Athlete's foot

Synonyms

Tinea pedis, tinea pedum, foot mycosis, athlete's foot, athlete's foot, dermatophyte infection of the foot
Notation: Athlete's foot
engl .: athlete`s foot

definition

Athlete's foot is a fungal infection (Mycosis) of the foot by a certain fungus (Dermatophyte) of just the skin or appendages like hair or Nails infested. These fungi can produce human keratin (Main component of skin and hair) break down and lead to redness and dandruff.

frequency

Of the Athlete's foot (Tinea pedis) is one of the most common skin diseases in Germany, but very few can be treated successfully. According to an epidemiological study, the Frequency in Germany in adults, for example 20 %, in certain population groups, such as Miners, chemical workers, athletes or swimmers the frequency can be up to 70 % be. Men are affected a little more often.

Pathogen

The infection is triggered by a fungus (Dermatophyte) of the skin. This mushroom is divided into three genera: Trichophyton species, Microsporum species and Epidermophyton species.
This Pathogen can from the Soil, from animals or from person to person be transmitted. Exist worldwide according to current knowledge about 40 different types. In Central Europe, the dermatophyte is transmitted from person to person Trichophyton rubrum one of the most common pathogens that emerged from the investigated Dander can be isolated. No personal contact needs to have taken place for the transfer, because the Spores and hyphae the mushrooms can be found on objects such as S.ocks, shoes, floors, bath mats or hotel rugs survive and remain contagious. The second most common pathogen is Trichophyton mentagrophytes, also Trichophyton interdigitale called and is mostly transmitted from pets. The third most common is the fungus Epidermophyton floccosum found.

These dermatophytes can grow after penetrating the top layer of skin (epidermis) spread centrifugally, i.e. starting from the center, and trigger inflammation of varying intensity.

Please also read our article on this Mushrooms.

causes

A infection (Athlete's foot) with a dermatophyte can happen wherever people go through Walk barefoot comes into contact with infectious flakes of skin that another person has lost naturally, which is particularly the case with public showers and baths may be the case. The fungus can survive for a long time, sometimes for months, not only in dry conditions, but also in water. The Type of contagion explains why the disease is so common, especially in professions that involve taking a shower every day in large communal facilities. Just one tDaily scrubbing disinfection of the floors can contain the fungus.

Various factors can make infection with the pathogen easier. The warm and humid climate in a shoe, which is also too tight, plays the most important role. Since heavy protective shoes are required in some professions, the Athlete's foot for example under Chemical workers particularly common. Excessive sweating (Hyperhidrosis) as well as a poor blood flow to the toes (Acrocyanosis) are also favorable factors because a high number of people are having Circulatory disorders of the arteries and the veins also suffer from athlete's foot. Also genetic factorsthat have been inherited and anatomical malformations of the foot as well Misalignments, nerve damage to the feet (peripheral neuropathies) and Diabetes mellitus are to be counted among the favorable factors for athlete's foot. Individual factors such as a weakened immune system at HIV / AIDS play only a minor role. But also about minor skin wounds the pathogen can invade and cause inflammation and then a Mycosis trigger.

Furthermore, the disease can also be the starting point for other mycoses, e.g. a Fungal disease of the nails, represent.

Symptoms

The typical symptoms of athlete's foot are usually limited to that skin and your Appendages. At the beginning there is usually one Swelling the skin, which then looks like you've been in the water too long. In addition there is usually one whitish color the agency. This is usually followed by various symptoms such as:

• Burn
• itching
• Flaking
• Reddening of the skin
• Blistering
• Oozing skin

The most common symptom is the stubborn one itching. It can also be used for Cracking the skin come and become one Odor development.
Depending on the main symptoms, there are three different types of athlete's foot:

• At the first type it is the mushroom in the spaces between the toes, especially in the spaces between the toes of the fourth and fifth toes.
  At first the skin softens a little in these areas before other typical symptoms like Reddening of the skin, Itchy skin, Flaking and Skin blisters occur on the side surfaces of the toes of the feet. Then there are usually softened, white, thick layers of skin and painful ones Skin cracks.
  The athlete's foot can remain undetected for a very long time and spread to other areas of the foot.

• At the second type of athlete's foot is a type, which slowly on Back of the foot and edge spreads and also on the Sole of the foot occurs. The spread to the back of the foot and the edge of the foot has one Moccasin shoe shape, hence this type is called the moccasin shape.
  Characteristic of the second type are also severe peeling of the skin and especially Keratinization of the skin. Usually this type of athlete's foot begins with a light, dry skin flaking, with the skin Signs of inflammation shows. Then more and more are formed Corneal layers. The heels in particular can then become painful Cracks come. The cracks can also allow pathogens to penetrate, especially bacterial pathogens that are also on the skin.

• At the third type it is a form with Blistering of the skin. These skin blisters are with liquid filled and can dry up. The blisters can make the skin itchy. The fabric is there flushed and irritated.

Athlete's foot complications
In the process it can happen that the athlete's foot occurs Toenails spreads. In addition, as mentioned above, it can be used for Ingress of bacteria or viruses get into deeper skin tissues.

In addition, manual scratching of the feet can cause a Spread of the fungus to other parts of the body come. When the feet are scratched and itchy, flakes of skin and the fungal pathogen collect under the fingernails. So it can become one by touching other parts of the body Spread of the fungus come. Another way of spreading the fungus is through Carpets or towels. The drying of the skin is sufficient to transfer the germ to other parts of the body.

The beginning of the athlete's foot infection

A Athlete's foot infection is mostly one very tedious affair. Often times the infection returns again and again and is persistent. But how does an athlete's foot begin and how does it make itself felt?

Athlete's foot can get you started not necessarily see. The pathogens are microscopic and the skin does not necessarily respond immediately with changes on it.
Man feel the fungus but quite quickly. Most of the time, the infection starts with one Itching between the toes. With increasing time the skin turns red and scales later. These scales will getting bigger and the affected area appears darker than the healthy skin. Then form Vesicles and pustules.

At heavier infestation These changes are no longer limited to the spaces between the toes, but rather spread to other areas of the foot. The skin appears how softened and torn. That can very painful be and favors the entry of further pathogens as well as the development of inflammation.

Other forms of athlete's foot can start directly on the sole of the foot and reach over to the outer foot edges. This is usually first expressed through dry, cracked skinwhich then basically the otherwise typical symptoms such as itching, redness, and oozing.

Prevent athlete's foot

Athlete's foot is one very common diseasethat can in principle affect anyone. Since the risk of infection with a fungal infection on the feet is very high, you are especially with the Use of public facilities at risk of catching athlete's foot. Fortunately, however, there are a few simple things you can do to reduce the chances of developing athlete's foot.

First of all, you should generally rely on a good foot hygiene respect, think highly of.
That means you can put your feet up Wash thoroughly every day if possible should, ideally with warm water and mild soap. Following this, it is important to get the feet easy to dry off again and above all also the Spaces between the toes not to forget.
Damp and softened skin is a particularly good breeding ground for athlete's foot to grow. It is ideal to also use your feet at regular intervals special care products to apply cream. In general, the feet should be supplied with blood as well as possible. Blood circulation-promoting act in addition to one regular physical activity for example alternating baths or thigh casts.
Towels should be changed regularly and they, just like socks, bed linen and bath mats, Wash at least at 60 ° Cto kill pathogens.

Especially when using public facilities such as swimming pools, saunas and public showers Appropriate behavior is important to protect yourself from athlete's foot.
In any case, you should always own towels and washcloths to use. Plus, it's best to wear Slippers. The disinfection systems that are installed in many swimming pools are only partially effective. The agents contained would actually have to be applied to the skin for at least 5 minutes in order to really develop an effect. In addition, the disinfectant sprays often contain certain substances that tend to damage the skin and its protective coat and thus promote the occurrence of athlete's foot.

This is also very important for the prevention of athlete's foot Wearing proper footwear. Shoes should in general be comfortable and fit well. They should be made of one breathable material (for example leather or microfibers) so that moisture can be quickly drawn away from the foot. Besides, you should change shoes more often, on the one hand to allow previously used pairs to dry and on the other hand to avoid the occurrence of misaligned feet and toe deformations caused by certain shoe shapes.
Socks should be changed every day and also off breathable materials (for example cotton) exist.

And of course it's good to have one recognizes existing athlete's foot at an early stage and can therefore start treatment in good time. To do this, it is necessary that you regularly rest your feet on the for Athlete's foot symptoms, such as itching, redness, flaking, dark spots or even cracks in the feet (especially in the area of ​​the toes and the spaces between the toes).
This is especially true for people who are predisposed to the occurrence of athlete's foot, such as diabetic. A doctor should then be consulted if athlete's foot is suspected.

therapy

The therapy is usually based on the extent of the athlete's foot Medicines for athlete's foot are special drugs. These are effective against athlete's foot fungicidal drugs, so-called Antifungal drugs.

They come in different forms like gels, sprays, Anoint, Powder, as a cream or, if necessary, as a tablet. In people who increase Sweaty feet a therapy with powders or gels is better to counteract sweat. Against it is at dry skin therapy with creams or ointments makes sense. Around Foot contact The anti-athlete's foot sprays are suitable to avoid.

The following means are approved antifungal agents:

• Econazole
• Itraconatole
• Amorolfin
• Miconazole
• Bifonazole
• Terbinafine
• Clotrimazole

The time it takes to heal depends on which drug is used here. The different Medication can be in groups organize:

• Group 1: Fungiostatic drugs: they ensure that that Inhibited growth of the fungus and it cannot spread any further. That is one of those means Cotrimazole. Usually one should take the medication Use about 3-4 weeks.
• Group 2: Fungicidal drugs: this does not inhibit growth, but rather the Targeted fungus killed. Thereby shortened the Time of application until healing.

In addition, the drugs have their specific mode of action and Form of administration have what is now explained in the following:

• Terbinafine can be taken in the form of gels, sprays, creams and tablets. Through a certain mechanism with enzyme inhibition, inhibits the drug den Structure of the fungal cell wall.
• Itraconazole however, only in Tablet form can be applied.
• Inhibits cotrimazole also the Structure of the cell wall by inhibiting the production of ergosterol, which is essential for cell wall formation. The drug is applicable in the form of sprays, creams, powders and solutions.
• Miconazole is also a drug which the Inhibits the build-up of cell wall formation. It can be used in the form of powders, solutions and creams.
• Bifonazole inhibits cell wall production, moreover, it stays on the skin longer and is good against inflammation.

Should the Mushroom shape If you don't know, an antifungal agent is usually used, which works against several forms of fungus. That's why they are also called Broad-spectrum antifungal drugs.
In addition to therapy, it is also important further contagion athlete's foot to other people prevent, there are special preventive measures that can be taken to protect yourself and others permanently from athlete's foot.

Medicines and medicines for athlete's foot

Athlete's foot, also Tinea pedis called, is primarily with so-called antifungal drugs treated. These are active ingredients that Kill mushrooms in different ways can. Usually cause so-called dermatophytes the athlete's foot. These are Thread fungi. One of the most common pathogens that belongs to the dermatophytes is Trichophyton rubrum.

The Therapy of fungal infection occurs in most cases localsay it will be Ointments, powders or sprays applied. At very resistant and severe infections However, one also leads one systemic therapy by where the medication oral or parenteral (as an infusion). A few active ingredients are presented in more detail below:

Drugs for oral use

1. Azoles

• Itraconazole
  This active ingredient belongs to the Subgroup of the triazoleswhich in turn belong to the superordinate group of azoles. Azoles prevent the build-up of the cell wall of fungi and act like that antifungal. Itraconazole becomes, if local therapy fails, very severe hyperkeratotic tinea pedis or if the local therapy is insufficiently effective.
  It's going to be oral in the form of tablets administered. The dosage is 100mg daily for four weeks or 200 mg daily for seven days.
• Fluconazole
  This ingredient belongs also to the triazoles. Treatment with fluconazole is allowed for athlete's foot not under six weeks be. Adults receive one Daily dose of 50 mg.
• Side effects of azoles
  Azoles can allergic reaction such as Discomfort in the gastrointestinal tract and Liver dysfunction cause. you are contraindicated in pregnancy and should while breastfeeding be avoided.

2. Griseofulvin

This drug is an active ingredient that exclusively against dermatophytes is effective. He mainly focuses in keratin-rich tissue and is therefore at Foot and nail fungus particularly effective. The drug is also compatible with children. Get this 125 mg 1-3 times a day. For adults this is Daily dose 500 mg. It can be taken once in the morning as a tablet or divided into four individual doses of 125 mg each. The maximum dose for adults is 1000 mg per day.

Griseofulvin can also allergic reaction or gastrointestinal complaints trigger. It's in the Early pregnancy contraindicated as it is too toxic to the embryo is. Besides, it is allowed not if you have liver disease can be used. It can Effect of the pill and is no longer prescribed as often in current therapy.

3. Allylamines

Of the Allylamines thinks Descendant terbinafine Application in the internal treatment of foot and nail fungus. Terbinafine blocks the cell wall structure the dermatophytes and thus has an antifungal effect. Adults receive once 250 mg daily for 4 - 6 weeks. The active ingredient should not be taken by children, pregnant women or people with liver diseases. Known side effects include gastrointestinal complaints, a headache, Changes in blood count, Liver dysfunction and very rarely Skin reactions.

Ointments against athlete's foot

There are active ingredients that come in the form of Ointments, gels, creams and powders be applied. This application is known as topical.

Here too there is different active ingredients.
First of all, the Azoles applied. The representatives Clotrimazole, Miconazole, Econazole, Bifonazole, Sertaconazole and Tioconazole are usually available both as ointments and as Shower gels or Liquids for direct application. The form of application can differ depending on the manufacturer.
Likewise are Allylamines how Naftifine and terbinafine, and morpholines such as amorolfine approved for topical use. Mopholins, like allylamines, inhibit the cell wall synthesis of the fungi.
Last but not least, there is Hydroxypyridones such as ciclopiroxolamine, which also interacts with the cell wall of the fungi and quite well tolerated is.

Most of these active ingredients need a certain amount of time until they take effect, as they affect fungi that are in the Growth phase are located. So the therapy has to necessarily long and continuously are executed. Treatment of athlete's foot should therefore usually about 3-4 weeks of clinical healing, that is, beyond the freedom from symptoms. This is the only way to ensure that all of the fungus eliminated is.
At Ointments and creams containing terbinafine seems after just 7 days the complete fungus to be eliminated.
The individual Concentration and duration of treatment however puts the attending physician fixed in individual cases. She is among other things depending on the extent and severity of the fungal attack.

It is also recommended worn socks and shoes to disinfectto prevent recurring infections.

You can find a lot more information under our topic: Ointments against athlete's foot

Athlete's foot spray

Sprays for treating athlete's foot are available without a prescription in the pharmacy to receive and can problem-free at home be applied.
There are a number of substances, so-called Antifungal drugs (Antifungal agents) that may be included in these sprays.
Especially common against fungi Clotrimazole or Bifonazole used. The spray should then be applied twice a day for about three to four weeks.
The newer active ingredient Terbinafine however, it only needs to be used once a day for a week.

If you use a spray to treat athlete's foot, you should Wash your feet before use and then dry them thoroughly. Then the affected areas and the adjacent skin are sprayed with the spray so that they are well moistened. It is not necessary to rub the spray into the skin as well.
Because the spray moves in quickly, you can put on socks and / or shoes relatively straight away after using it.
It is important that you get the Treatment carried out consistentlyeven if the symptoms seem to have gone, to prevent the infection from "flaring up" again.
There are several companies that make sprays to fight athlete's foot. These include Lamisil, Scholl, Efasit and Canesten®. Before using a spray for the first time, you should yourself Read the package instructions carefully and / or seek advice from a doctor or pharmacist.

The main advantage over athlete's foot cream is that the spray practical for on the go is. Unlike a tube, the spray cannot be crushed or leaked in its packaging. In addition, by simply spraying it on the affected areas, it can be applied without the hands coming into contact with the agent. Older or immobile people also benefit from the variant of a spray, as it is not necessary to reach the affected areas on the feet directly.

Through the Self-therapy can successfully treat about 70% of all athlete's foot become. However, if there is no improvement in the symptoms, it is absolutely necessary to consult a doctor.

Athlete's foot in pregnancy

Athlete's foot can naturally occur in the same way during pregnancy as usual. He can be favored by shoes that are too tight and increased sweating. To that to prevent, pregnant women should take care always dry shoes to wear and the To clean feet sufficiently.

If it happened anyway and you got infected, there is some peculiarities in therapythat you should pay attention to. Lots Antifungal drugs are contraindicated in pregnancy and should avoided during breastfeeding become. These include, among others Triazole itraconazole and the Allylamines terbinafine and naftifine. Griseofulvin may not in the early stages used during pregnancy as it damages the embryo and can cause mutations. Often there is a lack of sufficient empirical valuesin order to be able to make precise statements about compatibility.

It is usually recommended to pregnant women over-the-counter ointments, creams, solutions, sprays and powders with the active ingredient Clotrimazole. However, the application is also allowed here not easily longer than two weeks respectively.
in the first trimester of pregnancy caution is also advised. Nevertheless, clotrimazole is the drug of choice for treating athlete's foot during and after pregnancy. One should however best to consult a doctor and ask him if you are unsure about the therapy.

Athlete's foot in toddlers and children

Toddlers and children are often particularly at riskto catch a fungal infection. One of the reasons for this is that they often have a high urge to move have, do a lot of sport and often Visit swimming pools.

The Symptoms are in children basically the same. It itches, hurts, wet and is reddened.

As a parent you should be on a good foot hygiene respect the children and educate them to do so at an early age, their feet always thoroughly (especially between the toes) to dry off. You should also be on Socks with the lowest possible percentage of synthetic fibers be careful, as these only make your feet sweat. The sneakers should be done after exercising ventilate adequately or even disinfect. Infants and young children you should Do not wrap your feet too warm and always be careful not to sweat too much.

The Therapy in children is basically similar to that of pregnant women better to clarify with a doctor beforehand. True, there are many Over-the-counter active ingredients are safe for children, nevertheless should especially with babies the doctor will recommend the exact dosage and type of active ingredient, even if it is available without a prescription. In infants can namely even an over-the-counter active ingredient is incompatible be.
Of the Active ingredient terbinafine is with children absolutely contraindicated. However, there are also quite well-tolerated active ingredients such as the Griseofulvin. In general, it is difficult to convince small children and slightly older children to do so Therapy also after clinical healingafter the symptoms have subsided. However, it is also absolutely necessary for children Continue therapy for another 2-6 weeksto prevent symptoms from flaring up again.

forecast

The forecast in case of athlete's foot when therapy is usually Well.

Still should too about 2-3 weeks after successful therapy die treatment still a while continued to avoid relapse.
It is possible that the Space between the toes yet Fungal spores that persist for a long time after therapy and become one Outbreak the disease. Since the Skin defense then also after the initial infection by the athlete's foot weakened is, the Worsen prognosis.

At a Failure of therapy However, the fungus does not regress on its own or even spreads further. In general, however, athlete's foot is for humans harmless. Even so, the patient can have a significant Suffering due to the disease or the fungus can prove to be particularly persistent.

One danger that significantly affects the prognosis is the occurrence of Complications. Because the athlete's foot is the Skin defenses weakened and pathogens can penetrate and die Worsen prognosis.
Often it is an infection with bacteria, more precisely Group A streptococciwhat often a Sore rose (Erysipelas). It comes to through an eryispel high fever and a treatment in hospital is required.

In addition, there is always the risk of Procrastination of the fungus to other parts of the body or Appendages how Nailswhich worsen the prognosis.

Another point regarding the prognosis is that immune system of the sick. If there is a HIV Infection, one Cancer With chemotherapy, Patients in intensive care units or even in people with diabetes (diabetes) is this Immune system severely weakened and the fungus has a much better chance of spreading. This deteriorated the forecast and can be dangerous.

Others too Comorbidities can impair the body's defenses and worsen the prognosis.