Beginning of the foot fungus infection

A athlete’s foot infection is usually a very lengthy affair. Often the infection returns again and again and is persistent. But how does a athlete’s foot infection begin and how does it make itself felt?

You cannot necessarily see athlete’s foot at the beginning. The pathogens are microscopically small and the skin does not necessarily react immediately with changes. But you can feel the fungus quite quickly.

Usually the infection starts with an itching between the toes. With increasing time the skin reddens and scales later. These scales become larger and larger and the affected area appears darker than healthy skin.

Then blisters and pustules form. In more severe cases, these changes are no longer limited to the spaces between the toes but spread to other areas of the foot. The skin appears softened and tears.

This can be very painful and promotes the entry of other pathogens and the development of inflammation. Other forms of athlete’s foot can start directly on the sole of the foot and spread to the outer edges of the foot. This usually manifests itself first by dry, cracked skin, which later on basically shows the otherwise typical symptoms such as itching, redness and weeping.

Athlete’s foot is a very common disease that can affect anyone. Since the risk of infection is very high when a fungal infection on the feet, one is particularly at risk of catching a foot fungus when using public facilities. Fortunately, there are some simple measures that can significantly reduce the probability of developing athlete’s foot.

First of all, one should generally pay attention to good foot hygiene. This means that you should wash your feet thoroughly every day, preferably with warm water and a mild soap. Afterwards, it is important to dry your feet well again and not to forget the spaces between your toes.

Moist and softened skin is a particularly good breeding ground for the growth of athlete’s foot. It is optimal to apply special care products to the feet at regular intervals. In general, the feet should be well supplied with blood.

Besides regular physical activity, alternating baths or thigh watering can also improve circulation.Towels should be changed regularly and, just like socks, bed linen and also bath mats, should be washed at least at 60°C to 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 use your own towels and washcloths.

It is also best to wear bath slippers. The disinfection systems installed in many swimming pools are only partially effective. The contained agents should actually be applied to the skin for at least 5 minutes in order to really have an effect.

In addition, the disinfection sprays often contain certain substances that can damage the skin and its protective mantle and thus promote the occurrence of athlete’s foot. Wearing the right footwear is also very important for the prevention of athlete’s foot. In general, shoes should be comfortable and fit well.

They should preferably be made of a breathable material (e.g. leather or microfibers) so that moisture can be quickly removed from the foot. In addition, shoes should be changed more often, firstly to allow previously used pairs to dry out and secondly to avoid the occurrence of foot malpositions and toe deformations caused by certain shoe shapes. Socks should be changed every day and should also be made of breathable materials (for example cotton).

It is of course also good if an existing athlete’s foot can be detected early and treatment can be started in time. For this purpose, it is necessary to examine your feet regularly for the symptoms typical of athlete’s foot, such as itching, redness, scaling, dark spots or even cracks in the feet (especially in the area of the toes and between the toes). This is especially true for people predisposed to the occurrence of athlete’s foot, such as diabetics.

If athlete’s foot is suspected, a doctor should then be consulted. The therapy is usually based on the extent of the athlete’s foot. The drugs used to treat athlete’s foot are special drugs.

Effective against athlete’s foot are fungicidal drugs, so-called antimycotics. They are available in various forms such as gels, sprays, ointments, powders, as creams or, if necessary, as tablets. For people who produce more foot sweat, a therapy with powders or gels is better to counteract the sweat.

On the other hand, a therapy with creams or ointments is useful for dry skin. To avoid foot contact, the anti-fungal sprays are suitable. The following agents are approved antimycotics: Depending on which drug is used here, the time until healing is determined.

The different drugs can be divided into groups: In addition, the drugs have their specific mode of action and form of administration, which will be explained in the following: If the fungus form should not be well-known usually an antimycotic is used, which works against several fungus forms. Therefore one calls these also broad spectrum antimycotics. Apart from the therapy it is besides important to prevent a further infection of the foot fungus on other persons, for this there are special preventive measures, which one can take, in order to protect itself and others durably against foot fungus.

Econazole
Itraconatol
Amorolfin
Miconazole
Bifonazole
Terbinafine
Clotrimazole
Group 1: Fungiostatic drugs: they inhibit the growth of the fungus and prevent it from spreading further. One of these drugs is Cotrimazol. As a rule, the medication should be used for about 3-4 weeks.
Group 2: Fungicidal drugs: here the growth is not inhibited, but the fungus is killed in a targeted manner.
This shortens the time of application until healing.
Terbinafine can be taken in the form of gels, sprays, creams and as tablets. By a certain mechanism with enzyme inhibition, the drug inhibits the formation of the fungal cell wall.
Itraconazole, on the other hand, can only be used in tablet form.
Cotrimazole also inhibits cell wall formation by inhibiting the production of ergosterol, which is essential for cell wall formation. The drug is available in the form of sprays, creams, powders and solutions.
Miconazole is also a drug that inhibits the formation of cell walls.
It can be used in the form of powders, solutions and creams.
Bifonazole inhibits cell wall production, it also stays on the skin longer and is good against inflammation.

Athlete’s foot, also called tinea pedis, is primarily treated with so-called antimycotics. These are active ingredients that can kill fungi in different ways. As a rule, so-called dermatophytes cause athlete’s foot.

These are filamentous fungi. One of the most common pathogens that belongs to the dermatophytes is Trichophyton rubrum. The therapy of the fungal infection is mostly local, i.e. ointments, powders or sprays are applied.

In the case of very therapy-resistant and severe infections, however, systemic therapy is also carried out, in which the drugs are administered orally or parenterally (as an infusion). In the following a few active ingredients are presented in more detail: 1. azoles 2. griseofulvin This drug is an active ingredient that is exclusively effective against dermatophytes. It is concentrated mainly in keratin-rich tissue and is therefore particularly effective against athlete’s foot and nail fungus.

The drug is also well tolerated by children. They receive 125 mg 1-3 times daily. For adults the daily dose is 500 mg.

It can be taken once in the morning as a tablet or divided into four single doses of 125 mg each. The maximum dose for adults is 1000 mg per day. Griseofulvin may also cause allergic reactions or gastrointestinal problems.

It is contraindicated in the early stages of pregnancy as it is too toxic for the embryo. It is also not to be used in cases of existing liver disease. It may interfere with the effect of the pill and is not prescribed as frequently in the current therapy.

3. allylamines Of the allylamines, the derivative Terbinafin is used in the internal treatment of athlete’s foot and nail fungus. Terbinafine blocks the cell wall structure of the dermatophytes and thus has an antimycotic effect. Adults receive 250 mg once daily for 4 – 6 weeks.

The active substance should not be taken by children, pregnant women and people with liver diseases. Known side effects include gastrointestinal complaints, headaches, blood count changes, liver dysfunction and very rarely skin reactions.

ItraconazoleThis active ingredient belongs to the subgroup of triazoles, which in turn belong to the superordinate group of azoles.
Azoles prevent the formation of the cell wall of fungi and thus have an antimycotic effect. Itraconazole is used in the case of failure of local therapy, very severe hyperkeratotic tinea pedis or insufficient effectiveness of local therapy. It is administered orally in the form of tablets.

The dosage is 100 mg daily for four weeks or 200 mg daily for seven days.
FluconazolThis active ingredient also belongs to the triazoles. Treatment with Fluconazole should not be less than six weeks for athlete’s foot. Adults receive a daily dose of 50 mg.
Side effects of AzoleAzoles may cause allergic reactions as well as gastrointestinal complaints and liver dysfunction.
They are contraindicated during pregnancy and should be avoided while breast-feeding.

There are active ingredients that are applied in the form of ointments, gels, creams and powders. This application is called topical. There are also different active ingredients.

First of all, the azoles are also used here. The representatives clotrimazole, miconazole, econazole, bifonazole, sertaconazole and tioconazole are usually available as ointments as well as shower gels or liquids for direct application. The form of application may differ depending on the manufacturer.

Allylamines such as Naftifin and Terbinafin as well as morpholines such as Amorolfin are also approved for topical application. Mopholines inhibit the cell wall synthesis of fungi just like allylamines. Last but not least there are hydroxypyridones like ciclopiroxolamine, which also interacts with the cell wall of the fungi and is quite well tolerated.

Most of these active ingredients need a certain amount of time before they show their effect, as they affect fungi that are in the growth phase. It is therefore essential that the therapy is carried out continuously and for a long time. The treatment of athlete’s foot should therefore usually be continued for about 3-4 weeks beyond the clinical cure, i.e. beyond the absence of symptoms.

This is the only way to ensure that the entire fungus is eliminated. With Terbinafine-containing ointments and creams, the complete fungus seems to be eliminated after only 7 days.However, the individual concentration and duration of treatment is determined by the treating physician in each individual case. Among other things, it depends on the extent and severity of the fungal infestation.

It is recommended to disinfect worn socks and shoes to prevent a recurring infection. Sprays for the treatment of athlete’s foot can be obtained without prescription from the pharmacy and can be used at home without any problems. There are a number of substances, so-called antimycotics (anti-fungal agents), which can be contained in these sprays.

Clotrimazole or bifonazole are used particularly frequently against fungi. The spray should then be applied twice daily for about three to four weeks. The newer active substance Terbinafin, on the other hand, only needs to be applied once a day for one week.

If you use a spray to treat athlete’s foot, you should wash your feet before use and then dry them thoroughly. Then spray the affected areas and the adjacent skin with the spray so that they are well moistened. It is not necessary to rub the spray additionally into the skin.

Since the spray is absorbed quickly, you can put on socks and/or shoes again relatively immediately after use. It is important to carry out the treatment consistently, even when the symptoms have apparently disappeared, to prevent the infection from “flaring up” again. There are various companies that produce sprays to combat athlete’s foot.

These include Lamisil, Scholl, Efasit and Canesten®. Before using a spray for the first time, you should read the package instructions thoroughly and/or consult your doctor or pharmacist. The main advantage over a cream for athlete’s foot is that the spray is practical when you are on the move.

In contrast to a tube, the spray cannot be crushed or leak in its packaging. Furthermore, by simply spraying it onto the affected areas, it can be applied without the hands coming into contact with the product. Older or immobile people also benefit from the spray variant, as it is not necessary to reach the affected areas on the feet directly.

Through self-therapy, about 70% of all athlete’s foot fungi can be successfully treated. However, if the symptoms do not improve, it is in any case necessary to consult a doctor. Athlete’s foot can of course occur during pregnancy in the same way as usual.

It can be favored by too tight shoes and increased sweating. To prevent this, pregnant women should always wear dry shoes and clean their feet sufficiently. If it should have happened nevertheless and you have become infected, there are some special features in the therapy that should be considered.

Many antimycotics are contraindicated during pregnancy and should be avoided while breastfeeding. These include the triazole itraconazole and the allylamines terbinafine and naftifine. Griseofulvin should not be used in the early stages of pregnancy as it damages the embryo and may cause mutations.

There is often a lack of sufficient experience to be able to make accurate statements about tolerance. As a rule, pregnant women are recommended to use over-the-counter ointments, creams, solutions, sprays and powders containing the active ingredient clotrimazole. Here too, however, they should not be used for more than two weeks.

Caution is also advised in the first third of pregnancy. Nevertheless, Clotrimazol is the product of choice for treating athlete’s foot infections during and after pregnancy. However, it is best to consult a doctor if you are uncertain about the therapy.