Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

What Is Athlete’s Foot?

Tinea pedis — athlete’s foot — is a superficial fungal infection of the skin of the foot caused by dermatophyte fungi, most commonly Trichophyton rubrum and Trichophyton mentagrophytes. Despite its name, athlete’s foot affects people of all activity levels and ages. The fungus thrives in warm, moist environments and is spread through contact with contaminated surfaces — pool decks, locker room floors, shower stalls, and shared footwear. Foot hygiene habits, footwear choices, and immune status all influence susceptibility.

Types of Athlete’s Foot and Their Appearances

Interdigital (between the toes): The most common form. Begins in the fourth web space (between the fourth and fifth toes) and spreads. Skin is macerated (white and soft), cracked, itchy, and malodorous. Chronic maceration can allow bacterial superinfection. Moccasin pattern: A chronic, low-grade infection that covers the plantar surface and sides of the foot in a moccasin distribution. Skin appears dry, scaly, and thickened — often mistaken for dry skin or psoriasis. Vesicular (blistering): An acute inflammatory response, often related to T. mentagrophytes. Small, intensely itchy blisters on the arch and lateral foot. Ulcerative: The most severe form, with rapidly spreading ulceration between the toes — often with concurrent bacterial infection. Requires urgent treatment.

Effective Treatment

Mild to moderate interdigital athlete’s foot responds well to over-the-counter topical antifungals — terbinafine (Lamisil AT) or clotrimazole (Lotrimin) applied twice daily for 1–4 weeks. Apply to the entire foot, not just visibly affected areas. Continue treatment for one week after symptoms resolve to prevent recurrence. Tolnaftate (Tinactin) is effective for prevention but less effective for active infection. Prescription-strength topical antifungals (econazole, ciclopirox) treat resistant cases. Moccasin-type athlete’s foot requires oral terbinafine for 2–4 weeks to penetrate the thickened skin. Vesicular athlete’s foot benefits from drying agents (aluminum acetate soaks) during the acute blistering phase, followed by antifungals.

When Oral Antifungals Are Necessary

Widespread, chronic, or recurrent athlete’s foot; concurrent toenail fungus (which re-infects the skin continuously); immunocompromised patients; and cases that fail topical treatment all warrant oral antifungal therapy. Terbinafine 250 mg daily for 2 weeks is highly effective. Itraconazole is an alternative. Bacterial superinfection (indicated by increasing pain, purulent discharge, and warmth) requires concurrent antibiotic therapy — often seen in the ulcerative form and in diabetic patients.

Prevention: Breaking the Cycle of Reinfection

Athlete’s foot recurs readily without preventive measures. Dry feet completely after bathing — especially between toes. Apply antifungal powder to shoes daily, particularly athletic footwear that becomes wet with perspiration. Wear moisture-wicking socks and change them daily (or more frequently for athletes). Wear sandals in communal showers, pool decks, and locker rooms. Replace old shoes that harbor fungal spores. Alternate footwear daily to allow drying. Treat concurrent nail fungus to eliminate the reservoir of skin reinfection. With consistent prevention, recurrence rates drop dramatically.

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Persistent Athletes Foot That Keeps Coming Back?

Athletes foot (tinea pedis) is the most common fungal skin infection, but chronic or recurrent cases may indicate an underlying issue like immune compromise, diabetes, or a resistant fungal strain. A podiatrist can identify the specific organism and prescribe targeted treatment.

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Clinical References

1. Hainer BL. Dermatophyte infections. American Family Physician. 2003;67(1):101-108.
2. Gupta AK, et al. Tinea pedis. Dermatologic Clinics. 2003;21(3):431-444.
3. Elewski BE, et al. Tinea pedis and tinea manuum. Dermatology. 2002;204(suppl 1):7-11.

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Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.