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.
Key facts
Athlete’s Foot at a glance.
Typical signs
Itchy, cracked, peeling skin
Common locations
Between toes and on soles
Expected course
Clears; recurrence common
Treatment options
Antifungal cream
What is it?
Top things to know about Athlete’s Foot
- It is a fungal infection. Tinea pedis is infection of the outer foot skin by dermatophyte fungi.
- It takes several forms. It can cause peeling between toes, scale across the sole or itchy blisters.
- Not every peeling foot is fungal. Eczema, contact allergy and psoriasis can look similar.
- Some people should act early. People with diabetes, poor circulation or reduced immunity should seek advice early for skin breaks.
What it looks like
What Athlete’s Foot looks like
Athlete's foot is a fungal infection that usually starts between the toes, especially the fourth and fifth. The skin there turns white, soggy and cracked, and it often itches or burns. It can spread to the soles and sides of the feet, causing dry, fine scale in a moccasin-like pattern. Some people get small itchy blisters on the arch. It can also spread to the toenails, groin or hands.
Athlete's foot has a few common patterns. Each looks different and may need a different form of treatment.
Interdigital athlete’s foot
Between the toes; the most common type.
Moccasin-type athlete’s foot
Dry, thick scale on the sole and sides.
Vesicular athlete’s foot
Small blisters, usually on the arch.
Where it shows up
Athlete’s foot often affects toe webs and may involve the soles or sides of the feet. The body view locates the feet; soles are not visible.
Feet
The soles are not visible in this view.
On different skin tones
Athlete’s Foot on different skin tones
On lighter skin, athlete's foot looks pink to red with white peeling. On brown and Black skin, the surrounding skin may look gray, brown or purple instead of red, and the white peeling between the toes is often the most visible sign.
What happens in Athlete’s Foot?
Dermatophyte fungi grow in the keratin of the outer skin of the feet. Moisture favors their growth, and the resulting irritation can cause itching, peeling and cracks.
- Fungi reach the surface: Dermatophytes spread through contact.
- They grow in keratin: The fungi live in the outer skin layer.
- Skin flakes and becomes irritated: Moisture can encourage cracking and peeling.
Causes and triggers
What causes Athlete’s Foot
Causes
Why it happens
Athlete's foot is caused by fungi that thrive in warm, damp places. They grow in the skin between the toes and on the soles.
Risk factors
Raise the odds
- Sweaty feet
- Tight, closed shoes
- Diabetes
- Weakened immunity
Triggers
Passes it on
- Barefoot in locker rooms and pools (Well established)
- Shared towels and shoes (Strong link)
- Damp socks worn all day (Strong link)
When it usually starts
When it usually starts
Athlete’s Foot
More common after puberty and in adults, especially with persistently damp feet.
Daily care
Daily care for Athlete’s Foot
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.
Wear sandals on communal floors
Where most reinfection starts.
Wash socks, towels and mats hot
Cuts the fungus circulating at home.
Complete the antifungal course specified for your product
Treatment length differs between antifungals. Complete the product-specific course rather than extending every medicine for a fixed extra period.
Treat heavy foot sweating
An antiperspirant made for feet treats the cause.
Reduce prolonged heat and dampness when possible
Recurrences cluster in summer.
Avoid: Wearing the same shoes every day
Shoes need about 24 hours to dry inside.
Avoid: Closed, non-breathable footwear
Boots and heavy trainers hold sweat against the skin.
Avoid: Not drying between the toes
Wet web spaces are what the fungus wants.
Avoid: Leaving damp socks on
Keeps the skin softened for hours.
Avoid: Walking barefoot on wet floors
Where most people meet it.
Avoid: Sharing towels, shoes and clippers
How it spreads and reinfects a treated foot.
Avoid: Picking and peeling loose skin
Tears the barrier open and spreads it.
Avoid: Strong home soaks
Bleach and vinegar damage skin more reliably than fungus.
Avoid: Putting underwear on before socks
A known way of moving fungus to the groin.
Avoid: Stopping the cream when itching stops
The itch goes long before the fungus.
Avoid: Treating the skin, not the nails
Nails reseed the skin with every sock.
Avoid: Untreated feet in the household
The shared bathroom floor keeps it going.
Avoid: Vinegar and bleach soaks
Avoid harsh home soaks that irritate and crack the skin.
Avoid: Hydrocortisone
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.
Avoid: Steroid-antifungal creams
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.
Treatments
Treatments for Athlete’s Foot
Terbinafine cream
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.
Clotrimazole or miconazole cream
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.
Ketoconazole cream
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.
Antifungal powder and sprays
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
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.
Urea
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.
Tea Tree Oil
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.
Ciclopirox
Ciclopirox cream. 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.
Ciclopirox
Ciclopirox nail lacquer. 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.
Jublia
Efinaconazole nail solution. 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.
Terbinafine
Terbinafine tablets. 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.
Itraconazole
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.
Fluconazole
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.
Griseofulvin
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.
Outlook
What to expect with Athlete’s Foot
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.
- 1
First few days · Itching eases
The itch eases within a few days of starting an antifungal cream, well before the skin clears.
- 2
Two to four weeks · Skin clears
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.
- 3
Most of a year · If the toenails are involved
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.
- 4
Afterwards · Recurrence
Usually stopping as soon as the skin looked normal, an untreated toenail reinfecting the skin, or the same shoes and floors.
- 5
Any time · The complication to know about
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.
Complications
Complications to know about
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
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
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.
When to get help
When to get help
When to seek care
Seek care if antifungal treatment does not help, or sooner with diabetes, poor circulation, spreading redness, swelling or pain.
Lookalikes
What else could it be?
Eczema
Athlete’s foot often starts between the toes. Eczema more often affects both feet evenly, leaves the toe spaces clear, and may also appear on the hands.
Contact Dermatitis
Athlete’s foot often starts between the toes or on the sole. Contact dermatitis more often follows the shape of a shoe across the top of both feet.
Psoriasis
Psoriasis usually has thicker scale and a sharper edge than athlete’s foot. Similar patches on the elbows, knees or scalp can be another clue.
Questions
Questions you might be asking.
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.
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