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

Why Foot Hygiene Matters More Than Most People Realize

The feet are among the most infection-prone areas of the body, yet foot hygiene receives far less attention than hand hygiene in both public health messaging and individual daily routines. This neglect has consequences: athlete’s foot affects approximately 15–25% of the population at any given time; onychomycosis (fungal toenail infection) affects 10–12% of all adults and up to 50% of adults over age 70; plantar warts (verruca plantaris) are among the most common dermatological conditions seen in children and young adults. All three conditions share a critical characteristic: they are largely preventable with consistent, evidence-based foot hygiene practices.

Beyond these common infections, inadequate foot hygiene in patients with diabetes or peripheral vascular disease can directly contribute to wound complications that have life-altering consequences. Establishing good foot hygiene habits is a high-leverage health behavior with disproportionate benefits for foot health across the lifespan.

Daily Foot Washing Protocol

The feet should be washed daily with soap and warm water, with particular attention to the interdigital spaces (between the toes) — the warm, moist environment between the toes is the primary incubation site for tinea pedis (athlete’s foot). Many people wash their feet by allowing shower water to run over them without direct washing; this is insufficient to remove the skin scale, sweat residue, and microbial load that accumulates with daily activity. Use a washcloth or soft brush to actively clean the entire foot surface including the heel, arch, and all toe spaces.

Thorough drying is equally important. Pat — do not rub — the entire foot dry, paying meticulous attention to the interdigital spaces. Moisture left between the toes creates the ideal environment for dermatophyte fungal growth. A hairdryer on a low setting can assist with drying in patients who have difficulty toweling between toes due to toe deformity or limited flexibility.

Preventing Athlete’s Foot (Tinea Pedis)

Tinea pedis is a highly contagious superficial fungal infection caused primarily by Trichophyton rubrum and Trichophyton mentagrophytes. The fungi thrive in warm, moist environments and spread through direct contact with contaminated surfaces. Prevention focuses on disrupting transmission at these surfaces:

• Never walk barefoot in public areas where fungal contamination is likely: locker rooms, pool decks, gym showers, hotel bathrooms. Flip-flops or shower sandals are essential in these environments.
• Change socks daily — more frequently if feet perspire heavily. Moisture-wicking synthetic or wool socks reduce the duration of foot moisture exposure compared to cotton, which retains moisture.
• Alternate footwear to allow drying. Shoes worn daily accumulate significant moisture; rotating between two pairs of shoes allows each to dry thoroughly between uses.
• Apply antifungal powder (miconazole, clotrimazole, or tolnaftate) to shoes and socks if prone to recurrent tinea pedis.
• Treat active tinea pedis promptly — both to relieve symptoms and to prevent spread to toenails (onychomycosis). Over-the-counter topical antifungals (clotrimazole, terbinafine, miconazole) applied twice daily for 4 weeks resolve most cases. Persistent or extensive infections require prescription-strength topical or oral antifungals.

Preventing Fungal Toenail Infection (Onychomycosis)

Onychomycosis — fungal infection of the toenail plate — typically begins from adjacent tinea pedis spreading to the nail, or from direct nail trauma that allows fungal access to the subungual space. Prevention strategies include aggressive treatment of any tinea pedis (eliminating the primary source of infection), keeping toenails trimmed straight across at appropriate length (long nails accumulate debris and moisture that encourage fungal growth), and ensuring footwear provides adequate toe box room to prevent nail trauma.

Once established, onychomycosis requires months of treatment. Prevention is far preferable to treatment. Patients who have had onychomycosis previously should apply topical antifungal lacquer (ciclopirox) or efinaconazole to affected nails prophylactically after completing a successful treatment course to reduce recurrence risk.

Preventing Plantar Warts (Verruca Plantaris)

Plantar warts are caused by human papillomavirus (HPV) — specifically types 1, 2, 4, and 63 — that enters through microabrasions in the plantar skin. Transmission occurs through contaminated surfaces: pool decks, gym floors, locker rooms, and shared footwear. Prevention focuses on the same barefoot avoidance strategies used for tinea pedis prevention — consistent use of sandals in public wet areas. Prompt treatment of any plantar wart prevents satellite spread that creates large, multi-wart mosaic clusters difficult to eradicate. Any thickened, painful plantar lesion that does not resolve as expected for a callus should be evaluated by a podiatrist, as warts are frequently mistaken for calluses by patients.

Moisturization for Dry and Cracked Skin

Dry heel skin — particularly the thickened, fissured skin that develops over the heel with aging, diabetes, and prolonged standing — represents a portal for bacterial entry if fissures deepen. Daily moisturization with urea-based creams (10–20% urea is most effective), ammonium lactate lotion, or petroleum-based emollients maintains skin hydration and supple texture. Apply immediately after bathing while skin is still slightly moist for maximum absorption. Avoid applying between the toes as this encourages fungal growth.

Footwear Hygiene

Shoes and socks are significant vectors for fungal and bacterial contamination. Wash socks in hot water (above 140°F) to kill fungal spores — cold-water washing is insufficient. Use UV shoe sanitizers or antifungal shoe sprays inside footwear between uses. Replace athletic shoes every 300–500 miles or approximately every 6–12 months of regular use — old shoes accumulate microbial load and lose structural support simultaneously. Never share footwear, including flip-flops, sandals, or athletic shoes.

When to See a Podiatrist

Despite consistent hygiene practices, foot infections sometimes develop and require professional treatment. Seek podiatric evaluation for: tinea pedis that does not respond to 4 weeks of over-the-counter treatment, any signs of bacterial superinfection (increased redness, warmth, swelling, pain, or discharge), toenail changes including thickening, discoloration, or separation from the nail bed, plantar lesions that are painful or growing despite home treatment attempts, or any foot infection in the context of diabetes or circulatory compromise — where seemingly minor infections can escalate to serious complications rapidly. Balance Foot & Ankle provides prompt, effective treatment for all common foot infections in patients of all ages across Southeast Michigan.

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Foot Infection Treatment in Michigan

From athlete’s foot to fungal nails and plantar warts, foot infections are common but treatable. Dr. Tom Biernacki provides comprehensive infection treatment including topical and oral medications, laser therapy, and Swift microwave treatment at Balance Foot & Ankle.

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Clinical References

1. Havlickova B, et al. “Epidemiological trends in skin mycoses worldwide.” Mycoses. 2008;51(Suppl 4):2-15.
2. Gupta AK, et al. “Optimal management of fungal infections of the skin, hair, and nails.” Am J Clin Dermatol. 2004;5(4):225-237.
3. Al Hasan M, et al. “Dermatology for the practicing allergist: tinea pedis and its complications.” Clin Mol Allergy. 2004;2(1):5.