUSTAKES AWAY ITS CONDITIONSSTOPS REINFECTION

Keep going a week past the point where it looks clear, or it comes back.

For widespread infection, or when the nails are involved too.

Fungus needs warm and damp. Dry feet and rotated shoes do real work here.

The most common reason it keeps coming back.

The outer film of dead cells and oil. It holds water in and keeps irritants out, and it is thinner than a sheet of paper. Almost every dry, itchy, stinging skin problem starts here.

The outer layer, and the only one anything in a jar reaches. It renews itself constantly: a cell made at the bottom takes about a month to reach the surface and flake off. Most of what a skincare product does, it does here.

The living layer underneath, holding the blood vessels, the nerves and the collagen. It is where lasting change happens and it is hard to reach: most of what is sold for the skin never gets this far.

Over-the-Counter Products

−

Everything here you can buy without seeing anyone.

16:9 hero for Terbinafine. Never cropped: the tone strip and the corner logo depend on the full frame.
Terbinafine cream
Strong evidence
The most effective thing you can buy for athlete's foot, and the shortest course: once or twice a day for one to two weeks between the toes. It kills the fungus rather than just stopping it growing, which is why it works faster than the older creams. It will not clear an infected toenail, and it will not clear thick sole scale on its own.
A white cream tube lying on its side on a white background, with a plain white label reading Antifungal Cream and a yellow swoosh beneath it.
Clotrimazole or miconazole cream
Strong evidence
The cheap, widely available option, applied twice a day for four weeks. It works well, it just takes longer than terbinafine, so the temptation to stop early is greater. Cover the whole foot and both feet, and carry on for one to two weeks after the skin looks normal.
16:9 hero for Ketoconazole. Never cropped: the tone strip and the corner logo depend on the full frame.
Ketoconazole cream
Moderate evidence
Another azole cream, sold over the counter in some places and on prescription in others. It is a reasonable alternative if clotrimazole or miconazole has irritated the skin. It is no faster than they are, and the same four-week discipline applies.
Five white jars of 40% urea cream lined up, several also listing 2% salicylic acid16:9 hero for Urea. Never cropped: the tone strip and the corner logo depend on the full frame.
Limited evidence
A urea or salicylic acid cream thins the hard scale on the sole so an antifungal can actually reach the skin underneath. It is a helper, not a treatment: on its own it does nothing to the fungus. It is worth adding for the dry moccasin pattern, where cream otherwise sits on top of the thickened surface.
Antifungal powder and sprays
Antifungal powder and sprays
Limited evidence
Powder keeps feet and the inside of shoes dry and lowers the amount of fungus you put back on your foot each morning. It is prevention, and it is good at it. It is not strong enough to clear an established infection, so use a cream to clear it and powder to keep it away.
Foot antiperspirant
Foot antiperspirant
Limited evidence
An aluminum-based antiperspirant made for feet cuts the sweating that keeps the skin soft and the shoe damp. It treats the cause of recurrence rather than the infection itself. Useful for people who clear it every time and get it back every summer.
Five dark glass tea tree essential oil bottles with glass droppers and one green box on white16:9 hero for Tea Tree Oil. Never cropped: the tone strip and the corner logo depend on the full frame.
Weak evidence
Tea tree oil has some antifungal activity and a few small studies behind it, but it clears fewer infections than the pharmacy creams and takes longer. It also causes allergic reactions on the feet often enough to matter. An antifungal cream costs about the same and works.
Vinegar and bleach soaks
Vinegar and bleach soaks
Never use
Both slow fungal growth in a dish, and neither reliably clears an infection on a foot. What they do reliably is dry out and damage the skin, and cracked skin on a foot is the entry point for bacteria. This is one to skip rather than to try first.
A plain white ointment tube lying on its side, labeled Hydrocortisone with a blue swoosh16:9 hero for Hydrocortisone. Never cropped: the tone strip and the corner logo depend on the full frame.
Never use
A steroid cream calms the itch, so it feels like it is helping, while the fungus spreads underneath with less to show for it. The rash it leaves is harder to recognize and harder to treat, and it makes a later scraping unreliable. Do not put a steroid on an undiagnosed foot rash.

Prescriptions

−

These need a prescription.

A white cream tube lying on its side on a white background, with a plain white label reading Ciclopirox and a blue swoosh beneath it.
Ciclopirox cream
Moderate evidence
A prescription antifungal that works differently from terbinafine and the azoles, so it is a useful option when one of those has irritated the skin or has not cleared it. Applied twice a day for up to four weeks. It is no more powerful, just different.
A white nail lacquer bottle on a white background, with a plain white label reading Efinaconazole and a blue swoosh beneath it.
Efinaconazole nail solution
Moderate evidence
A liquid painted on infected toenails daily for about a year, for people who cannot take antifungal tablets. It matters here because an untreated nail is the usual reason foot skin keeps getting reinfected. Cure rates are well below tablets, and it works best on nails that are only mildly affected.
A white nail lacquer bottle on a white background, with a plain white label reading Ciclopirox and a blue swoosh beneath it.
Ciclopirox nail lacquer
Limited evidence
An older nail lacquer, applied daily for up to a year with the build-up removed weekly. It clears only a small share of infected nails on its own. It is worth knowing about, but if the nails are the reason your feet keep flaring, tablets are the conversation to have.
A white cream tube lying on its side on a white background, with a plain white label reading Steroid + Antifungal and a blue swoosh beneath it.
Steroid-antifungal creams
Never use
Combination creams that mix a steroid with an antifungal are still prescribed for itchy foot rashes. The steroid takes the itch away quickly and lets the fungus spread wider and deeper, which is a common route to a longer, harder-to-treat infection. A plain antifungal is the better choice on a foot.
16:9 hero for Terbinafine. Never cropped: the tone strip and the corner logo depend on the full frame.
Terbinafine tablets
Strong evidence
The first-choice tablet for athlete's foot that cream cannot reach: the thick moccasin pattern, widespread infection, and infected toenails. Two weeks usually clears the skin; nails need three months and most of a year to grow out. Liver blood tests are sometimes checked, and it interacts with several common medicines, so the doctor needs your full list.
An amber prescription bottle lying on its side on a white background with a plain white label reading Itraconazole, and six small round white tablets spilled out in front of it.
Itraconazole
Strong evidence
An equally effective alternative, often given as short pulses rather than daily. It is chosen when terbinafine does not suit or has not worked. It interacts with a long list of other medicines, including some heart and cholesterol drugs, so it needs a proper medication review first.
16:9 hero for Fluconazole. Never cropped: the tone strip and the corner logo depend on the full frame.Diagram: how Fluconazole works in the skin
Moderate evidence
A once-weekly tablet, used for skin infection that has not cleared with cream when the other two do not suit. It is less effective than terbinafine for the dermatophytes that cause athlete's foot, and slower for nails. If you are pregnant or breastfeeding, ask the doctor managing your pregnancy before taking any antifungal tablet.
An amber prescription bottle lying on its side on a white background with a plain white label reading Griseofulvin, and six small round white tablets spilled out in front of it.
Griseofulvin
Limited evidence
The oldest antifungal tablet. It still works, but it needs months rather than weeks, has to be taken with fatty food, and clears fewer infections than terbinafine. It is now mostly reserved for cases where the newer tablets cannot be used.

Procedures

−

These are done in the office, usually over several visits.

No procedures listed yet.

When to See a Dermatologist

−

Most athlete's foot never needs a dermatologist - an over-the-counter antifungal on the whole foot twice a day, kept up past the point where the skin looks normal, clears the usual version. Book if four weeks of proper treatment has not helped, if the skin is cracked, weeping or crusted, if blisters are painful rather than itchy, if toenails are thick, crumbly or discolored, or if the rash is spreading to the top of the foot, groin or hands. Ask to be seen sooner with diabetes, poor circulation, a swollen leg or a weak immune system. Go to urgent care the same day if the foot or lower leg turns hot, swollen and painful, or you get a fever - that is bacterial, not fungal. When the picture is unclear, scale from the edge is checked under the microscope, so stop antifungal cream a week or two beforehand; it makes that test read negative even with live infection.

— Dr. Schwarz, Board Certified Dermatologist

Complications

−

Cellulitis

Cracks between the toes are a well-recognized way for bacteria to get into the leg, causing a hot, swollen, spreading redness that needs antibiotics. It is uncommon in healthy feet and much more likely in people with diabetes, poor circulation or a swollen leg. Treating athlete's foot promptly in those groups is mostly about closing that door.

Nail Fungus (Onychomycosis)

The same fungus moves into the toenails, which become thick, crumbly and yellow-brown. Cream cannot get through a nail, so an infected nail keeps putting fungus back on the skin every time a sock goes on. It is the usual answer to why athlete's foot keeps coming back, and it takes tablets and most of a year to fix.

The itchy hand rash (id reaction)

Some people get an itchy blistering rash on the palms or the sides of the fingers while their feet are flaring. There is no fungus in the hand rash. It is an allergic reaction to the fungus on the feet, which is why antifungal cream on the hands does nothing, and it settles once the feet are treated.

Lookalikes

−

Eczema

Eczema on the feet blisters on the sides of the toes and the arch, which is exactly where the blistering kind of athlete's foot appears. Eczema is usually on both feet evenly, spares the web spaces, and often shows up on the hands at the same time. Athlete's foot tends to favor one foot first, starts between the outer toes, and has a scaling edge. A scraping settles it, and treating eczema as fungus wastes weeks.

Contact Dermatitis

An allergy to rubber, glue or dye in a shoe makes an itchy, scaly rash that is easily called athlete's foot. The giveaway is the shape: it sits on the top of the foot in the outline of the shoe, matches on both feet, and leaves the web spaces between the toes untouched. Athlete's foot works the other way round, starting between the toes and on the sole.

Psoriasis

Psoriasis on the sole is dry and scaly across the whole weight-bearing area, so it reads as the moccasin kind of athlete's foot. Psoriasis scale is thicker and silvery, the edge is sharply drawn, and there is usually psoriasis somewhere else, on the elbows, knees or scalp. It also does not respond to antifungal cream, which is often the moment the question gets asked.

Myths

+
  • “Only athletes get it.” The name comes from where it was first noticed spreading - communal changing rooms - not who gets it. Anyone in closed shoes for long stretches can.
  • “It means my feet are dirty.” It does not The fungus needs warmth, moisture and keratin, and you pick it up from floors and shared items. Washing more does not prevent it; leaving the feet damp afterward makes it slightly more likely.
  • “If the itching has stopped, it is gone.” The itch is the first thing to go and the fungus is the last. Stopping there is the most common reason it comes back within a month.
  • “Soaking my feet in bleach or vinegar will cure it.” Some household substances have mild antifungal activity in a dish, but the evidence they clear a real infection is weak. What they reliably do is damage skin, and cracked skin on a foot invites bacterial infection. An antifungal cream costs little and works.
  • “Smelly feet mean fungus.” Foot odor is usually bacterial. One bacterial condition, pitted keratolysis, causes small shallow pits on the sole with a strong smell and is treated differently. Fungus and odor often coexist, but smell alone is not the diagnosis.
  • “Antifungal powder will clear it.” Powder keeps feet and shoes dry and prevents recurrence, but is not strong enough to clear an established infection. Use a cream to clear it, powder to keep it away.
  • “I can only catch it in a locker room.” Any surface where infected flakes land - the bathroom floor at home, a shared bath mat, borrowed shoes, hotel carpets. Most reinfection happens at home.

Questions Patients Ask

+

How long does it take to clear?

The itch settles in a few days. The skin takes two to four weeks, depending on the cream and how thick the scale is. Keep treating for one to two weeks after it looks clear, because the fungus outlasts the symptoms. If nothing has changed after four weeks of proper use, the question is whether it is really fungus, not whether you need something stronger.

Do I need to throw away my shoes?

Usually not. Shoes hold fungus, so alternate two pairs to let each dry fully for a day, and use an antifungal powder or spray inside them. Shoes you cannot clean or dry - old fabric trainers you wore through a long infection - are reasonable to replace.

Do I have to treat my toenails too?

If they are thick, crumbly, lifting or discolored, yes, and that is usually why it keeps coming back. Fungus inside a nail is out of reach of creams, so the nail is a permanent source that reinfects the skin. Treatment usually means tablets for several months, and the nail only looks normal once healthy nail has grown all the way out.

Can I give it to my family?

Yes, though it is not highly contagious. It spreads through shared floors, bath mats, towels, shoes and nail clippers. Use your own towel, wear something on your feet in the bathroom while it is active, wash mats and socks hot, and do not share footwear. If someone else has itchy feet, treat both of you at once.

Why do I keep getting it back?

Three usual reasons, all fixable. You stopped treating when it looked better rather than a week or two after. Your toenails are infected and reseeding the skin. Or your feet sit in a warm damp shoe all day.

Why did my hands break out when my feet were bad?

Most likely an id reaction - an allergic response elsewhere on the body to fungus on the feet. The hand rash has no fungus in it, which is why antifungal cream there does nothing, and it settles once the feet are treated. There is also a separate pattern where two feet and one hand are genuinely infected, typically the hand used to pick at the toes. A scraping tells them apart.

References

+