- Athlete’s foot (tinea pedis) is a fungal infection of the skin of the feet, most commonly between the toes or on the soles.
- It causes itching, scaling, peeling, and sometimes blistering — and it spreads easily in warm, moist environments.
- Most cases respond to topical antifungal treatment over 2–4 weeks, but recurrence is common if the cause isn't addressed.
- A coexisting fungal nail infection is the most common reason athlete's foot keeps coming back — both must be treated together.
- Diabetic patients and patients with impaired immunity should not self-treat — see us early to prevent complications.
What is athlete’s foot?
Athlete’s foot — clinically called tinea pedis — is a fungal infection of the skin of the feet, most often caused by the same dermatophyte fungi that cause fungal nail infections (Trichophyton rubrum is the most common). It is one of the most common fungal infections in adults, affecting an estimated 15–25% of the population at any given time. It spreads through contact with infected skin or contaminated surfaces — locker room floors, pool decks, shared towels, communal showers.
There are several patterns. The most common is the "interdigital" type, with itching, peeling, and scaling between the toes (particularly the 4th and 5th toes). The "moccasin" type causes diffuse scaling and thickening of the soles and sides of the feet — often mistaken for dry skin. The "vesicular" type produces fluid-filled blisters, usually on the soles. All three are caused by the same family of fungi but respond to different treatment intensities.
At Northwest Extremity Specialists, our approach to athlete's foot looks beyond the visible skin infection. Recurring or stubborn cases almost always involve a fungal nail infection — which acts as a reservoir of fungus that re-infects the skin every time the topical treatment is stopped. The best results come from treating both the skin and the nails together, plus addressing the environmental factors (sweaty shoes, communal exposure) that allow the infection to persist.
What it feels like
Athlete’s foot presents in several distinct patterns:
- Itching between the toes (especially the 4th and 5th toes)
- Peeling, scaling, or cracking skin between the toes
- Redness or inflammation in the affected areas
- Burning or stinging, especially after activity
- Dry, scaly, thickened skin on the soles and sides of the feet (moccasin type)
- Fluid-filled blisters (vesicular type)
- A foul odor in some cases
- Often coexists with thickened or discolored toenails (fungal nail infection)
Why it develops
Athlete’s foot is acquired by contact with the fungus, and risk factors that allow it to persist include:
- Walking barefoot in locker rooms, gyms, pools, or showers
- Sweaty feet, especially in non-breathable shoes
- Wearing the same shoes daily without rotation
- Sharing towels, socks, or shoes
- Coexisting fungal nail infection serving as a fungal reservoir
- Diabetes or peripheral vascular disease
- Impaired immunity from any cause
- A previous episode (recurrence is very common)
How we diagnose athlete’s foot
Athlete’s foot is typically diagnosed by visual examination. Your provider will identify the pattern of involvement, examine the nails for coexisting fungal infection, and look for any secondary bacterial infection. KOH preparation (a quick microscopic examination of a skin scraping) can confirm the presence of fungus in unclear cases. Fungal culture is occasionally used for resistant or recurring cases. Most patients leave the same day with a clear diagnosis and a treatment plan that addresses both the skin and any underlying nail involvement.
Non-surgical care
Treatment intensity is matched to the severity and chronicity of the infection. Most patients are managed with topical therapy plus environmental changes:
- Topical antifungal creams or sprays (terbinafine, clotrimazole, miconazole) for 2–4 weeks
- Prescription-strength topical antifungals for stubborn cases
- Oral antifungal medication for severe, widespread, or recurring infections
- Simultaneous treatment of any coexisting fungal nail infection
- Moisture management — breathable shoes, moisture-wicking socks, antifungal foot powder
- Shoe rotation (let shoes dry fully between wears)
- Antifungal sprays or powders inside shoes
- Avoiding barefoot walking in communal areas during treatment
- Treating household contacts if recurring
When to see a specialist
- Athlete’s foot that hasn't cleared after 2–3 weeks of over-the-counter treatment
- Recurring infections that keep coming back
- Athlete's foot in a diabetic patient (even mild cases)
- Blistering, swelling, or signs of secondary bacterial infection (redness, warmth, drainage)
- Coexisting thick or discolored toenails
Athlete’s foot treatment is offered at all 8 of our clinics by any of our board-certified podiatrists. Recurring or severe cases — particularly those involving the nails — are evaluated alongside any underlying fungal nail infection so both can be treated together. Diabetic patients are typically managed as part of their broader diabetic foot care.