Athlete's foot and fungal skin infections explained

What athlete's foot is

Athlete's foot is caused by microscopic fungi called dermatophytes that feed on keratin, the protein in the outer layer of skin. They love warm, damp, enclosed conditions — exactly what sweaty feet inside shoes provide. The infection usually starts in the moist skin between the toes, most often the little toes, causing itching, a red or cracked, soggy or flaky appearance, and sometimes a stinging soreness. It can spread to the soles and sides of the feet and, if scratched, to other parts of the body such as the hands or groin. It is easily picked up in shared damp spaces like changing rooms, swimming pool surrounds and communal showers, where the fungus survives on wet floors.

The wider family of fungal infections

The same fungi cause several related infections that look different depending on where they land. Ringworm is a fungal infection of the body's skin that forms a red, scaly, ring-shaped patch that is often itchy and clears in the centre as it spreads outward — despite the name, no worm is involved. Fungal infection of the groin (sometimes called jock itch) causes an itchy, red rash in the skin folds and is common in people who sweat a lot. Fungal nail infections make nails thickened, discoloured and crumbly and are much harder to treat than skin infections. Recognising these as the same underlying problem helps, because they respond to similar antifungal treatments and can spread from one site to another.

Treatment from the pharmacy

Most fungal skin infections can be treated effectively with antifungal creams, sprays, gels or powders bought from a pharmacy, and a pharmacist can recommend a suitable product. Treatment is applied to the affected skin and usually continued for a period after the rash looks better, to make sure the fungus is fully cleared and to reduce the chance of it coming back — stopping too soon is a common reason for relapse. It is important to keep treating the whole affected area, not just the itchiest part. Fungal nail infections are different: they often need a long course of an antifungal treatment and are best assessed by a clinician, as over-the-counter creams alone rarely clear them.

Self-care and prevention

Good foot care both speeds recovery and prevents recurrence. Wash and, importantly, thoroughly dry the feet, especially between the toes, every day. Change socks regularly, choose breathable footwear, and avoid wearing the same shoes two days running so they can dry out. Do not share towels, and dry your feet last after a shower to avoid spreading the fungus to other body areas. In communal changing rooms and pool areas, wearing flip-flops reduces the risk of picking it up. Because the fungus can live in socks and shoes, keeping them clean and dry helps stop reinfection. These simple habits make a real difference for people prone to repeated bouts.

When to see a GP

Most fungal skin infections clear with pharmacy treatment, but some situations warrant a GP. See a clinician if the infection does not improve after treatment, keeps coming back, is very widespread or severe, or if you are not sure it is fungal, as other skin conditions such as eczema can look similar. People with diabetes should be more cautious with any foot problem, because they are at higher risk of complications and skin breaks can let in more serious infection — a fungal foot infection in someone with diabetes is worth getting checked. Also seek advice if the skin becomes hot, swollen, increasingly painful or oozing pus, which can mean a bacterial infection has developed on top and may need different treatment.