Athlete's foot was first medically described in 1908.[9] Globally, athlete's foot affects about 15% of the population.[2] Males are more often affected than females.[4] It occurs most frequently in older children or younger adults.[4] Historically it is believed to have been a rare condition, that became more frequent in the 1900s due to the greater use of shoes, health clubs, war, and travel.[10]

Athlete’s foot appears as a scaly red rash on the bottoms or sides of the feet often accompanied by itching, dry or cracked skin, stinging, and odor. You can also have moist, raw skin between your toes. Though athlete’s foot is fairly easy to treat with over-the-counter anti-fungal creams or sprays, this foot fungus is quite contagious and may easily spread to your toenails.

If the fungal infection has spread to the toenails, the nails must also be treated to avoid reinfection of the feet. Often, the nails are initially ignored only to find the athlete's foot keeps recurring. It is important to treat all of the visible fungus at the same time. Effective nail fungus treatment may be more intensive and require prolonged courses (three to four months) of oral antifungal medications.
One of the best remedies for toenail fungus, apple cider vinegar can be used topically, internally, or both. Mix one part ACV and one part Epsom salts with six parts hot water.  Let the water cool so that it is still warm to the touch, but not so hot as to be damaging to your skin.  Soak feet up to twice daily for at least thirty minutes to kill fungus.  Mix two tablespoons of organic apple cider vinegar with eight ounces of warm water and add a teaspoon of honey to sweeten the beverage.

Oral antifungal therapy has a high cure rate, depending on the medication. It can take nine to 12 months to see if it has worked or not, because that is how long it takes for the nail to grow out. Even when therapy works, the fungus may come back. Currently, an oral antifungal therapy is considered the best treatment for toenail fungus because of higher cure rates and shorter treatment duration compared to topical therapy.

Griseofulvin (Gris-Peg, Grifulvin V, Griseofulvin Ultramicrosize) is an antibiotic prescribed to treat fungal infections such as ringworm of the body, athlete's foot, barber's itch, and fungal or ringworm of the nails. Side effects, drug interactions, dosing, storage, and pregnancy and breastfeeding information should be reviewed prior to taking this medication.

Physical exam alone has been shown to be an unreliable method of diagnosing fungal nails. There are many conditions that can make nails look damaged, so even doctors have a difficult time. In fact, studies have found that only about 50% of cases of abnormal nail appearance were caused by fungus. Therefore, laboratory testing is almost always indicated. Some insurance companies may even ask for a laboratory test confirmation of the diagnosis in order for antifungal medicine to be covered. A nail sample is obtained either by clipping the toenail or by drilling a hole in the nail. That piece of nail is sent to a lab where it can by stained, cultured, or tested by PCR (to identify the genetic material of the organisms) to identify the presence of fungus. Staining and culturing can take up to six weeks to get a result, but PCR to identify the fungal genetic material, if available, can be done in about one day. However, this test is not widely used due to its high cost. If a negative biopsy result is accompanied by high clinical suspicion, such as nails that are ragged, discolored, thickened, and crumbly, it warrants a repeat test due to the prevalence of false-negative results in these tests.


What you need to know about fungal infections Some fungi occur naturally in the body, and they can be helpful or harmful. An infection occurs when an invasive fungus becomes too much for the immune system to handle. We describe the most common types, including yeast infection, jock itch, and ringworm. Here, learn about risk factors and the range of treatments. Read now
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