IF SYMPTOMS PERSIST Dr. Jose Pujalte, Jr.

“Be good, keep your feet dry, your eyes open, your heart at peace and your soul in the joy of Christ." — Thomas Merton OCSO (1915-1968) Trappist monk and theologian Merton, Harper and Row 80

What do you think happens in the hot and moist insides of shoes? It’s the perfect laboratory to grow fungi. However, to get athlete’s foot, the person must be susceptible (see risk factors). Otherwise, this person may only spread, but not show, the signs of fungal infection himself. The offending fungus is tinea pedis. Types. The most commonly seen is the interdigital space infection (toe web) which is felt as an uncomfortable, squishy sensation in between the toes. That’s because the skin is either cracked or macerated as the fungi eats its away. Don’t worry, you won’t mistake it for something else because your feet will smell bad. The sole and heel skin may crack and peel. Oftentimes, the nails are infected as well. This is the moccasin type of athlete’s foot. Perhaps the most bothersome is the vesicular infection in which blisters appear on the foot, becoming red and inflamed with pressure. Risk Factors. Any of these increases the likelihood of getting athlete’s foot: * Male sex (as a rule, men ignore their feet). * Depressed immune system, from diabetes or cancer. * Elderly. * Use of public showers (gym, swimming pool) without slippers. * Enlarged prostate. * Diabetes. Signs and Symptoms: * Itching or burning sensation. * Cracking or peeling of skin. * Foul smelling feet. * Blisters (in vesicular infection). * Skin breakdown (maceration). Diagnosis. Visit a certified dermatologist or the friendly neighborhood general/family medicine practitioner. Although a visual inspection by your trusted doctor to diagnose may be reliable, she can insist on some tests. A KOH (potassium hydroxide) medium will demonstrate a fungal colony in skin or nail scrapings. In special cases, the doctor may request a fungal culture or even a skin biopsy. Treatment. Over-the-counter anti-fungal powders, creams, and sprays are available. Do not take anti-fungal pills without prescription. Side effects have to be monitored. Athlete’s foot generally responds to medication and the common problem is discontinuing the treatment course. This makes recurrence more likely. Continue applying the medication even when the infection has cleared, usually for one to two weeks more, for good measure. Prevention. These simple tips may save you from the discomfort and embarrassment of athlete’s foot: * Use slippers in public showers. * Wipe damp feet after bath and keep dry with foot sprays or powder. * Use cotton socks and use sandals or slippers during hot days. * Keep shoe insides dry and avoid tight, ill-fitting shoes. E-mail [email protected]