Athlete’s foot is a common condition caused by a fungal infection. An itchy red rash develops in the spaces between your toes.

As well as being itchy, the skin in the affected area may be scaly, flaky and dry. The medical name for athlete’s foot is tinea pedis.

Read more about the symptoms of athlete's foot. 

Do I need to see my GP?

Athlete’s foot is usually mild and can be easily treated using antifungal medication, which is available from your pharmacy.

You only need to see your GP if the infection doesn't go away, although pharmacists often prefer children to see a GP to confirm a diagnosis. The GP may prescribe stronger antifungal medication, often in tablet form.

With effective treatment, athlete’s foot usually only lasts for a few days or weeks.

Antifungal medication kills the fungi that cause the infection. It is available in many forms including:

• creams
• sprays
• liquids
• powders
• tablets

Read more about treating athlete's foot.

What causes athlete's foot?

Athlete’s foot is caused by a fungal infection. Harmless bacteria and fungi live naturally on your skin. If these organisms multiply, your skin can become infected.

A group of fungi called dermatophytes is responsible for athlete’s foot. These fungi feed off other organisms to survive. Your feet provide a warm, dark and humid environment. These are ideal conditions for dermatophytes to grow.

Athlete's foot spreads easily. It can be passed from person to person through contaminated towels, clothing or surfaces.

The fungi multiply in warm and humid places such as showers, swimming pools and changing rooms. 

Read about what causes athlete's foot.

Complications of athlete's foot

If it is not treated effectively, the infection can sometimes spread to other parts of your body, such as the toenails, causing a fungal nail infection, or the palms of your hands.

The fungi that cause athlete's foot usually only grow on the surface of your skin. However, if your skin is cracked, it can enter your body and spread to exposed tissue.

Read about the complications of athlete’s foot.

Who is affected?

Anyone can develop athlete’s foot, but it is more common in men and teenagers. Children under 12 years of age rarely develop the condition.

It is not known why some people develop athlete’s foot more than others. However, people who play a lot of sport are often affected because the infection is easily spread in communal areas such as showers and changing rooms.

Sport and exercise can also make your feet warmer and more moist than usual, which provides an ideal environment for the fungi to grow. Tight-fitting trainers can also encourage the fungi to grow.

Athlete’s foot causes an itchy rash to develop in the spaces between your toes.

As well as being itchy, your skin may also be:

• red
• scaly
• flaky
• dry

You may also have other symptoms such as:

• cracked skin
• blisters (which may be oozing or crusting)
• swollen skin
• burning or stinging skin
• scaling patterns around your sole and on the side of your foot

If you have severe athlete's foot, your skin may begin to crack. This can sometimes expose the raw tissue underneath, which can be particularly painful and increase your risk of developing a bacterial infection.

Read more about the complications of athlete’s foot.

Spread of infection

Athlete’s foot often develops between the little toe and the one next to it. If the infection is not treated, a rash can form on the bottom and sides of your feet. The infection can also spread to your toenails, causing them to become dry and crumbly.

Scratching the infected skin and then touching other parts of your body can spread the infection. Therefore, it is important to treat the infection promptly. Always wash your hands thoroughly after touching the rash.

Read more about treating athlete's foot.

Tinea manuum

The fungal infection that causes athlete’s foot can sometimes be spread to the hands. This is known as tinea manuum and it can occur if you touch the infected skin on your feet and do not wash your hands afterwards.

However, it is very rare for athlete's foot to be passed to the hands. If it does occur, it usually affects the palm of one hand, which can become dry, red and itchy.

Athlete’s foot is caused by a fungal infection of one or both feet.

Everyone has bacteria and fungi on their skin. Most of the time they are harmless and do not cause problems.

However, at certain times – for example in moist, warm conditions – the fungi can grow and multiply, causing your skin to become infected.

What are fungi?

Fungi are organisms that are similar to plants. They feed off broken-down tissue, including human tissue. Unlike plants, they cannot produce food using energy from sunlight (photosynthesis).

Athlete’s foot is caused by a group of fungi called dermatophytes. Dermatophytes are parasitic, which means they feed off other organisms to survive. Your feet provide a warm, dark and humid environment, ideal conditions for dermatophytes to grow.

Dermatophytes can cause fungal infections to develop in areas such as the outer layers of the skin, nails, scalp and hair.

Many other types of fungi can cause various infections. However, the main groups that cause fungal infections such as athlete’s foot are:

• dermatophytes (tinea)
• yeasts (candida)
• moulds

How it spreads

Athlete’s foot is very contagious and can be spread through direct and indirect contact:

• Direct contact – this involves skin-to-skin contact. For example, someone may become infected if they touch the affected area of your skin and do not wash their hands afterwards.
• Indirect contact – this is where the fungi can be passed on through contaminated objects such as towels, bed sheets and clothing.

Communal showers, swimming pools and changing rooms are common places where athlete's foot is spread. Like your feet, these places are usually warm and humid, which encourages bacteria and fungi to multiply.

There are several things you can do to prevent athlete's foot spreading. Read more about preventing athlete's foot.

Most cases of athlete’s foot are mild and can be treated at home. This type of fungal infection usually responds quickly to treatment.

Athlete’s foot can often be treated using self-care techniques and antifungal medication.

If you have a more severe infection, your GP may prescribe a stronger antifungal medicine, which will usually be in tablet form.

If athlete's foot is not treated, the infection may spread to your toenails, causing a fungal nail infection, or other areas of your body, such as the palms of your hands.

Untreated athlete's foot can lead to complications such as a bacterial infection.

Self care

The following steps can help treat athlete’s foot:

• Wash your feet regularly and thoroughly using soap and water.
• After washing, dry your feet, paying particular attention to the areas between your toes.
• Wear clean cotton socks.
• Change your shoes and socks regularly to help keep your feet dry.
• Do not share towels, and wash your towels regularly.

Antifungal medication

Antifungal medication works by killing the fungi that are causing your infection. This type of medicine is available in several different forms including:

• creams
• sprays
• liquids 
• powders
• tablets

Topical antifungal medicines, which are applied directly to the area being treated, are widely available from pharmacies without a prescription. 

The type of antifungal medicine you use is usually down to personal preference. Your pharmacist can recommend the most suitable antifungal for you.

Types of antifungal medicine include:

• terbinafine 
• clotrimazole 
• econazole 
• ketoconazole 
• miconazole 
• sulconazole

Several oral antifungal medicines are also available. They can be prescribed by your GP and include:

• itraconazole 
• griseofulvin 
• terbinafine 

In rare cases, oral terbinafine can cause liver inflammation in people who are susceptible to this.

Antifungal treatments in tablet form are usually only recommended to treat severe cases of athlete's foot and when topical antifungal treatments have not worked.

Read more about antifungal medication.

Risks

Some antifungal tablets are not suitable for children or elderly people. Check the patient information leaflet that comes with your medicine to see if it is suitable for children. Different doses may be needed for children of different ages.

Some antifungal treatments can interfere with pregnancy, and the reproductive system in men and women.

Your GP can give you more information and advice about using antifungal medicines.

How to use antifungal medication

Apply antifungal medication directly to the rash and surrounding area (4–6cm) of normal, healthy skin. Make sure that the area is dry before applying the treatment.

Skin may sometimes be infected with the fungus without showing any symptoms. Therefore, it is important to treat the surrounding area of skin to help prevent re-infection. Always wash your hands before and after applying the treatment. 

Continue to apply your antifungal treatment for as long as recommended in the instructions that come with the medicine. Some antifungals need to be used for longer than others.

Although your rash may disappear quickly, it does not necessarily mean that the infection has been completely treated. You may need to use medication for one to two weeks after your symptoms have disappeared to ensure the infection has been successfully treated.

Hydrocortisone treatment

If athlete's foot is making your skin particularly sore and inflamed, you can use an antifungal treatment that contains an ingredient called hydrocortisone.

Treatments with low doses of hydrocortisone are available over the counter from pharmacies. However, if you have a severe infection, your GP may prescribe a stronger hydrocortisone treatment. 

Hydrocortisone reduces inflammation and eases irritation and itching. Follow the instructions that come with the treatment.

Hydrocortisone cannot be used for longer than seven days. You may need to use an alternative antifungal treatment (one that does not contain hydrocortisone) until your infection has been successfully treated.

If you are pregnant or breastfeeding, ask your GP or pharmacist for advice before using hydrocortisone.

Athlete’s foot is usually a mild infection, so it rarely causes complications.

However, it is best to treat the infection as soon as you develop symptoms. This will minimise your risk of developing complications.

Some of the complications that athlete’s foot can cause are described below.

Fungal nail infection

If it is not treated, an athlete’s foot infection may spread to your toenails. A fungal nail infection causes your nail to become thick, discoloured and crumbly. The skin beneath the nail may also be painful and inflamed.

Most fungal nail infections can be easily treated using antifungal medication. This is either taken orally or is painted on to your nail using special antifungal nail paint. If it is not treated, a fungal nail infection can cause significant pain and discomfort, which may make it difficult to wear shoes or walk around.

Read more about fungal nail infections.

Bacterial infection

If you have severe athlete’s foot, your skin may also be cracked, exposing the raw tissue underneath.

It is fairly rare for a fungal infection to affect exposed tissue because fungi usually only grow on the skin's surface.

However, as bacteria can thrive inside the body, they can cause an infection if they enter your body through cracked skin.

Cellulitis

Bacteria release substances that break down skin and tissue. Once inside your body, bacteria can spread quickly and cause widespread infection. If left untreated, a bacterial infection can be very serious.

Cellulitis is caused by a bacterial infection of the deep layers of skin, fat and soft tissue. If it is not treated, cellulitis can lead to serious complications, such as blood poisoning (septicaemia), or the infection can spread to the bone.

The symptoms of cellulitis include a sore, red area of skin that is hot and tender to touch.

Cellulitis is a rare complication of athlete’s foot, but should be treated quickly if it occurs. Most cases can be effectively treated using antibiotics.

Read more about cellulitis.

The best way to prevent athlete’s foot is to always practise good foot hygiene.

The following steps will help keep your feet clean and hygienic:

• Wash your feet thoroughly every day, particularly between your toes.
• Reduce foot perspiration by using talcum powder on your feet.
• Avoid wearing tight-fitting footwear, particularly during the summer.
• Do not put on socks, tights or stockings before your feet are completely dry.
• Change your socks, stockings or tights regularly.
• If possible, wear pool slippers or flip-flops in communal changing rooms or shower areas.
• Alternating footwear can help ensure that you wear dry shoes at all times.
• Avoid borrowing shoes to lower the risk of spreading the infection.
• Wash your towels and bedding frequently.

Should I keep my child off school?

The Department of Health does not recommend that children with athlete’s foot should be kept off school.

You should, however, ensure that your child does not walk barefoot while they are at school, for example during physical education (PE) classes. This will help prevent the infection being spread to others.

You should also tell your child's teacher that your child has athlete's foot so that the teacher can make sure they wear appropriate footwear during PE.