Allylamines such as terbinafine are considered more efficacious than azoles for the treatment of athletes foot.Severe or prolonged fungal skin infections may require treatment with oral antifungal medication. Topical treatments
There are many topical antifungal drugs useful in the treatment of athletes foot including: miconazole nitrate, clotrimazole, tolnaftate (a synthetic thiocarbamate), terbinafine hydrochloride, butenafine hydrochloride and undecylenic acid. The fungal infection may be treated with topical antifungal agents, which can take the form of a spray, powder, cream, or gel. Topical application of an antifungal cream such as butenafine once daily for one week or terbinafine once daily for two weeks is effective in most cases of athletes foot and is more effective than application of miconazole or clotrimazole. Plantar-type athletes foot is more resistant to topical treatments due to the presence of thickened hyperkeratotic skin on the sole of the foot. Keratolytic and humectant medications such as urea, salicyclic acid (Whitfields ointment), and lactic acid are useful adjunct medications and improve penetration of antifungal agents into the thickened skin. Topical glucocorticoids are sometimes prescribed to alleviate inflammation and itching associated with the infection.A solution of 1% potassium permanganate dissolved in hot water is an alternative to antifungal drugs. Potassium permanganate is a salt and a strong oxidizing agent. Oral treatments
For severe or refractory cases of athletes foot oral terbinafine is more effective than griseofulvin. Fluconazole or itraconazole may also be taken orally for severe athletes foot infections. The most commonly reported adverse effect from these medications is gastrointestinal upset.
Some individuals may experience an allergic response to the fungus called an id reaction in which blisters or vesicles can appear in areas such as the hands, chest, and arms. Treatment of the underlying infection typically results in the disappearance of the id reaction. Causes
Athletes foot is a form of dermatophytosis (fungal infection of the skin), caused by dermatophytes, fungi (most of which are mold) which inhabit dead layers of skin and digest keratin. Dermatophytes are anthropophilic, meaning these parasitic fungi prefer human hosts. Athletes foot is most commonly caused by the molds known as Trichophyton rubrum and T. mentagrophytes, but may also be caused by Epidermophyton floccosum. Most cases of athletes foot in the general population are caused by T. rubrum; however, the majority of athletes foot cases in athletes are caused by T. mentagrophytes. Transmission
According to the UKs National Health Service, "Athletes foot is very contagious and can be spread through direct and indirect contact." The disease may spread to others directly when they touch the infection. People can contract the disease indirectly by coming into contact with contaminated items (clothes, towels, etc.) or surfaces (such as bathroom, shower, or locker room floors). The fungi that cause athletes foot can easily spread to ones environment. Fungi rub off of fingers and bare feet, but also travel on the dead skin cells that continually fall off the body.