Athletes Foot

Athletes foot is the common name for a fungal infection of the foot, often called ringworm (although there is no worm involved). The three fungi most commonly implicated in athletes foot, Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum, favor the warm, moist areas between the toes and tend to flare up during warm weather. Similar infections can occur in the nails, scalp, groin, and beard.

Infection with these fungi generally causes mild scaling between the toes, but it can also cause more severe scaling, an itchy red rash, or blisters that cover the toes and the sides of the feet. Since the fungus may also cause the skin to crack, it can lead to bacterial infections, especially in older people or those with poor circulation in their feet. If the infection takes root under the toenails, it is called onychomycosis, and can be very difficult, if not impossible, to eradicate.

Because the fungi that cause athletes foot thrive in warm, moist areas, its important to keep the feet clean and dry. Over-the-counter or prescription topical antifungal treatments containing miconazole, clotrimazole, econazole, or ketoconazole can generally cure athletes foot, but treatment may have to be continued for a month or more for full results. In severe cases, oral antifungal medications may be necessary.

Principal Proposed Treatments for Athletes Foot:

Preliminary evidence suggests that tea tree oil might be helpful for athletes foot.

Tea Tree Oil

Tea tree oil (Melaleuca alternifolia) has a long traditional use in Australia for the treatment of skin and other infections. This use is supported by evidence that tea tree oil is an effective antiseptic, active against many bacteria and fungi. Two preliminary studies suggest it may be helpful for athletes foot.

What Is the Scientific Evidence for Tea Tree Oil?

A double-blind placebo-controlled trial followed 104 individuals given either a 10% tea tree oil cream, the standard drug tolnaftate, or placebo. The results showed that tea tree oil reduced the symptoms of athletes foot more effectively than placebo, but less effectively than tolnaftate. Neither treatment cured the infection in 100% of the cases, but each treatment cured many cases.

Another double-blind study followed 112 people with fungal infections of the toenails, comparing 100% tea tree oil to a standard topical antifungal treatment, clotrimazole. The results showed equivalent benefits; however, because topical clotrimazole is not regarded as a particularly effective treatment for this condition, the results mean little.

For more information, including dosage and safety issues, see the full tea tree article.

Other Proposed Treatments for Athletes Foot:

Garlic has known topical antifungal properties, and there is preliminary evidence suggesting that ajoene, a compound derived from garlic, might help treat athletes foot.

Very preliminary evidence suggests that oil of bitter orange, a flavoring agent from dried bitter orange peel, might have some effectiveness against athletes foot when applied topically. Test tube studies indicate that the aromatic constituents of other essential oils such as peppermint and eucalyptus also have antifungal activity, but they have yet to be tested on people.

More than 120 plants traditionally used to treat skin diseases in Mexico, Palestine, British Columbia, and Guatemala have demonstrated antifungal properties in test tube studies. Further research is needed to determine if they are safe and effective for athletes foot or other fungal infections.