Athlete’s Foot & The Gut – Skin Axis

Did you know that your gut affects your skin health? Read about the gut-skin axis and different skin conditions in our latest blog series. We have written about psoriasis here  and here, rosacea, eczema  and acne. 

Today we look at Athlete’s Foot. 

In this blog, you will learn:

• What is Athlete’s Foot & how does it relate to the gut-skin axis?
• What are the triggers for Athlete’s Foot?
• How can Athlete’s Foot be treated naturally?

What is Athlete’s Foot?

Athlete’s Foot is a fungal infection on the skin of the feet, usually between the toes. It causes redness, itching or scaly skin. The medical name for Athlete’s Foot is tinea pedis. 

Athlete’s foot is caused by dermatophytes. Dermatophytes are a type of fungi that grow as molds. They cause infections like ringworm and athlete’s foot. The main species of dermatophytes are Trichophyton rubrum, T mentagrophytes, T interdigitale and Epidermophyton floccosum. They feed on keratin, a protein found in skin, hair and nails.  

Direct contact with dermatophytes is typically how the infection starts. Dermatophytes grow in hot and humid environments. Public pools and showers with water are where many infections are likely to be contracted. It can happen when walking barefoot in locker rooms, public showers and swimming pools. In fact, Athlete’s Foot is more common in people who use public showers and pools and have long exposures to water. 

Dermatophytes can grow when wearing tightly fitting footwear with sweaty feet for a long time. Wearing completely closed shoes that can’t breathe for long periods of time increases the risk of dermatophyte infections. 

Athlete’s Foot is contagious. It can spread through person-to-person contact, contaminated surfaces or objects. It can spread to other parts of the body after touching the infection. It can spread by indirect contact with the contaminated belongings of someone with Athlete’s Foot. Transmission amongst family members is very common. Thoroughly washing hands after touching areas with Athlete’s Foot can reduce this risk of spreading.

• Approximately 10% of the world population have tinea pedis (Nigam P, 2023).
• The peak age incidence is between 16 and 45 years of age (Nigam P, 2023). 
• Tinea pedis is more common among men than women (Leung AK, 2023).

The Mechanism of Action of Athlete’s Foot

The fungi that cause Athlete’s Foot grow in the keratin of the skin on the feet. The fungi produce enzymes called keratinases. These enzymes break down keratin, the main protein in the skin’s outer layer, allowing the fungi to penetrate and colonize the skin. The warm, moist environments where dermatophytes are found allows for the fungi to grow and spread.

In response to the infection, the body mounts an inflammatory immune response. This causes the classic symptoms of athlete’s foot; redness, itching, scaling and sometimes blistering.

How is Athlete’s Foot Linked to the Gut?

A balanced and healthy gut is essential for overall good health. Any imbalance in gut health can increase susceptibility to health issues. This is because 70-80% of immune cells reside in the gut. This means that immune strength is directly linked to gut health.

Poor gut health can leave one vulnerable to chronic inflammation and health problems. Imbalances in gut microbiota or dysbiosis weakens the immune system and skin barrier function. This can potentially increase risk of infections like Athlete’s Foot. 

A disrupted gut microbiome disrupts the skin microbiome. This weakens the skin barrier. Dysbiosis, leaky gut and weak immune health are all disruptive to the skin microbiome. An impaired skin microbiome allows for something like a fungal infection to be able to take root.

• Gut imbalances and issues weaken the skin’s defenses. Dysbiosis of the skin and/or gut microbiome increases risk of athlete’s foot. Leaky gut increases risk.
• A compromised skin barrier raises the likelihood of developing an infection. Skin conditions that cause skin dryness, like eczema can weaken the skin barrier and make it easier for fungi to overgrow. A weak skin barrier in the form of small cuts on the feet or dry and cracked skin can allow the fungus to enter.
• People with a weak immune system, diabetes, HIV, autoimmune disorders or on immunosuppressive drugs are more prone to infections. Poor circulation due to conditions like diabetes or neuropathy can also increase risk of skin infections of the feet. 

Other Risk Factors for Athlete’s Foot

There are certain factors that are easy to control which can reduce the chances of getting athlete’s foot:

• Avoid direct contact with the fungi in warm, moist environments such as locker rooms, communal showers and swimming pools. Wear sandals or flip flops to prevent contact with possibly contaminated floors. 
• Don’t wear tight, closed shoes that don’t breathe well.
• Practice good foot hygiene and dry feet properly after bathing or sweating. Keep feet dry and avoid having sweaty feet.
• Don’t wear the same socks or shoes for long periods. Change socks every day.
• Don’t share shoes or towels.

Complications with Athlete’s Foot 

Athlete’s Foot can resemble other conditions and it can transform into other conditions. A fungal infection can look like eczema with dry, red, itchy and flaky skin. Athlete’s Foot can be mistaken for eczema or trigger eczema-like reactions.

A fungal infection like athlete’s foot can trigger an immune response elsewhere on the body, such as blisters or eczema-like rash on hands or arms (Nigam P, 2023). If chronic, Athlete’s Foot can irritate the skin and cause a secondary bacterial infection. The compromised skin barrier enables bacteria to enter, potentially leading to more infections. It can turn into secondary eczema in some cases.

If untreated or poorly managed, the fungal infection between the toes can turn into a fungal infection in the toenails. The fungus can infiltrate the nail and lead to thickened, discolored and brittle nails

What is the Treatment for Athlete’s Foot?

In conventional medicine, a topical antifungal treatment is commonly used. There are a number of topical antifungal creams that are OTC. Prescription antifungal creams are also available. This may be necessary in an extreme or persistent case. But we can often start with natural approaches to avoid these creams.