The medical term for athlete's foot is tinea pedis. It is caused by a type of fungus — the dermatophytes. Athlete's foot (AF) is a very common skin condition. Many people will develop AF at least once in their lives. We called this condition athlete's foot because people who play a lot of sports tend to get it more often. This is because the warm, moist environment created by the sweaty socks in sneakers is ideal for the growth of the fungi. AF is most prevalent amongst teenagers and adult males who love to wear sneakers. The condition is also common amongst chefs, police officers, soldiers and security guards who have to be in shoes for long hours. It is uncommon in women where open-toed shoes and sandals are the preferred footwear.

Athlete's foot may not appear in the same way for everyone. In some people, the toe web (especially between the last two toes) appears scaly and white with cracks. These cracks are painful on contact with water . The cracks also permit entry of bacteria which give rise to secondary bacterial infection. This is especially dangerous for patients with diabetes as their immune system is defective. This bacterial infection may progress rapidly leading to cellulitis (inflammation of the entire foot) and even amputation if not caught early. In others, there may be scaling all over the feet with or without blisters on the sole and along the side of the feet. The blisters (water bumps) are very itchy and usually leave dark spots once healed . These dark spots are more bothersome to the patients than the actual condition. Often patients seek treatment for these unsightly dark spots rather than the scaling and itching. This condition may spread and infect the toenails. Fungal toenail infection results in the discolouration, crumbling, thickening and even loss of the affected nail.

Athlete's foot is contagious! If this infection is not treated, it may spread to other areas of the body such as the groin, resulting in "jock itch" or your hands (tinea manus). An untreated patient can act as a reservoir of this fungus, which may lead to the infection of family and friends.

MANAGEMENT:

Prevention is the key! You can prevent AF by following these simple rules:

• Wash your feet daily with an anti-fungal soap (ariSulfur bar) and dry your feet and toe webs properly.

• Wear rubber slippers when showering in public facilities such as the gym or health club.

• Avoid closed shoes! Whenever possible, wear sandals or opentoed shoes to "air out" your feet.

• Wear cotton or synthetic socks that absorb sweat.

• Change socks daily or as soon as they become damp.

• Dust an anti-fungal powder on your feet and into your shoes if you tend to perspire a lot.

If infected, add water to the ariSulfur bar until a rich lather is produced, then apply to the feet for 1-2 hours nightly. Use over-the-counter anti-fungal cream (Lamisil-1) as instructed by the label. If over-thecounter medications do not clear up the condition, or if it becomes worse, see a doctor/dermatologist as soon as possible. Antifungal cream and tablets are prescribed together to kill the fungi. Fungal toenail infection is difficult to treat and requires several months of oral antifungal medication.Once the condition is successfully treated, precautions must be taken by following the above simple rules of prevention to avoid recurrence.

Dr Patricia Yap is a dermatologist at Apex Skin Care and Laser Center. E-mail:

apexskinclub@gmail.com