The same type of fungus that causes jock itch and ringworm also causes athlete’s foot. Wet shoes and socks and a humid warm environment allow it to grow and spread. The confined spaces in between the toes, soggy wet skin, and heat together allow the bacterial areas to be overrun by the infection. The fungus releases enzymes known as keratinases to break down the keratin layer of the skin. The cell wall of the dermatophyte contains molecules that hamper the work of the body’s immune system response. 

Risk factors for developing tinea pedis include:

• Heavy sweating
• Constantly wearing enclosed shoes
• Walking barefoot in humid public areas like saunas, swimming pools, and locker rooms
• Sharing rugs, mats, clothes, or shoes with someone who is infected

Other significant risk factors include having diabetes, having a weakened immune system, being obese, or already having a wound or tissue damage on your feet. 

Athlete’s foot is very contagious. It can be spread through someone that has the condition. Coming into contaminated surfaces that someone who is infected has touched is how it is able to thrive. This includes shoes, towels, and floors. It can be spread by scratching an infected part of the body and then touching another part. 

Most commonly it is spread from skin to skin contact. Usually, in groups with large amounts of people like swimming pools and saunas, you will see rapid spread. That is why athlete’s foot is so common. About 3% to 15% of the population has tinea pedis, and about 70% of the population will have to deal with it at some point. 

You can have tinea pedis in one foot or both. Common signs of athlete’s foot include: 

• Itchiness that persists after taking off socks and shoes
• Skin that is inflamed, depending on skin color can be grayish, reddish, or purple-ish 
• Peeling, cracked, or scaly skin in between the toes
• Burning or stinging
• Scaly, dry skin on the bottom of the foot that goes up the side
• Blisters

Depending on the type of athlete’s foot you have, you may have other symptoms like moccasin-type infection, toe web infection, ulcerative infection, or vesicular-type infection. 

When you have a rash on the foot that persists for longer than 2 weeks of over-the-counter treatment and home remedies, you should see your doctor. Diagnosis of tinea pedis could include a biopsy, in which your doctor removes a small piece of skin and sends it for a laboratory exam. In the lab, they will use potassium hydroxide to make the fungal cells appear under a microscope.

The skin samples may be taken from the heel, arch, or sides of the foot. A Q-tip may be rubbed in between the toes. A blister should be unroofed, and scrapings made from the roof underside.  

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Other conditions of the feet that may mimic athlete’s foot include:

• Contact allergic dermatitis
• Eczema of the foot
• Plantar pustulosis
• Psoriasis
• Plantar keratoma

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