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Clinician’s Corner: Athlete’s Foot

Athlete’s feet is usually treated topically due to decreased side effects of this route of administration. It is the most common skin fungus infection, affecting up to 70% of adults. Infection is usually acquired by means of direct contact with the fungus as may occur by walking barefoot in locker rooms or swimming pool facilities.

If unchecked, osteomyelitis (bone infection) can result from athletes feet.  These complications are seen more frequently in patients with diabetes.  Diabetics should check their feet every day with a mirror, and look between the toes for signs of athlete’s feet. The cracks between the toes can serve as a major port of entry for Staph aureus, the major cause of osteomyelitis in patients with diabetes, which may lead to amputation.


  • Terbinafine (Lamisil cream):
    • Mechanism- inhibits squalene epoxidase, thus weakening the fungal cell wall
    • For tinea pedis apply twice a day x 7 day. 2 weeks on bottom/sides of feet.
  • Miconazole (Micatin) or Clotrimazole (Lotrimin):
    • Mechanism- inhibits ergosterol synthesis.
    • Apply twice daily for 4 weeks.
    • Any of the OTC or Rx azole antifungals are equally effective

Unfortunately, athlete’s feet symptoms may linger for up to 4 weeks. Because 70% of athletes feet cases will come back,   use these prevention tips:

  • Patients should be advised to wear open footwear such as sandals as frequently as possible, but especially in the summer.
  • Wash socks after each wearing in the hot cycle of the washer and dried in the hot cycle of the dryer before wearing again. Athletic shoes also may be sprayed with disinfectants and/or treated with bleach to destroy fungi.
  • During the bath or shower, patients must wash the feet and toes carefully each day. Patients should be taught to dry the feet thoroughly after each bath or shower, paying closer attention to the interdigital spaces.
  • Wait for 10 to 15 minutes after bathing to don socks and shoes to help the feet dry. The goal is to have the feet completely dry other than when bathing.

What socks are best??

Wool socks:  If your feet are often cold, like here in Central Pennsylvania, wool socks may be a better fit. Wool fibers both repels water and absorbs water. In fact, they – wool fibers – can absorb up to 1/3 of their own weight in moisture before feeling “wet”. Merino wool is less like to be itchy. Merino wool socks are more expensive, it is best not to machine wash wool socks. The outer layer of wool fiber have anti-bacterial properties, and reduce foot odor.

Cotton socks: less itchy, and absorb moisture, saturate quickly and dry slowly.  Are cooler on the feet and are machine washable.  When cotton socks get damp/wet they will continue to feel cold and damp, which wetness and increased friction may enhance blister formation.

Feel free to consult with your Thompson Pharmacist about athlete’s feet treatment.  Go ahead and ASK!  At Thompson Pharmacy, it’s all for YOU.