Disease, Illness and Condition Library
extremely common skin disease that affects the shoe wearing population around the world. It has been estimated that up to 40 percent of American will suffer at some time from this infection of the outer layer of the skin. Doctors have historically considered athlete’s foot to be a simple fungal infection. However, studies performed in the mid 90’s showed that bacteria can also play a key role. It is now clear that bacteria, moisture, and fungi participate in a complex interaction that leads to development of the severe forms of athlete’s foot. Athlete’s foot is characterized in its mild form by minor scaling and itching in the spaces between the toes. The mildly itchy annoyance can evolve into an incapacitating disease characterized by foul smelling, soggy, cracked, and ulcerated skin. The spaces between the third, fourth, and fifth toes are most commonly involved, although the infection can spread to the soles of the feet and to the toenails. Common Causes Moisture – It has long been estimated that moisture plays an important role in producing athlete’s foot. While the condition is almost non existent among primitive peoples who do not wear shoes, it is a common problem of all shoe wearing populations. It is particularly common among athletes, whose feet are continually moist from perspiration and in warm climates, where people tend to sweat more. It is believed by enclosing the feet so that sweat cannot evaporate, shoes produce the ideal moist environment for athlete’s foot. Furthermore because the third, fourth, and fifth toes are so close together, sweat is trapped in the spaces between them. Individuals, whose toes are naturally fat and thus especially close together, are particularly prone to athlete’s foot. Fungi – It has been estimated that 10 to 20 percent of the world’s population harbor fungi between their toes at any given time. These are dermatophytes, skin- loving fungi that thrive in warm, moist environments, and feed on keratin, a protein in the layer of the dead cells on the surface of the skin. For years dermatophytes were thought to be solely responsible for causing athletes foot because they could be recovered more frequently from the spaces between the toes of diseased feet than from normal healthy feet without any evidence of the disease. However, the fungi were sometimes present on normal healthy feet without evidence of the disease. And in approximately 70 percent of cases of severe athlete’s foot, scientists could not find any fungi. This fact was frequently played down. Medications were routinely tested only on patients afflicted with the mildest forms of athlete’s foot, concealing the fact that the treatment of the severe form with antifungal products was frequently ineffective. Bacteria – Studies at a number of universities focused on why fungi are not always present in athlete’s foot and investigated the factors that caused mild athlete’s foot to evolve into the severe form of the disease. It seem that in mild cases of athlete’s foot, if the amount of moisture trapped between the toes increases, the number of dermatophytes also increases. As the fungi increases in numbers, they damage the skin, thus weakening its ability to act as a barrier against infection. They also produce antibiotics, including penicillin and streptomycin, locally in the skin. This has an important effect on the bacteria that are normally present in the skin. It kills many of them off and encourages the growth of more dangerous antibiotic resistant bacteria. Like the fungi the harmful bacteria thrive in moisture. And as the numbers of these bacteria increase in the spaces between the toes, they release substances that further damage the skin. Ironically, these substances also kill the local fungi, which is why cultures from the patients with severe athlete’s foot routinely show no fungi. Treatment Once the origin and development of athlete’s foot are understood, it is not surprising to find a dermatologist promoting dryness as the most effective treatment. Keeping the feet dry not only reduces fungal overgrowth, but also limits the bacterial growth seen in severe cases of the disease. Removing shoes when possible, changing sock frequently, avoid footwear that promotes sweating and instead wearing sandals or other well ventilated and loose fitting shoes, dusting the feet and outside the toes with talcum powder and using gauze to separate the toes are all highly effective in promoting dryness. In most patients these common sense practices clear up athlete’s foot. In addition, in severe cases dermatologists frequently apply aluminum chloride solutions or aqueous dye solutions such as gentian violet to the affected skin. These agents produce an additional drying effect, but they also have a potent antibacterial effect. Another group of antifungal agents for the treatment of athlete’s foot are imidazole compounds. These are actually highly effective even for severe athlete’s foot and also have an antibacterial effect. Prevention It probably comes as no surprise that keeping the feet dry and clean is very important in preventing athlete’s foot. After bathing the feet should be thoroughly dried, especially between the toes. A light sprinkling of powder on the feet and in the shoes to absorb moisture will help keep them that way. Shoes should be allowed to air out and dry between uses. Sandals, open toed shoes, or thongs, should be worn as much as possible, weather permitting. Natural Herbal Remedies Helpful for Athlete's Foot |
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