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What helps to get rid of athlete's foot?

Created: ; Last Update: June 14, 2018; Next update: 2021.

Athlete's foot is very common and usually doesn't cause any serious problems. But it can make skin itch, crack, and look unattractive. The fungus may spread to the nails, and sometimes to other areas of skin – although that rarely happens. The infection can usually be treated effectively with over-the-counter creams, gels or sprays from the pharmacy.

Athlete's foot fungi grow particularly well in the areas between our toes. It is often moist and warm there, and the skin on our feet also provides the fungus with nutrients to feed on. Topical (external) treatment such as creams or gels can usually successfully get rid of the infection. It's very rarely necessary to take tablets.

To prevent infection, it' s a good idea to wear flip-flops at the swimming pool or in the sauna. If you already have athlete's foot, you should change your socks and towels often, and wash them at 60 degrees Celsius or more. Paying close attention to hygiene also helps to stop others from being infected.

What medications are available for athlete's foot?

Creams, gels and sprays for fungal infections are available from pharmacies without a prescription. All of these products contain a drug that stops the growth of the fungus or kills it.

Many of the more commonly used products contain drugs known as allylamines or azoles.

  • The allylamines include terbinafine and naftifine.
  • The azoles include bifonazole, clotrimazole, miconazole and oxiconazole.

How are the treatments used?

Exactly how the treatment is used, and how long they have to be used for, depends on the product. Some products only need to be applied once a day, others have to be put on the affected skin twice a day. Most products have to be used for three to six weeks. Products that contain terbinafine are an exception. They often only have to be used once a day for one week.

You can find out exactly how to use the product by consulting your doctor, pharmacist or the package insert. It's important to continue the treatment as instructed, even if your skin looks healthy again.

How effective are these athlete's foot treatments?

Topical treatment is usually enough to get rid of athlete's foot. For example, studies on the effectiveness of allylamine products showed that, after six weeks,

  • athlete's foot had cleared up in 17 out of 100 people who didn't treat it,
  • and in 73 out of 100 people who used the medication.

In other words, treatment with an allylamine got rid of the fungal infection in about 56 out of 100 people. Terbinafine isn't less effective than other medications, even though it's used for just one week.

Azole medications are similarly effective.

The drugs that are used in topical medication for athlete's foot are well tolerated. They can cause slight reddening of the skin or a mild burning sensation, but other side effects are rare.

When are tablets considered?

Athlete's foot is nearly always treated topically. Tablets are only considered if topical treatment isn't successful. It may also be a good idea if the infection has spread to one or more toenails, or if the infection is very severe.

The tablets taken to treat athlete's foot generally contain the active ingredients itraconazole or terbinafine. Itraconazole is usually taken once daily for four weeks (dose: 100 mg). Terbinafine is typically taken once daily for two weeks (dose: 250 mg). The treatment lasts longer if you also have a fungal nail infection. This is true for both medications.

What disadvantages do the tablets have?

Tablets for fungal infections cause more side effects than topical medications do. The possible side effects of itraconazole include headaches, dizziness, gastrointestinal (stomach and bowel) problems and rashes. Terbinafine can cause gastrointestinal problems and a temporary loss of taste and smell. But these kinds of side effects didn't last long in the studies. Because both medications can interact with other drugs, it's important to let your doctor know about any other medication you are taking.

There's a very small risk of serious liver damage. For this reason, people with a liver disease are only given these medications if it’s absolutely necessary.

Can home remedies such as foot baths help?

Home remedies are sometimes recommended for the treatment of athlete's foot. Examples include herbal foot baths, or applying apple cider vinegar or tea tree oil. Studies on tea tree oil didn't prove that it was effective. No other home remedies have been tested in good-quality studies.

Sources

  • Crawford F, Young P, Godfrey C, Bell-Syer SE, Hart R, Brunt E et al. Oral treatments for toenail onychomycosis: a systematic review. Arch Dermatol 2002; 138(6): 811-816. [PubMed: 12056964]
  • Rotta I, Otuki MF, Sanches AC, Correr CJ. Efficacy of topical antifungal drugs in different dermatomycoses: a systematic review with meta-analysis. Rev Assoc Med Bras 2012; 58(3): 308-318. [PubMed: 22735222]
  • IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

© IQWiG (Institute for Quality and Efficiency in Health Care)
Bookshelf ID: NBK279548

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