Millions of people deal with persistent itching on their feet, often dismissing it until the discomfort becomes impossible to ignore.
One possible cause is tinea pedis, more commonly known as athlete’s foot or a fungal foot infection.
This infection develops when feet spend extended periods in warm, dark and damp conditions. Such an environment allows dermatophytes, a group of fungi that feed on skin, to survive and multiply.
The resulting itch occurs because the fungi damage the skin’s protective barrier, prompting an inflammatory response from the immune system.
Around 33 million Americans are estimated to develop tinea pedis during their lifetime—equivalent to roughly 10 percent of the population.
The infection is more likely among people who wear socks and shoes for long stretches. It can also spread when someone scratches an infected area, such as the groin, and then touches their feet.
Although athlete’s foot is often viewed as a minor problem, untreated cases can sometimes lead to complications including foot ulcers. In rare situations, the infection may enter the bloodstream and cause potentially fatal sepsis.
Early treatment with antifungal creams or prescription tablets can therefore be crucial in stopping the infection from worsening or spreading.
More than 10 percent of the population may be living with a foot infection that could cause severe secondary infections and sepsis
Tinea pedis can become particularly serious when damaged skin develops into an ulcer, a risk that is greater for people with diabetes.
Persistent moisture makes the skin more fragile and increases the chance of breakdown, especially around pressure points such as the toes and heels.
One form, known as moccasin-type tinea pedis, may be linked to unsuitable footwear and socks that are not changed regularly. It can gradually spread across the entire sole of the foot.
A heavy layer of scaly plaques on the sole can also make moisturising products, known as emollients, less effective and may trap additional moisture against the skin.
The symptoms of athlete’s foot can appear suddenly, but the conditions that allow the infection to take hold may have been developing over a much longer period.
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I recall treating a man in his 40s who had spent more than a decade working in construction. His shifts could last up to 14 hours, and by the time he arrived home, he often had little time beyond showering, eating and going to bed.
A crack had formed between his first and second toes. Daily use of steel-toe boots, socks worn for his entire shift and physically demanding lifting work had made the problem worse.
The damp, peeling and flaking skin between his toes was a clear warning that the fungal infection had progressed.
He had not realised the seriousness of the condition until I explained that the wound had developed a secondary bacterial infection. He needed antibiotics and weekly clinic appointments. Understanding that the problem could interfere with his work became the motivation he needed to change his routine.
Over the following six weeks, he reorganised his schedule so he could apply antifungal cream to the soles of his feet and use spray between his toes. He also began washing his feet every day and changing his socks after returning home.
Unfortunately, many people wait too long before seeking help for athlete’s foot. By then, prolonged symptoms may have progressed to complications such as ulceration.
Without timely treatment, a fungal skin infection can also lead to a secondary bacterial infection or spread to the toenails, causing a fungal nail infection.
When dermatophytes become established in the nails, they can produce the familiar yellow discoloration often associated with infected toenails.
Because tinea pedis thrives in warm, dark and moist conditions, treating it promptly is important to reduce the risk of the infection spreading to other areas of the body.
Over-the-counter antifungal creams, gels and sprays are commonly used to treat athlete’s foot.
Anyone unsure about the cause or severity of foot itching should consider speaking with a podiatrist, particularly when symptoms continue even while resting.
Do not ignore persistent foot symptoms. Seeking advice early can reduce the risk of the infection becoming more severe, spreading elsewhere on the body or passing to other people.
Jonathan Brocklehurst, MSc, MIRL, MRCPod, is a UK-based podiatrist and author.
