Fungal Foot Problems

Fungal foot problems are more common that you would think.  We are trying to exercise more for our mental health, as well as our physical health during the covid-19 lockdowns, and the lockdowns during different seasons makes us vary the types of exercise we can undertake.

Back in Spring 2020 when the first lockdown occured, we were going running, cycling, or simply going for more walks, wearing running shoes or similar light footwear.  We probably went further with the weather being so much nicer.

Under the 2021 January lockdown, we are more likely to put the walking boots on with 2 pairs of socks whilst either just walking the dogs through the snow or muddy woods, or possibily going 'slightly' further afield (hopefully not too further!).

Both forms of exercise use different footwear, but, the feet still take a pounding, and a warm, moist sweaty environment is the perfect breading-ground for a fungal infection.

A Big Thank You

It would be far more difficult to write these articles without the permission from my clients to use the photo's I've taken of their feet, so I'd like to express my gratitude to my various clients who have let me photo their feet and use them in my  educational posts to help others. 

A fungal foot infection, is a fungal based infection which normally resides on the surface of the foot or 'skin'.  It can be red, itchy or burning in sensation, or sometimes just doesn't look very pleasant.  It can occur in males and females of all ages, but is more common in people who are more active.

The most common foot infection is called Tinea Pedis, also known as Athletes Foot (for reasons described above).  The type more often recognised is Inter Digital Tinea Pedis (Between the Toes / Digits), but there are far more varieties.  The second most common version I come across is 'Plantar Tinea Pedis' - on the bottom of the foot.  Most people mistake this for 'dry skin', and try to treat it with moisturiser.  This is the wrong treatment, but I'll chat about that a little later.

Fungal foot infections are highly contagious (more than verrucas in my option), but far more easy to treat.

Diagnosis

Most common fungal foot problems can be diagnosed by visual assessment, and taking the symptoms into account, by a Health Care Professional such as a Podiatrist / Chiropodist, a Dermatologist or your local GP (not always easy to see during the current climate).  Occaisionally skin scrapings may need to be taken and sent away for analysis.

Common Treatments

Most fungal foot remedies can be purchased other the counter at a pharmacy or even from your local supermarket.  But with so many options, it can be confusing which ones to buy.  Some are more suitable treatments to others, depending on where abouts the fungal infection is.

Anti-Fungal Creams

Anti-fungal creams are best for the bottom of the foot and the heels.  A small amount can be applied and rubbed in until it has been fully absorbed.  Creams should never be applied inbetween the toes, as this will cause the skin to macerate and break down, increasing the risk of further infections.

Anti-Fungal Sprays

Anti-fungal sprays are best used for fungal infections occuring inbetween the toes, as the are easily absorbed, and the excess will run off the skin.  Sprays can also be  applied to the inside of footwear, where fungal spores can harbour, waiting for your foot to return and continue to spread!  Spraying inside footwear is a key method to stop the infection re-infecting the feet.  You will have seen this happen if you've ever been 10pin bowling and hired shoes!

Anti-Fungal Foot Powder

Foot powders are great all-round treatments for the feet, and can be used as a preventative to help stop infections from re-occuring.

Oral Anti-Fungal Tablets

For more severe cases, oral anti-fungal tablets can be prescribed to really hit hard at out-of-control fungal infections.  These would normally be prescribed, and cannot be bought over-the-counter.

I had the fortune to see an unusual case recently.  I'd had an online booking placed at one of my clinics, with the note added 'I've got a strange rash to my foot, and my G.P has recommended I see a Podiatist'.  Now, this is very unusual as more often than not, anyone with a skin complaint will normally be referred to a dermatologist, as they are the skin experts - just ask and watch the work of Dr Sandra Lee  - AKA 'Dr Pimple Popper', or Dr Emma Craythorne at 'The Bad Skin Clinic'.

However, not wanting to re-direct someone away before at least giving the problem a 'once over' look, I waited for the appointment, especially during the current climate when many health care services are telephone consultations only.

When the client arrived, they advised the problem had been going on for quite a few months, and had been previously seen by a nurse, a dermatologist (telephone consultation) and then finally advised by the G.P to see a podiatrist.  They had been prescribed a basic emolient cream for several months, which hadn't helped, then a steroid cream, which also hadn't helped.

It's alway easy to recommend a course of treatment when you have a list of previous treatments which haven't worked, and rule out several conditions.  But in this case, several signs were visable to point me to a fungal infection.

A rash on the top of the foot is not overly common for fungal infections.  However, putting the signs together of small circular patches of dry skin on the end of the toes, on the bottom of the foot and on the heel, along with some itching, it all pointed at a fungal infection over opther options.  The other question I asked was about any new footwear being worn at the time it started, and have they continued to wear them.  As this was not the case, my diagnosis was a fungal foot infection.

The Treatment Plan

My advise to attack this problem was a three way strike.

1. Anti-fungal cream for the rash on the top of the foot, to the heel, and to the bottom of the foot and tips pf the toes.
2. Anti-fungal spray between the toes, and to all footwear before and after wearing.
3. Anti-fungal foot power between the toes after the spray had soaked in / dryed.

I explained it would take probably take 6 - 8 weeks to resolve the problem, but they should see an improvement in 2-3 weeks of treatment.

The Result

I received a phone call 4 weeks later advising the rash had vastly improved and looked better than it had done for a long time.  I suggested they continue with the treatment for at least another month, which should fully resolve the problem, and to call me back if there was any more problems or issues.

My other diagnosis to be considered would have been a condition called 'contact dermatitis'.  This is where the skin has an allegic reaction to a substance it comes into contact with.  This can be anything from wearing new shoes that have been made with a specific material or glue, or sometimes changing your fabric conditioner, soap, shampoo etc.

Most problems are best diagnosed when physically seen, as sometimes photo's can make skin look a different colour, due to light, angle etc.

Podiatrists are exempt from closing during the covid-19 pandemic, and therefore remain open.  If you have a foot problem that is causing you pain, discomfort, or affecting your ability to exercise / manage day to day funtions, please get in touch for an appointment at one of my clinics at either Acklam Hall, Middlesbrough or Bondgate Clinic, Helmsley.  Email info@footmanpodiatry.com, or call / leave a message on 07846 752 993.