Athlete’s foot treatment

What athlete’s foot looks like

The fungi that cause athlete’s foot thrive in dark, warm, damp places, like the inside of a sweaty shoe, and the infection is more common in warm weather, when feet sweat more.^[1] It usually shows up in one of three patterns:^[5]

• Between the toes. This is where it is most often seen.^[5] It itches, burns or stings, the skin peels or cracks, and the skin between the toes can turn white, soft and soggy, sometimes with an odor.^[2]
• Across the sole (the “moccasin” type). Dry, scaly, thickened skin on the sole, heel and sides of the foot.^[10,5]
• With blisters. An inflammatory form causes itchy, sometimes painful blisters.^[5]

Touching the infected skin can carry the fungus to your hands, and it can also spread into the toenails.^[2,1]

When it’s something else

Telling athlete’s foot apart from other rashes by looks alone is unreliable, even for doctors,^[5] so a rash that hasn’t improved with an antifungal deserves a closer look. Conditions that can look similar include:

• Eczema, contact dermatitis and psoriasis. These common skin conditions can look very much like athlete’s foot,^[5] and an antifungal won’t treat them.
• Dyshidrotic eczema. Blisters on the feet aren’t always fungal. This type of eczema causes tiny, intensely itchy blisters on the hands or feet that can flare with sweat and hot weather and may last three to four weeks before clearing. It isn’t contagious.^[11]
• A bacterial infection between the toes. Red, soggy, weeping skin in the toe webs can be a bacterial infection; when the cause is a gram-negative germ, it is most often Pseudomonas. Damp, enclosed feet and an existing fungal infection make it more likely, and severe cases can lead to cellulitis. It is diagnosed with bacterial and fungal cultures, and it needs its own treatment.^[7]

When the diagnosis isn’t clear, a small scraping of the skin can be checked for fungus under the microscope, and a culture can confirm it if needed.^[5,4]

Over-the-counter or prescription treatment

Start with an over-the-counter antifungal. A cream or spray bought without a prescription may clear athlete’s foot, and a mild case usually clears in about two weeks.^[4] In a Cochrane review, both main types of cream, allylamines (such as terbinafine) and azoles (such as clotrimazole), cleared far more infections than placebo, and allylamines cleared slightly more.^[3] To help it work:

• Wash and dry your feet, including between the toes, and apply it exactly as the label directs.
• Keep using it for the whole time the label or your prescription says, even after the itch stops. Stopping early can leave the infection behind and make it harder to treat.^[4]
• Skip creams that combine an antifungal with a steroid. A 2025 review for family doctors advises against them for fungal skin infections, to help treatment work and to limit resistance.^[6]

When prescription treatment makes sense. If athlete’s foot is severe, or hasn’t cleared after about two weeks of an over-the-counter product, stronger medicine is the next step.^[4] That may be a prescription cream, antifungal tablets, or both. Tablets are generally reserved for severe or widespread infection, infection that hasn’t responded to creams, infection that has also reached the toenails, and people with a weakened immune system.^[5,6]

In small trials, terbinafine and itraconazole tablets both worked better than a placebo, and terbinafine cleared more infections than the older drug griseofulvin. Stomach upset was the most commonly reported side effect.^[10] Using a cream and tablets together may help more infections clear.^[5] Before prescribing tablets we review your health and your other medicines. Liver damage from terbinafine is rare but possible,^[12] and terbinafine can interact with some antidepressants, beta blockers and other drugs.^[13]

What to expect at your visit

We see patients with athlete’s foot at our offices in Lyndhurst, Paramus and Millburn, NJ. We examine the skin between your toes and on your soles, check your nails, and ask about your shoes, your sports and anyone at home with a similar rash. If you have diabetes, we also check the feeling and circulation in your feet. You leave with a plan for the skin, the nails if they are involved, and your shoes.

Athlete’s foot and diabetes

With diabetes, athlete’s foot deserves more attention, because diabetes can make it harder to clear.^[5] In advanced cases the skin cracks and blisters, and a bacterial infection can follow.^[1] In a review of six studies, athlete’s foot was linked to about three times the odds of cellulitis of the leg, a bacterial infection of the deeper layers of the skin. That risk applies to everyone, not only people with diabetes.^[8] Diabetes adds two problems: nerve damage can stop you from feeling a crack or blister, and reduced blood flow can make an infection hard to heal.^[9]

If you have diabetes, check your feet every day, including between the toes. After washing, dry carefully and put a little talcum powder or cornstarch between the toes, because that skin tends to stay moist, and keep lotion off the skin between the toes.^[9] Don’t self-treat cracks, blisters or redness between the toes; have them looked at within a day or two.

Our two-minute daily foot check walks through the routine, and diabetic foot care explains the rest of what we do to protect your feet.

Preventing reinfection, and the link with nail fungus

Athlete’s foot can come back. The usual reasons, and what to do about each:

• Your toenails. Once the fungus is on the skin it can spread to the nails, and infected nails can then reinfect the skin.^[10] That is why we treat the skin and the nails together. Thick, discolored nails need their own plan; see toenail fungus treatment.
• Other infected skin. It is common to have the same fungus on one or both hands. Treat every infected area at the same time.^[4]
• The people you live with. It often spreads between people who live together, directly or through shared belongings.^[5] Don’t share towels, linens or shoes with someone who has athlete’s foot.^[14]
• Damp shoes and socks. Wear shower shoes or sandals around pools, gyms, locker rooms and hotel rooms. Wash your feet daily and dry them completely, change your socks every day and whenever they get wet, and alternate your shoes so each pair dries out.^[14]

Our article on how athlete’s foot spreads and how to prevent it has more tips.

Common questions

How long does athlete’s foot take to clear?

A mild case usually clears in about two weeks with an over-the-counter antifungal.^[4] Courses of antifungal cream typically run from one to six weeks, applied once or twice a day.^[5]

What if the cream isn’t working?

First, make sure it is athlete’s foot: a diagnosis made by looks alone can be wrong, and a skin test can help confirm it.^[6,5] Then check the toenails, which can reinfect the skin.^[10] If it is a fungal infection that hasn’t cleared, prescription treatment is the next step. Rarely, the cause is one of the newer, harder-to-treat fungal infections, which may not respond to the usual creams or tablets and may need specialized testing and longer treatment.^[6]

Do I need a dermatologist or a foot doctor?

Either can treat athlete’s foot. Dr. Ozturk is a Foot and Ankle Surgeon and podiatrist, so seeing us makes sense when the problem is on your feet: we look at the toe webs, the nails, your shoes and, with diabetes, the nerves and circulation. If the rash is also elsewhere on your body, or looks more like eczema or psoriasis, a dermatologist may be the better next step.

When to seek care

Book a visit if a rash on your feet hasn’t cleared after two weeks of an over-the-counter antifungal, keeps coming back, has spread to your toenails, or you aren’t sure it is athlete’s foot.