I have a question about my boyfriend's feet. He seems to have some kind of fungus, and I'm not sure what it is. I've tried using a pumice rock to scrub off what looks like over-grown calluses. His feet have a foul odor. He wears work boots most of the time, so I figured it was from having sweaty feet, and it was possibly athlete's foot, but he doesn't complain of burning or itching. Please help me figure out what this "infection" might be, and what we can do to get rid of it.
Fungus itself is confusing. The infections are named by the location of the infection, not the organism. In fact, three similar organisms cause most cutaneous (on the skin) infections. These three offenders, called dermatophytes, cause infections in the skin, nails and even hair. They metabolize keratin, what gives our skin, nails and hair strength, breaking down our natural wall of defense.
Tinea pedis, or athlete's foot, is the most common dermatophyte infection doctors see. In fact, as much as 15 percent of the population suffers from tinea pedis. There are two distinct types, acute and chronic, but they are transmitted the same way. Someone with athlete's foot walks around a pool, gym floor, takes a shower, sheds the dreaded arthrospores and then you show up. This is why our moms bought us shower shoes when we went to camp or even started college.
Acute athlete's foot is usually caused by Trichophyton mentagrophytes, var. interdigitale. It pops up when you get sweaty feet in the form of "vesicular" lesions (like a boil). These lesions are itchy and painful, and sometimes they spread to the instep of the sole. The fugal infection can disappear on its own but will come back when the feet are sweaty again.
Chronic athlete's foot is usually caused by Trichophyton rubrum. It starts out like acute athlete's foot usually between the fourth and fifth toes. As the fungus grows, skin may form cracks called "fissures," and scaling of the skin may be seen. A distinct border is seen between infected and normal skin. Eventually, the fungus creeps down to the soles of the foot and can even come up the side to the top of the foot, like a moccasin.
So what to do? I think we should go over some basic fungal principles. Fungi love dark moist places. We know fungi like to break down keratin to infiltrate the skin -- this means activities to break down your skin only help the fungus, not hurt it.
1. Keep your feet dry. Dry them carefully after showering, even consider using foot powder and wearing cotton socks. Look for shoes made of leather or ones created so your foot can breathe. Try treating your shoes with antifungal foot powder.
2. Don't wear shoes at home. I know it is embarrassing, but if you keep your tootsies in the open air they will stay dry. Dry feet are happy feet, and dry fungi are unhappy fungi.
3. Use some meds. Most over the counter creams are equally effective. You just have to use them for the full course. One week is recommended for interdigital infections and two to four weeks of cream for tinea pedis. Be sure to rub the cream in! Remember, fungus is hard to treat. Which brings me to my next point...
4. Go see your doctor! They may have some more tricks up their sleeve. This can be a complicated case of athlete's foot if toenails are involved or if hair follicles are involved. Oral medicine may be required. Also, if the area looks super infected by bacteria (warm, hot, red, swollen with pain or pus is draining out), you may need antibiotic on top of the antifungals.
5.Do you have a condition such as diabetes or HIV that affects your immune system? Are you on steroids for any reason? Any of these conditions can decrease your body's ability to fight off infection.
6. There are some home remedies that might be helpful, like a foot soak in vinegar or Burow's wet dressings. I can't find any hard facts on the subject, but people swear by it.
Lisa Hermann is a Cavalier Daily Health & Sexuality Columnist. She can be reached at lisa@cavalierdaily.com or through the Sex & Balances submission page at cavalierdaily.com/sex.asp. This column is used for educational purposes only and is not meant to substitute advice from your doctor.
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