Table of ContentsView AllTable of ContentsSymptomsTypesRisk FactorsDiagnosisTreatmentPreventionComplicationsWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Symptoms
Types
Risk Factors
Diagnosis
Treatment
Prevention
Complications
When to See a Provider
When athlete’s foot turns severe, it can move beyond the toes and involve the entire foot or cause itchy blisters (vesicles) or pitted sores (ulcers).
This article describes the symptoms and causes of severe athlete’s foot, including the risk factors and possible complications. It also explains how severe athlete’s foot is diagnosed and treated and when to see a healthcare provider.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet and © Raimo Suhonenwww.dermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet and © Raimo Suhonenwww.dermnetnz.org2023.
Symptoms of Severe Athlete’s Foot
Athlete’s foot commonly affects the spaces between the toes, a condition referred to as interdigital athlete’s foot.Symptoms may be mild and sometimes barely recognizable. At other times, the symptoms will be more overt and cause:
When the condition turns severe it can cause:
Athlete’s foot is highly contagious and can be spread through direct contact with infected skin or indirect contact with contaminated items (such as clothing or towels) or surfaces (such as locker room floors or shower stalls).
Types of Athlete’s Foot
But, there are two other subtypes that can cause more severe symptoms and be less likely to resolve without extensive treatment. These are largely regarded as severe athlete’s foot.
Plantar Athlete’s Foot
Plantar athlete’s foot cause fine, dry, silvery scales and the progressive thickening of the skin of the sole. Over time, the skin can crack and peel, exposing red, raw skin.
The infection can even sometimes spread to the hand with scratching and then to the opposite foot. The usual pattern of infection is two feet and one hand, or one foot and two hands. Less commonly, this infection can spread to other areas of the body.
Acute Vesicular Athlete’s Foot
One of the contributing factors to this type of infection is persistently moist feet. Historically, it was known as “jungle rot” as it affected soldiers fighting in moist, tropical conditions.
A severe form of vesicular athlete’s foot is calledacute vesiculobullousathlete’s foot because it causes larger blisters (bullae) that can burst and form pitted, painful ulcers.
Risk Factors for Severe Athlete’s Foot
Athlete’s foot can affect anyone, but there are several risk factors that can predispose you to the infection including:
Risk factors for severe athlete’s foot include:
Athlete’s foot affects about 15% of adults and is more common in males than females.
How Is Severe Athlete’s Foot Diagnosed?
Athlete’s foot can often be diagnosed with a physical examination alone. Laboratory tests may be used to rule out other possible causes or identify the specific fungal strain (particularly when a severe infection does not respond to standard treatments).
Physical Exam
For the physical exam, your healthcare provider will ask you about your symptoms, how long you’ve had them, and whether you have predisposing factors. Your healthcare provider will then visually inspect your feet, as well as other areas of your skin.
KOH Test
You might also have aKOH test. This is a painless procedure in which a skin scraping is taken from scales, a rash, or a blister for rapid testing.
A positive KOH test confirms the presence of skin-associated fungi (referred to as adermatophyte). A negative KOH test does not rule out athlete’s foot as the fungi can be difficult to isolate, particularly with interdigital athlete’s foot.
Fungal Culture
A fungal culture is a more specific test in which the scraping is sent to the lab to physically “grow” the fungus. This culture takes several days to grow but can identify the specific type and strain of dermatophyte.
If another cause of your foot symptoms is suspected—such as a bacterial infection, poison ivy, or vascular disease—you may undergo additional testing.
How Athlete’s Foot Is Treated
Even severe athlete’s foot can be cured with the right treatment plan. It will ultimately involve medical treatment along with some lifestyle adjustments.
The treatment plan may include:
Home remedies, such as washing your feet in a vinegar solution, can also be helpful when used along with antifungal medication but are not curative.
Medication for Athlete’s Foot
How to Prevent Severe Athlete’s Foot
Even if you have predisposing factors for athlete’s foot, there are things you can do to effectively avoid getting infected:
Complications if Left Untreated
The main complication of severe athlete’s foot is asecondary bacterial infection. This occurs when the fungal infection causes a break in the skin that allows bacteria easy access to the underlying tissues. Common bacterial agents includeStaphylococcal aureusandStreptococcus pyogenes,both of which reside on the skin.
A secondary bacterial infection can lead to a potentially serious superficial infection calledcellulitis. On rare occasions, the infection can spread to the bloodstream and trigger a potentially life-threatening reaction known assepsis.
A less serious but potentially more persistent complication is a fungal nail infection (onychomycosis). Also known astinea unguium, the infections are notoriously difficult to treat and can lead to cracking, pitting, discoloration, and the eventual shedding of the nail from the nail bed.
Early-Stage Toenail Fungus Symptoms and Treatment
When to See a Healthcare Provider
The first rule of thumb is to see a healthcare provider when athlete’s foot fails to respond to over-the-counter antifungals after four weeks of consistent use.
Seek immediate medical treatment if there are signs of severe bacterial infection, including:
Summary
Severe athlete’s foot can occur if the fungal infection involves more than the toes and fails to respond to standard antifungal treatment. This includes plantar athlete’s foot (a.k.a. “mocassin shoe”) which involves the entire sole of the foot and acute vesicular athlete’s foot which causes painful blisters and sores on the foot.
Risk factors for severe athlete’s foot include diabetes, having a compromised immune system, and failing to treat (or failing to respond to) antifungal therapy. The treatment of severe athlete’s foot may require lifestyle changes and oral antifungals like itraconazole and terbinafine.
The 9 Best Athlete’s Foot Treatments to Soothe Your Feet
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ilkit M, Durdu M.Tinea pedis: The etiology and global epidemiology of a common fungal infection.Crit Rev Microbiol.2015;41(3):374-88. doi:10.3109/1040841X.2013.856853Ward H, Parkes N, Smith C, Kluzek S, Pearson R.Consensus for the treatment of tinea pedis: a systematic review of randomised controlled trials.J Fungi (Basel).2022 Apr;8(4):351. doi:10.3390/jof8040351Kong QT, Du X, Yang R, Huang SY, Sang H, Liu WD.Chronically recurrent and widespread tinea corporis due to Trichophyton rubrum in an immunocompetent patient.Mycopathologia.2015 Apr;179(3-4):293-7. doi:10.1007/s11046-014-9834-5Newland JG, Abdel-Rahman SM.Update on terbinafine with a focus on dermatophytoses.Clin Cosmet Investig Dermatol. 2009;2:49–63. Published 2009 Apr 21. doi:10.2147/ccid.s3690Lestner J, Hope WW.Itraconazole: an update on pharmacology and clinical use for treatment of invasive and allergic fungal infections.Expert Opin Drug Metab Toxicol. 2013 Jul;9(7):911-26. doi:10.1517/17425255.2013.794785Kara Polat A, Akın Belli A, Göre Karaali M, Koku Aksu AE.The attitudes, behaviors, and opinions about non-pharmacological agents in patients with tinea pedis.Dermatol Ther.2020 Nov;33(6):e14041. doi:10.1111/dth.14041Karaman BF, Topal SG, Aksungur VL, Ünal İ, İlkit M.Successive potassium hydroxide testing for improved diagnosis of tinea pedis.Cutis.2017 Aug;100(2):110-114. PMID: 28961287.Centers for Disease Control and Prevention.Hygiene related diseases: athlete’s foot (tinea pedis).Jimenez-Garcia L, Celis-Aguilar E, Díaz-Pavón G, et al.Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis. A randomized controlled clinical trial.Braz J Otorhinolaryngol.2020 May-Jun;86(3):300-307. doi:10.1016/j.bjorl.2018.12.007
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ilkit M, Durdu M.Tinea pedis: The etiology and global epidemiology of a common fungal infection.Crit Rev Microbiol.2015;41(3):374-88. doi:10.3109/1040841X.2013.856853Ward H, Parkes N, Smith C, Kluzek S, Pearson R.Consensus for the treatment of tinea pedis: a systematic review of randomised controlled trials.J Fungi (Basel).2022 Apr;8(4):351. doi:10.3390/jof8040351Kong QT, Du X, Yang R, Huang SY, Sang H, Liu WD.Chronically recurrent and widespread tinea corporis due to Trichophyton rubrum in an immunocompetent patient.Mycopathologia.2015 Apr;179(3-4):293-7. doi:10.1007/s11046-014-9834-5Newland JG, Abdel-Rahman SM.Update on terbinafine with a focus on dermatophytoses.Clin Cosmet Investig Dermatol. 2009;2:49–63. Published 2009 Apr 21. doi:10.2147/ccid.s3690Lestner J, Hope WW.Itraconazole: an update on pharmacology and clinical use for treatment of invasive and allergic fungal infections.Expert Opin Drug Metab Toxicol. 2013 Jul;9(7):911-26. doi:10.1517/17425255.2013.794785Kara Polat A, Akın Belli A, Göre Karaali M, Koku Aksu AE.The attitudes, behaviors, and opinions about non-pharmacological agents in patients with tinea pedis.Dermatol Ther.2020 Nov;33(6):e14041. doi:10.1111/dth.14041Karaman BF, Topal SG, Aksungur VL, Ünal İ, İlkit M.Successive potassium hydroxide testing for improved diagnosis of tinea pedis.Cutis.2017 Aug;100(2):110-114. PMID: 28961287.Centers for Disease Control and Prevention.Hygiene related diseases: athlete’s foot (tinea pedis).Jimenez-Garcia L, Celis-Aguilar E, Díaz-Pavón G, et al.Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis. A randomized controlled clinical trial.Braz J Otorhinolaryngol.2020 May-Jun;86(3):300-307. doi:10.1016/j.bjorl.2018.12.007
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ilkit M, Durdu M.Tinea pedis: The etiology and global epidemiology of a common fungal infection.Crit Rev Microbiol.2015;41(3):374-88. doi:10.3109/1040841X.2013.856853Ward H, Parkes N, Smith C, Kluzek S, Pearson R.Consensus for the treatment of tinea pedis: a systematic review of randomised controlled trials.J Fungi (Basel).2022 Apr;8(4):351. doi:10.3390/jof8040351Kong QT, Du X, Yang R, Huang SY, Sang H, Liu WD.Chronically recurrent and widespread tinea corporis due to Trichophyton rubrum in an immunocompetent patient.Mycopathologia.2015 Apr;179(3-4):293-7. doi:10.1007/s11046-014-9834-5Newland JG, Abdel-Rahman SM.Update on terbinafine with a focus on dermatophytoses.Clin Cosmet Investig Dermatol. 2009;2:49–63. Published 2009 Apr 21. doi:10.2147/ccid.s3690Lestner J, Hope WW.Itraconazole: an update on pharmacology and clinical use for treatment of invasive and allergic fungal infections.Expert Opin Drug Metab Toxicol. 2013 Jul;9(7):911-26. doi:10.1517/17425255.2013.794785Kara Polat A, Akın Belli A, Göre Karaali M, Koku Aksu AE.The attitudes, behaviors, and opinions about non-pharmacological agents in patients with tinea pedis.Dermatol Ther.2020 Nov;33(6):e14041. doi:10.1111/dth.14041Karaman BF, Topal SG, Aksungur VL, Ünal İ, İlkit M.Successive potassium hydroxide testing for improved diagnosis of tinea pedis.Cutis.2017 Aug;100(2):110-114. PMID: 28961287.Centers for Disease Control and Prevention.Hygiene related diseases: athlete’s foot (tinea pedis).Jimenez-Garcia L, Celis-Aguilar E, Díaz-Pavón G, et al.Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis. A randomized controlled clinical trial.Braz J Otorhinolaryngol.2020 May-Jun;86(3):300-307. doi:10.1016/j.bjorl.2018.12.007
Ilkit M, Durdu M.Tinea pedis: The etiology and global epidemiology of a common fungal infection.Crit Rev Microbiol.2015;41(3):374-88. doi:10.3109/1040841X.2013.856853
Ward H, Parkes N, Smith C, Kluzek S, Pearson R.Consensus for the treatment of tinea pedis: a systematic review of randomised controlled trials.J Fungi (Basel).2022 Apr;8(4):351. doi:10.3390/jof8040351
Kong QT, Du X, Yang R, Huang SY, Sang H, Liu WD.Chronically recurrent and widespread tinea corporis due to Trichophyton rubrum in an immunocompetent patient.Mycopathologia.2015 Apr;179(3-4):293-7. doi:10.1007/s11046-014-9834-5
Newland JG, Abdel-Rahman SM.Update on terbinafine with a focus on dermatophytoses.Clin Cosmet Investig Dermatol. 2009;2:49–63. Published 2009 Apr 21. doi:10.2147/ccid.s3690
Lestner J, Hope WW.Itraconazole: an update on pharmacology and clinical use for treatment of invasive and allergic fungal infections.Expert Opin Drug Metab Toxicol. 2013 Jul;9(7):911-26. doi:10.1517/17425255.2013.794785
Kara Polat A, Akın Belli A, Göre Karaali M, Koku Aksu AE.The attitudes, behaviors, and opinions about non-pharmacological agents in patients with tinea pedis.Dermatol Ther.2020 Nov;33(6):e14041. doi:10.1111/dth.14041
Karaman BF, Topal SG, Aksungur VL, Ünal İ, İlkit M.Successive potassium hydroxide testing for improved diagnosis of tinea pedis.Cutis.2017 Aug;100(2):110-114. PMID: 28961287.
Centers for Disease Control and Prevention.Hygiene related diseases: athlete’s foot (tinea pedis).
Jimenez-Garcia L, Celis-Aguilar E, Díaz-Pavón G, et al.Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis. A randomized controlled clinical trial.Braz J Otorhinolaryngol.2020 May-Jun;86(3):300-307. doi:10.1016/j.bjorl.2018.12.007
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