Athlete’s foot does not always cause scaling, itching, blisters, and a rash. Sometimes deep furrows and “wear and tear” on the sole of the foot are signs of a persistent fungal infection your immune system can’t quite shake. In these cases, ironically, making sure the skin of the foot is moisturized is essential for recovery.
How do you know you have athlete's foot?
∆ Mild to severe scaling between the toes
∆ Red rash
∆ Blisters covering the toes and sides of the feet
Athlete’s foot is a chronic fungal infection of the skin of the feet, particularly between the toes. In the medical literature it is referred to as tinea pedis. The three species of fungi that most frequently cause athlete’s foot are Epidermophyton floccosum, Trichophyton mentagrophytes, and Trichophyton rubrum. These organisms only survive in warm, moist conditions. They live in the stratum corneum, the outermost layer of the skin.
The fungi that cause athlete’s foot are not readily infectious. They need precise conditions of warmth and moisture to survive, so they are not easily spread from person to person. The body’s defense against athlete’s foot fungus is to shed skin faster than the fungus can multiply, eventually ridding itself of the infection. When the feet cannot shed skin faster than the infection spreads, treatment is necessary. This is especially true when the fungus causes the skin to crack, leading to painful bacterial infections, especially in people who have poor circulation to their feet. In these cases, keeping the skin of the foot too dry can accelerate infection, although skin moisturizers can deter it.
What can you do about athlete’s foot?
To treat athlete’s foot infection:
- Sosa (Solanum chrysothrichum) extract creams (available from herb stores, hierberías, and compounding pharmacists)
- Tea tree oil, in creams containing 8–20 percent tea tree oil or 40 (or higher) percent solution, massaged into the feet 2–3 times daily. Use tea tree foot powders or sprays after drying the feet.
To prevent secondary bacterial infections:
∆ Black walnut hull, one 500 mg capsule daily, taken by mouth.
∆ Peppermint foot lotion, alternating with tea tree oil lotions for especially reddened skin on the feet.
The ideal “natural” treatment would be a combination of arrowroot, baking soda, basil oil, tea tree oil, sage oil, and clove oil. A test with a single participant found that even when the feet are damp, this mixture completely inhibits bacterial growth on the skin. Application of essential oils of cinnamon, thyme, and/or cloves to the foot is also anti-fungal, although not as effective as the baking soda treatment. (There is added risk of irritation if the essential oils are over-applied. ever take essential oils by mouth. ) However, if you aren’t inclined to make this formula for yourself or to track down the essential oils to apply before you put on socks, there are other treatments, natural and pharmaceutical, that work somewhat less efficiently.
Antifungal ointments containing clotrimazole (Gyne-Lotrimin), econazole (Eco-Derm), ketoconazole (Nizoral), or miconazole (Daktarin) can generally cure athlete’s foot. They cannot, however, strengthen the skin against secondary infections, nor are they always successful in eradicating the fungus. One combination product, Lotrisone (clotrimazole plus betamethasone) was found to cause unusual hair growth and developmental retardation in children after it had been on the market for several years.
Doctors typically reserve oral antifungal drugs for especially severe cases. The drawback to any antifungal drug taken orally is that it kills both pathogenic and friendly yeasts and bacteria of all kinds throughout the body, including friendly bacteria in the lower digestive tract. About 20 percent of the time, oral antifungal agents do not kill all of the fungus. The remaining infection is then antibiotic-resistant. The people who are most likely to benefit from systemic antifungal drugs are those who have severe athlete’s foot infections occurring with skin allergies.
One of the most promising treatments for athlete’s food is found in the Mexican herb sosa (Solanum chrysotrichum). A scientifically controlled clinical trial conducted in Mexico involving 101 patients found that herb was slightly more effective than Nizoral, with no side effects. You can find sosa in herb stores, hierberías, and compounding pharmacies.
Tea tree oil relieves athlete’s foot infections, bacterial inflammation, and foot odor. It allows the skin to “catch up” with the fungus and eliminate it by shedding. Tea tree oil is not as effective as the antifungal agent tolnaftate in eliminating the fungus. In a clinical trial involving 104 patients with athlete’s foot, only 30 percent of subjects applying tea tree oil were culture-negative, that is, free of the infection, compared to 85 percent in the tolnaftate group. Moreover, the downside of tea tree oil is that it can cause burning of its own, but it is also more likely than tolfranate to relieve the very same symptoms. In this clinical trial, more patients achieved relief of scaling, inflammation, itching, and burning from tea tree oil than from tolnaftate.
Black walnut hull was traditionally used in baths and compresses to relieve skin inflammation of all kinds. It contains tannins that “tan” the skin, cross-linking keratin proteins to form a protective barrier against bacterial infection. There is no direct scientific evidence to support the use of black walnut hull capsules in the treatment of skin infection in humans. However, toxicological studies of black walnut involving horses find that giving the herb orally makes the veins and arterioles in “excited feet” less likely to constrict in response to adrenaline, maintaining healthy circulation in times of stress. In horses, black walnut hull opens circulation in capillaries not previously filled with blood.
Oak bark, more commonly used as a bath additive, would have a similar effect.
Peppermint oil is a broad-spectrum antifungal, although its use specifically in treating athlete’s foot has not been clinically tested. Its use in relieving pain, however, is well accepted. Peppermint oil stimulates the nerves that perceive cold while simultaneously depressing nerves that perceive pain.
The effect is cooling and soothing. After the initial cooling effect, there is a period of warmth. Its net effect in treating athlete’s foot is to relieve inflammation and to assist other treatments in controlling fungal infection.
Due to content of the chemical ajoene, garlic creams should deter athlete’s foot infections. Foot odor, however, would be unavoidable. Bitter orange oil has a pleasant odor, but its action against athlete’s foot is unreliable.
To prevent reinfection with athlete’s foot:
- Dry feet thoroughly after bathing or showering. Trichophyton mentagrophytes can penetrate the skin in 2–4 days at temperatures ranging from 50–90°F (15–27°C) if the humidity of the air around the skin is 100 percent. If the humidity of the air around the skin is lowered to just 80 percent, the fungus does not penetrate the skin at all.
- Remove bath mats and shower grids. If the bathroom is kept at 80°F (27°C) or higher, they harbor fungi.
- Disinfect the floor of the tub and shower daily. All of the major household cleaners have been tested and found effective for controlling athlete’s foot.
- After you use athlete’s foot treatments, keep your feet warm and moist. Warmth and moisture (from moisturizers such as Eucerin, not from water or sweat) without treatments increase the growth of fungus, but warmth and moisture with treatment decrease it.
People who take the diuretic furosemide (Lasix) for congestive heart failure frequently have symptoms resembling athlete’s foot even without fungal infection. Flaking and crusting will be absent although there can be intense burning and redness. This is due to a vitamin B12 deficiency. Taking 1,000 mg of vitamin B12 a day sometimes stops the burning and redness in as little as 2 days. It is necessary to continue supplementation at lower dosage, 100–250 mg a day, as long as you take furosemide (Lasix).
Athlete’s foot is a special concern for diabetics. Diabetic with neuropathy are less likely to feel pain and less likely to take care of symptoms. Athlete’s foot infections are usually especially persistent in diabetics’ feet, causing minimal inflammation but eventually taking on the appearance of grooves in the skin. Diabetics who have athlete’s foot, however, are, for reasons unknown to researchers, significantly (27 per cent) less likely to develop foot ulcers.
Inouye S, Uchida K, Nishiyama Y, Hasumi Y, Yamaguchi H, Abe S. Combined effect of heat, essential oils and salt on fungicidal activity against Trichophyton mentagrophytes in a foot bath. Nihon Ishinkin Gakkai Zasshi. 2007;48(1): 27-36. PMID: 17287720. Free full text.
Misner BD. A novel aromatic oil compound inhibits microbial overgrowth on feet: a case study. J Int Soc Sports Nutr. 2007 Jul 13;4: 3. PMID: 17908343. Free full text.