The treatment of athlete’s foot

Synonyms in a broader sense

Tinea pedis, tinea pedum, foot mycosis, athlete’s foot, dermatophyte infection of the foot spelling: athlete`s footFor the treatment of fungal diseases of the skin (athlete`s foot), so-called antimycotics, i.e. anti-fungal agents similar to antibiotics, are usually used. These should kill the fungi. If the skin areas are acutely inflamed, the inflammation should first be treated with moist compresses or soothing skin lotions without antimycotic agents, such as Oleum Zinci Oxid, i.e. zinc oxide oil, until the inflammation has healed.

Afterwards, an antimycotic adequate to the skin condition can be used. If the fungus should be treated rather acutely, creams are used, in case of dry scaling rather ointments. The fungus in the interdigits of the toes is treated with solutions after removing the scales.

These local therapies must be continued continuously for about four weeks. Treatment should also be continued beyond a definite cure in order to eliminate all fungi. Furthermore, a distinction can be made between local (creams, ointments) and systemic (drops, tablets) treatment, which can act on the whole body.

The main criterion for the selection of the drug, apart from the pathogen detection, is the relationship between efficacy and tolerability. For the therapy of athlete’s foot there are different creams with different active ingredients. One of the best known is probably Canesten®, which contains the active ingredient clotrimazole.

A further frequently used cream for athlete’s foot is Daktar® cream, which contains the active ingredient miconazole. There are many other anti-fungal creams that can combat athlete’s foot through various antimycotic active ingredients. In general, most creams have to be generously applied twice a day on the athlete’s foot for about 2 weeks.

Which cream is best suited when should be decided by the treating physician. In addition to local therapy with creams or home remedies, athlete’s foot can also be treated with medication in tablet form (so-called systemic antimycotics) if it is persistent and spreads over a large area. The decision which remedy to choose for treatment should be made by the treating physician.

In general, this form is only chosen if the athlete’s foot could not be successfully treated with creams or if there is a risk of superinfection (infection of the athlete’s foot wound with other dangerous germs such as bacteria). There are also different active agents (e.g. griseofulvin, itraconazole, fluconazole, terbinafine) in the drug therapy, which are administered individually. These are usually taken by mouth in the form of tablets.

These are griseofulvin, a narrow-spectrum antifungal, which can be used from the age of 1 year. Often a treatment lasting several weeks is sufficient, but in the case of the excessively keratinizing athlete’s foot (hyperkeratosis) the medication must be used for months. It is very well tolerated, but must not be used during pregnancy and can be accompanied by nausea and headaches.

The azoles can also be used systemically. Itraconazole and Fluconazole are used in adults if they do not respond to local therapy. It should be used for two to four and seven weeks, respectively. Again, pregnancy is not allowed and nausea and headache may occur. Furthermore, the drug Terbinafine can also be used systemically if the disease does not heal with local therapy.