The initial thought when someone mentions fungus might be, “you mean those mushrooms at the grocery store?” However if you ask a Chiropodist, they may tell you something different. Whether it’s yourself or someone that you know, fungal infections of the feet are fairly common and they can appear in different forms. This week we are going to talk about different types of fungus that exist on our feet, discuss their signs and symptoms, available treatments, and how to prevent infections.
What is fungus?
Fungi (plural) are organisms that present themselves in different forms and can live in different environments. These microorganisms can be found outdoor (on plants and in soil), indoor (on surfaces or circulating in our air), or on people (on the skin or inside the body). There are millions of different species of fungus present in the world, but only a few hundred are able to make us sick.
As a Chiropodist, we often see and treat a lot of people with fungus on their feet. Fungus on the feet can appear either on the skin or on the nail. So how or where do we even pick it up from? Fungus thrives in warm and moist environments such as the inside of shoes, pool decks, locker rooms, communal showers, etc. Individuals with excessively sweaty feet are also at a higher risk of developing these fungal foot conditions. Fungal particles can be contagious, and can be easily transferred between people through sharing of nail clippers or shoes. It’s no wonder fungal infections of the feet are so common.
Signs and symptoms:
Tinea pedis, better known as athlete’s foot, is a fungal infection of the skin on your feet. Typically someone with athlete’s foot will complain of burning, itchiness, redness, peeling, cracking and sometimes even blistering of the skin. Different types of athlete’s foot will present with different patterns and can appear on different areas of the foot.
For instance, interdigital athlete’s foot will appear in between the toes, and presents as red, inflamed, white and soggy. Fungus on the foot can also appear in a moccasin pattern. The involved skin will usually appear irritated, dry, itchy, and scaly. Often, this pattern can occupy the entire bottom and up the sides of the foot (like a moccasin!). A less common type called vesicular athlete’s foot causes sudden outbreak of fluid-filled blisters that will eventually dry out and cause scaling of the skin.
Nail fungus (also known as onychomycosis), on the other hand, will usually begin as a white or yellow spot under the toenail. If left untreated, the infection may further discolour the nail and may lead to thickening of the nail over time. The nail can also become brittle, crumbly and chalky. Nail fungus can develop in people of all age but those who are older are at a higher risk of contracting it.
Fungal infection of the skin is usually treated with a prescription of a topical antifungal. These topical medications will vary depending on where the fungus is located. Fungus on the skin will require an antifungal cream, whereas fungus between the toes will require an antifungal spray.
Nail fungus on the other hand is a little trickier to treat. Treatment can take multiple months or even years to resolve depending on the severity and the degree of nail involvement. These treatments usually involve growing out the fungal portion of nail. If you remember from my previous article, our toenails tend to grow around two millimeters a month. So the more infected the nail is, the longer it takes to grow out. Topical antifungals prescribed for nail fungus can either be an oil consistency or a nail polish consistency. The method of antifungal delivery is very important as the antifungal must be able to penetrate the hard exterior of the nail. Another treatment option is oral antifungals. Oral antifungals can only be prescribed by your family doctor as this treatment option requires strict monitoring of blood work. Oral antifungals can be hard on your liver, kidney and heart so not everyone is a suitable candidate.
So what are some ways that we can avoid contracting fungus on our feet? To begin with, foot hygiene and cleanliness is very important. Remembering to wear clean socks every day or switching into a new pair of socks throughout the day (especially if you sweat more) will help to reduce those fungal breeding grounds. While showering, remember to clean in between the toes using soap and most importantly, dry your feet properly using a towel afterwards. If you find yourself having difficulty reaching down to your feet, I would recommend spraying rubbing alcohol in between the toes to help dry out the area. Shoes are a prime breeding ground for fungus. It is important to wear socks with closed toe shoes. If you choose to wear closed toe shoes without socks on, make sure that you clean the insides of your shoes on a regular basis using rubbing alcohol or disinfectant wipes. Remember that nail fungus can be transferred between people so avoid sharing nail clippers and shoes with others.
Now what about nail salons, are they safe to go to? Transferring of fungus can be easily done without proper infection control measures. Nail salons that lack infection control and hygiene protocols can put you at risk of contracting fungus. It’s important to ask and observe the sterilization process of their instruments and tools as well as their cleaning protocols. A lot of people don’t think about it, but nail polish can be a prime location for fungus to be lurking around in. For these reasons, I wouldn’t recommend going to one as there can be many factors that could put you at risk. However, should you ever find yourself needing to visit a nail salon I would recommend bringing in your own instruments and nail polish for your own peace of mind.
I hope you were all able to learn a bit more about foot fungus this week!