Athlete's foot is a fungal infection found between the toes and sometimes in the toenails. Traditionally, it is linked with sport because the fungi breed in warm, moist places such as changing rooms, communal showers and sweaty trainers, but it can affect anyone. Women are prone in late pregnancy because they find drying their feet difficult. The infection, which causes soreness and itching, is increasingly common - affecting around 15% of people at any time. Once caught, it can be difficult to eradicate. But effective treatments can clear up the problem within weeks.
If the infection is only in the skin, you can normally treat it successfully with a medicated cream. There are two basic kinds. Fungistatic creams, available over the counter, halt the growth of the fungi until the infected skin has been shed. Brand names include Canesten AF and Daktarin, technically called azoles; Mycota, which contains the active ingredient undecenoic acid; and Mycil or Scholl cream, which contain tolnaftates. But a breakthrough in the 80s led to the development of a fungicidal cream, Lamisil, which kills the infection. It is available only on prescription.
Which works best?
A study of 72 clinical trials worldwide found that Lamisil cures athlete's foot in 80% of cases, while the azoles cure rate is 72%. The tolnaftates had similar success to the azoles. Only a few trials of undecenoic acid have been done but results look promising. However, the difference between fungicidal and fungistatic creams is so small, researchers recommend trying the cheaper, over-the-counter brands first, which will save you money in prescription charges and cost the NHS less. If these creams fail to work then visit your GP. When the infection affects the toenails, you normally need fungicidal or fungistatic tablets, which are prescription-only. They can have unpleasant side-effects including headaches and nausea. Researchers are still studying which tablets work best for nails, although they have found that tea tree oil was little use - curing only 10% of cases within six months.
Better foot hygiene helps keep athlete's foot at bay. Make sure to dry feet carefully, especially between toes, after swimming, baths and showers, and do not wear damp shoes.