Skin Health Foot Care

Two Feet Under: Treating Fungal Infections

By Christine Haran

If you're not careful, you might pick up something other than a fit fellow exerciser at the gym or yoga studio. Foot fungus, which can appear as athlete's foot or as a toenail fungus, is likely to spread from person-to-person in communal locker rooms and other public facilities where people walk around barefoot.

Below, Darryl Haycock, DPM, a spokesperson for the American College of Foot and Ankle Surgeons, discusses how you can prevent and treat these itchy, sometimes painful and always unwanted infections.

What kinds of fungal infections affect the feet?
Basically there are two different kinds of fungal infections. One is a nail infection, which is called onychomycosis, and then the other one is a skin infection, what is called tinea pedis, commonly known as athlete's foot.

What causes these infections?
Fungus is in the same class of organisms as mushrooms, yeast and molds. They're basically organisms that grow on dead or dying tissue. The outer layer of our skin and our nails are dead tissue. In other words, they don't have blood flow to them, and they become hard and thickened and allow us to have kind of a water-proof surface. So when someone has a fungal infection, the fungus gets into those tissues and starts to grow.

Who is likely to have these infections?
Older individuals are more likely to have it. We're not sure why. It might be that their immune system is diminished, or just that they've had more trauma to their toenails over the years.

Because of the association with trauma, you also see fungal infections in individuals who are in sporting activities such as soccer or ballet because they frequently injure their toenails. They might get a blood clot underneath the nail and, over a prolonged period of time, the fungus can get underneath the toenails. The blood clot creates a nice environment for the fungus to set up shop because fungus likes areas that are warm and moist.

But fungal infections can occur in most anyone, and the incidence of fungal infection has been increasing over the last 100 years. It may be due to the spread of the fungus in communal locker rooms and spas and showers. It may even be because of its association with diabetes.

Why is diabetes a possible risk factor?
People with diabetes often have a poor blood supply to the extremities, therefore the foot is not as healthy and fungus can set up more easily. Maybe it's also that many people with diabetes have decreased sensation, so any trauma—which they may not notice—plays a role.

We also see an association between foot fungus and immune deficiency diseases such as HIV and AIDS.

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