As the days heat up and we head into the Summer, many of us suddenly seem to remember that the appendages at the end of our legs need some love and care too. Feet are so often forgotten and neglected until we are getting ready to put them on show, whether that’s wearing snazzy new sandals, picnics in the park or walking on a beach.

However, it’s not just the aesthetics of our feet we need to pay some attention to at this time, but also to their health. The warm summer weather often makes Athlete’s Foot (tinea pedis) and other fungal or bacterial infections much worse as the heat and the moisture from extra perspirations creates the ideal habitat for growth. For those with eczema, dermatitis or psoriasis the risks rise further. Broken skin for any reason damages the skin barrier and increases the risk of infection particularly if the skin is itchy and leads to scratching.

Data from a recent real-world study, undertaken on behalf of Typharm – the brains behind the Nystaform range of prescribed creams and ointments for fungal and bacterial infections like athlete’s foot – have revealed that three quarters of people affected by skin conditions (77%) say they become concerned when the weather heats up. Athlete’s foot is one fungal infection that affects many of us in the summer months. Here’s a guide to what athlete’s foot is, the causes, who gets it together with treatment information, plus advice tips on how to avoid and beat this health peril this summer.

Athlete’s foot

Athlete’s foot is a fungal infection of the skin that can lead to intense itching, cracked, blistered or peeling areas of skin, redness and scaling. It can occur on moist, waterlogged skin, often between the toes or on dry, flaky skin around the heels. If not treated, large painful fissures can also develop and the condition can also spread along all five toes, to the soles of the feet and to the toenails and beyond.

Symptoms may include:

• Itchy, scaly rash between the toes
• A burning feeling
  • Small, red blisters
  • Dry scales or flaking on the soles or sides of the feet
  • Cracks in the skin that can be very sore and prone to bacterial infection
  • Oozing red sores (severe cases).

What causes athlete’s foot?

While it gets its name because of the prevalence among athletes who share grimy changing room floors, you don’t need to play a sport to get athlete’s foot. It’s incredibly common and anyone can get it.

Athlete’s foot thrives in moist and warm environments, such as inside sweaty shoes and socks. It grows and survives by consuming keratin, a type of protein found in your hair, skin, and nails. 

While athlete’s foot loves to live and grow on feet, the fungus isn’t tied to your toes. Athlete’s foot is highly contagious and able to spread to other parts of your body when it comes in contact with it or by being transferred through items like towels, socks, shoes, or floors that may have particles of dead skin. This can include your scalp, hands and even the groin. And, of course, it can spread to anyone else who comes into contact with it, by touching any of those things.

Who gets athlete’s foot?

Anyone can get athlete’s foot at any age. It is more common in those who spend lots of time barefoot in shared spaces and also in those who have broken skin, perhaps because of eczema or psoriasis.

Real-world data from the Nystaform survey, revealed that most of those living in the UK currently have a skin condition or have previously been affected:

• 51% have had Athlete’s Foot
• 70% say they had eczema
• 29% noted dermatitis as a problem
• 25% said they had psoriasis.

Why is athlete’s foot worse in summer?

There are two main reasons why we are more likely to get athlete’s foot during the summer. Firstly, you are more likely to be walking around barefoot in shared spaces like swimming pool changing rooms and decking. This means there is a greater likelihood of your feet coming into contact with tiny, infected skin cells that have been shed by others onto the floor. Secondly, those who sweat more are more prone to infection and, let’s be honest, we all sweat more during the summer.

Once your feet have been contaminated, the warm, dark and sweaty environment of feet in shoes or trainers provides the ideal breeding ground for the fungus. The sun can also make your skin dry out so it loses its natural protective oils and this can leave your feet more prone to infection.

Treating athlete’s foot, fungal or bacterial infections?

Once you have athlete’s foot, or fungal or bacterial infections, it is vital to treat the health problem. Used and recommended for more than 40 years by healthcare professionals and patients, the Nystaform range incorporates Nystaform Cream, Nystaform HC Cream and Nystaform HC Ointment and can be used to treat athlete’s foot, ringworm, and infected nappy rash, as well as fungal and bacterial infections associated with cracked and damaged skin. 

Here’s a fast product summary to the Nystaform range: 

NYSTAFORM CREAM: Is a prescription-only cream which contains the anti-fungal medicine Nystatin in combination with antibacterial Chlorhexidine. It is used to help treat skin infections caused by fungi and/or bacteria such as ringworm, athlete’s foot, and infected nappy rash. www.medicines.org.uk/emc/product/2693/pil

NYSTAFORM HC CREAM: A combination cream containing an anti-fungal (nystatin), an antibacterial (chlorhexidine) and 0.5% hydrocortisone (corticosteroid to reduce redness, swelling and itching as well as having a vasoconstrictive action) and provides many clinical practice benefits when it comes to dermatological solutions. In addition to be being prescribed for athlete’s foot, Nystaform HC Cream has been used for the effective treatment of infected dermatoses where fungal (particularly monilial) and/or bacterial infections are present. www.medicines.org.uk/emc/product/2702/pil

NYSTAFORM HC OINTMENT: Is a prescription only medicine which contains Nystatin and Chlorhexidine as well as Hydrocortisone, a corticosteroid that helps reduce redness, swelling and itching. It is used to treat skin infections caused by fungi and/or bacteria such as ringworm, athlete’s foot, and infected nappy rash. www.medicines.org.uk/emc/product/8074/pil

Addressing antimicrobial resistance (AMR)

With skin infections, the causative organisms, in the main, are bacterial, and/or fungal. Increasingly, AMR is a major cause for concern globally with the use of antibiotics in human medicine. There is also evidence indicating an increase in AMR to antifungal agents and antivirals. As a result of this growing AMR issue especially within dermatology, the Nystaform range has many benefits versus an antibiotic for the following reasons:

• The avoidance of topical antibiotic therapy in the first instance which contributes to the antimicrobial stewardship strategy

Nystaform^® is:

• A fixed dose combination topical medication which allows ease of application for the patients.
• Includes chlorhexidine – an antimicrobial agent which is effective against a number of bacteria
• Remains an effective anti-fungal with low AMR issues compared to other anti-fungals
• Nystaform preparations are licensed for both children and adults
• Nystaform topical products act locally on the skin and are not intended to be absorbed systemically through the skin.

Busting athlete’s foot and other fungal and bacterial infections?

The most important tip for preventing athlete’s foot is to ensure your feet are completely dry after washing them and before shoes and socks are put on.

However, there are self-care actions you can do to make your feet less hospitable to fungal infections.

• Wash your feet well with soap every day – at least once and more if you’re feeling sweaty. Make sure you dry them well too, especially between the toes
• Check your feet daily – it will literally only take a couple of seconds but check for any signs of damage and, if a problem is developing, treat it quickly before it spreads or gets worse
• Change your shoes regularly. Try not to wear the same shoes two days running. There’s no point treating your feet if you constantly re-infect them by putting them into damp, fungally infected shoes. It takes 24-48 hours for shoes to dry out properly, so alternate your shoes daily. If you can’t manage that, make sure you dry your shoes properly when you take them off by using a hairdryer on a cool setting – this gets rid of the moisture quickly without creating more heat. To help shoes dry out more quickly, take any insoles out, loosen any laces and open your shoes out fully so that air can circulate. When buying trainers, choose ones with ventilation holes when possible
• Make sure your shoes are wide enough. If your shoes are so tight that they squeeze your toes together, this allows moisture to gather between your toes and encourages fungus. Instead, let air circulate between the toes by choosing footwear with a wider, deeper toe box and choose shoes made from natural materials. If you’re wearing socks, make sure to change them socks daily
• Choose footwear that lets your feet breathe and doesn’t keep in moisture and heat, like plastic or vinyl. Wear sandals often to help feet dry out and keep your skin temperature low to prevent sweating. If you wear socks in the summer, choose natural materials, like cotton – and change them often!
• Don’t ever share towels, flannels, shoes etc
• If you or anyone in the house has athlete’s foot, consider washing their clothes, towels and bedding separately – research indicates the fungus that causes athlete’s foot is able to survive on surfaces and in washing machines unless they’re run using hot water
• Always, wear flip-flops, sliders, sandals or water shoes in public showers, around the pool and in changing rooms. Even at home! This will ensure that you don’t pick up any fungal skin cells that anyone has shed and also stop you from leaving any shed skin if you have an infection
• After the gym or playing sport, change shoes as soon as you can, especially if you won’t be able to shower until later. It’s also a good idea to clean and disinfect your shoes and gym gear after each use, using hot water and/or disinfectant wipes or spray. Don’t forget to dry everything thoroughly
• Wearing flip flops and sandals with no arch support puts extra pressure on your feet and can lead to problems, such as cracked heels which weaken the skin’s barrier and leaves it open to infection. Using a moisturizer on your heals can help and try to switch your shoes choices up – variety will definitely aid the chances of keeping your feet healthy