What is the treatment for athlete's foot?
Nili N. Alai, MD, FAAD
The treatment of athlete's foot can be divided into two parts. The first, and most important part, is to make the infected area less suitable for the athlete's foot fungus to grow. This means keeping the area clean and dry.
Buy shoes that are leather or another breathable material. Shoe materials that don't breathe, such as vinyl, cause your feet to remain moist, providing an excellent area for the fungus to breed.
Absorbent socks like cotton that wick water away from your feet may help.
Powders, especially medicated powders (such as with miconazole or tolnaftate) can help keep your feet dry. Finally, your feet can be soaked in a drying solution of aluminum acetate (Burow's solution or Domeboro solution). A homemade remedy of dilute white vinegar soaks using one part vinegar and roughly four parts water, once or twice a day as 10-minute foot soaks, may aid in treatment.
The second part of treatment is the use of antifungal creams and washes. Many medications are available, including miconazole, econazole nitrate, clotrimazole, terbinafine sprays and creams, ketoconazole shampoo and cream, etc. Ask your health care professional or pharmacist for a recommendation. Treatment for athlete's foot should generally be continued for four weeks or at least one week after all of the skin symptoms have cleared.
More advanced or resistant cases of athlete's foot may require a two- to three-week course of an oral (pill) antifungal like terbinafine, itraconazole, or fluconazole. Laboratory blood tests to make sure there is no liver disease may be required before taking these pills.
- Terbinafine: 250 mg once a day for two weeks
- Itraconazole: 100 mg twice a day for two weeks
- Fluconazole: 100 mg once weekly for two to three weeks
Topical corticosteroid creams can act as a fertilizer for fungus and may actually worsen fungal skin infections. These topical steroid medications have no role in treating athlete's foot.
If the fungal infection has spread to the toenails, the nails must also be treated to avoid re-infection of the feet. Often, the nails are initially ignored, only to find the athlete's foot keeps recurring. It is important to treat all the visible fungus at the same time. Effective nail fungus treatment may be more intensive and require prolonged courses (three to four months) of oral antifungal medications.