Q: I live in my favorite pair of sneakers, but for the past few weeks they've
made my feet extremely itchy and red. I've tried several over-the-counter
hydrocortisone creams, but nothing seems to help. Now it's gotten so bad
that I can't wear my sneakers much at all, and when I do I'm constantly
slipping them off to scratch. Can you help me?
Dr. Donnica: It sounds as if you have a bad case of athlete's
foot, otherwise known as "tinea pedis." The main causes are occlusive
footwear (wearing footwear without absorbent socks) combined with sweating,
which provides the perfect growth environment for the responsible fungus. This
is an extremely common condition and not just among athletes. Estimates are
that 7 out of 10 adults will have athlete's foot at some point. It is
rare in prepubertal children, but becomes more common with increasing age.
The most common symptoms are itchiness, pain, and redness between the toes.
Athlete's foot may also cause scaly soles, painful fissures between the
toes, and less frequently may cause vesicular or ulcerative lesions. These fissures
or lesions become risk areas for secondary infection. Certain activities, such
as swimming and communal bathing, may also increase the risk of infection.
The good news is that athlete's foot is usually easily treated with
over-the-counter antifungal medications such as clotrimazole (Lotrimin™)
or tolnaftate (Tinactin). You may be actually making your condition worse with
hydrocortisone cream. These creams should be used sparingly but regularly, as
directed. An application the size of a chocolate chip should be adequate to
cover the entire bottom of your foot. Other tips in managing athlete's
foot: keep your feet clean and dry. Wear clean absorbent socks made of natural
fibers, such as cotton, and change them during the day if your feet become moist
or sweaty. Dusting the inside of your shoes and socks with talcum powder or
a medicated powder such as Desenex will help to decrease the moisture level.
Alternate wearing different pairs of shoes to allow them to dry out for a day
or two at a time. If using topical antifungal medications and following those
tips doesn't help clear up your infection with 7 days, ask your doctor
about prescribing an oral antifungal medication.
Created: 11/24/2004  - Donnica Moore, M.D.