Athlete's foot is a fungal infection of the skin which commonly occurs in between the toes of people with diabetes. It appears as a rash which may spread to the soles or borders of the feet. It is estimated that at any one time around 17% of adults in the UK have athlete's foot. Fungal infections also occur between the toes and in the toe nails.
This condition is caused by a fungus, which is a bit like the mould which grows on stale bread. The feet may be more susceptible to fungal infections because of the moist environment due to sweating or covered footwear. These micro-organisms thrive in warm, moist conditions. People with diabetes are more prone to developing athlete's foot.
There may be scaling, fissuring (cracks) and redness of the skin. The rash may be itchy. If not treated in time this may develop into a chronic infection. Small white or brown blisters may occur. The skin between the toes may look soggy and white. The heels may appear powdery and dry.
Topical (locally applied) anti fungal treatments are widely used. There is a range of powders, creams and ointments available. The powders have limited value in treating established infections though they may have a useful role in preventing re-infection. Creams work best but vary enormously in effectiveness. Check with your doctor or podiatrist.
There is no evidence that Oral treatments are more effective. They are useful for widespread conditions but are not recommended for mild cases. It is better to alter the environment so the fungi do not thrive and use a topical agent.
Dr Nishan Wijenaike, Consultant Physician
West Suffolk Hospital Diabetes Service