Relief for severe athlete's foot misery

September 19, 2014 5:08 PM

It's time for my first gross Ask Metafilter question. I've been battling athlete's foot on and off for the past two years. Non-prescription antifungals keep it in check for several weeks, but it always comes back. I have the worst case ever now. The spaces between my toes are extremely painful, burning, oozing, bleeding chunks of falling-off skin. Weeks of Lotramin application have not helped at all this time.

My question is: Should I try to see my primary care doctor, or will she just refer me to a podiatrist or dermatologist, since this appears to be a very severe and unrelenting case? I have good health insurance and I want to see someone next week, but do I just...start calling around to doctors on my plan? I've never had a serious health problem before, so I don't know how this works.

Also: What can I do to stop the pain and burning like right now until I can see an MD?

And: Is there anything I can do to my house (besides dousing everything with bleach again) to kill the fungus DEAD FOREVER?!

posted by anonymous to Health & Fitness (27 answers total)

I think you really need to go to your doctor and get an anti-fungal. It doesn't seem like in your case it is going to resolve on its own. I would try to get into a clinic, actually, and resolve the problem asap.

I have had a mild case before (between two of my toes) and that was bad enough. I killed it with zinc lotion. But that will not be enough to do it in your case. It's time to pull out the heavy firepower, and now.
posted by Nevin at 5:15 PM on September 19, 2014 [1 favorite]

Poor baby!

Go to a Minute Clinic or any Doc-In-The-Box, show the PA your feet. You should get a prescription for a mighty anti-fungal. You can do this tomorrow.

Fungus is a beast. You have to apply it religiously as directed and it might take months or never for your fungus to go away. The good news is that the creams make your feet feel good nearly instantly!

You may have to fool with creams for the rest of your life. But that's okay, it's better than what you're describing!
posted by Ruthless Bunny at 5:18 PM on September 19, 2014

For typical US insurance plans, you'll need to see a primary care doctor first. It's likely that they can do something (oral antifungals, prescription strength creams) in the interim even if they want you to see a specialist.

In the meantime, try to keep your feet as clean as possible. That cracked skin is a prime site for bacterial infection.

Since it's about to be the weekend, and since you seem to be in real discomfort, I'd recommend you get to an urgent care clinic right away. They can help you.
posted by mr_roboto at 5:20 PM on September 19, 2014 [1 favorite]

I'd be surprised if your Primary Care Physician can't prescribe something, even if it's temporary until you can see a podiatrist. I'd start there myself (and as others have noted, you should if you want your insurance to cover it).

I haven't ever let it get to the point of bleeding or painfulness, so my usual suggestion of trying hydrocortizone cream is probably not going to fly here. In your case I'd nth that urgent care is probably the way to go.
posted by Aleyn at 5:24 PM on September 19, 2014

I have had good results with Tinactin (tolnoftate) cream on my occasional and very minor athlete's foot. Maybe that will help until you can get to a doctor.
posted by H21 at 5:30 PM on September 19, 2014

Go to a doctor and get something for a recurring stubborn fungal infection, like Sporanox tabs. It will likely make you super constipated so make sure to get a fiber supplement when you pick up the prescription.
posted by poffin boffin at 5:36 PM on September 19, 2014

Best answer: Hey I had persistent athlete's foot for nearly two years! In addition, it was a rare blistering kind, so it was misdiagnosed as dishydrotic eczema, and I treated it with steroids for most of that time which let it get MUCH MUCH worse! I was in agony, my quality of life was seriously affected. I begged my doctor for a referral to a different dermatologist, he complied, the derm took one look at my foot and said "oh my, that is fungus, let me do a scraping" and then came back with a victorious look on her face and a prescription for Lamisil (terbinafine) tablets. Because of the steroid use, I had to do two 2-week courses and I have some pretty bad scarring, but touch wood, the stuff seems to be gone for good. I also bought the terbinafine cream over the counter and once a week I slather both feet in it up to the ankle, including the soles, and elevate them for an hour.

Right now: fill a bucket with a gallon of cold water (or your bathtub) and add a teaspoon of bleach (per gallon if it's your bathtub). Soak your foot in that. It won't be a permanent fix but you will definitely feel much better for a few hours.
posted by KathrynT at 5:45 PM on September 19, 2014 [2 favorites]

Oh the Lamisil made my hair fall out -- not to the point where it was noticeable, but to the point where I would definitely pull away 30 hairs or so every time I ran my fingers through my hair. And I had to abstain from alcohol and acetaminophen because the shit's hard on your liver. It was completely worth it.
posted by KathrynT at 5:47 PM on September 19, 2014

I had to combine anti fungal cream with new socks (white cotton), new shoes, anti fungal powder (on feet/socks/shoes) AND nightly foot bath. Foot bath consisted of a good soapy wash, cleaning nails, exfoliating, soaking in hot water with vinegar and tea tree oil, and then applying the antifungals and putting on socks. It was time consuming, but it worked. Once cleared up, I bought another round of new shoes and socks. Haven't had a problem since and it's been a few years.

If you can get prescription antifungals, by all means do!
posted by jrobin276 at 5:49 PM on September 19, 2014 [1 favorite]

Can you try to get a script for something like diflican?
posted by spunweb at 5:58 PM on September 19, 2014

Also: keep your feet dry by wearing breathable shoes and possibly changing socks more than once a day. Thick leather shoes can cause dampness. Damp = fungus, dry = less fungus.
posted by sninctown at 6:00 PM on September 19, 2014

Best answer: Air and light are the enemy of fungi. When not required for work wear shoes that admit air and light.

"What can I do to stop the pain and burning like right now until I can see an MD?" Any antifungal with hydrocortizone will likely help in the short term. This includes "jock itch" and "female" type ointments. I used Vagisil to fix my between the toes.

"My question is: Should I try to see my primary care doctor?" My answer is: Fuck yes.

"And: Is there anything I can do to my house (besides dousing everything with bleach again) to kill the fungus DEAD FOREVER?!"

No. Spores are ubquitous but not really a problem. It's not your fault and it's impossible to eliminate fungus. It's more a matter of creating an environment where they can't flourish.

Go to your doctor and She'll give you some goo and it will be fine.
posted by vapidave at 6:03 PM on September 19, 2014 [2 favorites]

Best answer: You have systemic fungus, for which your PCP (or urgent care or whatever) can write you a scrip. Topical treatment will not work, which you've figured out.
posted by Lyn Never at 6:18 PM on September 19, 2014

Lotramin Powder. This stuff is amazing. I keeps things dry, doesn't hurt, and kills the fungus. The main part is dry. Creams are all fine and dandy, but they are still wet. Apple cider vinegar soaks feel good and help kill off the fungus.
posted by PJMoore at 6:18 PM on September 19, 2014 [2 favorites]

Yes, see your doctor.
I had a persistent case that Clotrimazol (lotrimin) no longer worked on, but mine was nowhere near as bad, no bleeding, just peely skin that was painful when I poked at it. My solution was (1) a different brand of anti-fungal (I assume I had basically bred a heroic lotrimin-resistant strain of fungus), plus (2) washing my foot carefully with soap and water as opposed to just letting the shower water rinse it. I'm somewhat shocked that this fairly low-impact approach worked as thoroughly as it has; there are certainly bigger guns to throw at the problem. Given that your symptoms are more severe, definitely go see the doctor.
posted by aimedwander at 6:18 PM on September 19, 2014 [1 favorite]

I had ringworm (not on the feet, but same fungus) and found one OTC cream (clotrimazol) totally useless, while the next one I tried (terbinafine) did the trick. No idea why the difference.

Obviously "see a doctor" makes the most sense here, but I thought I'd mention this because if you're not able to get to the doc immediately, you might be able to get relief from trying another cream. In my case, I used Lotrimin for weeks without seeing any change, and literally overnight improvement with the terbinafine.

Some pharmacies stock these things in different areas. Stuff branded for athlete's foot may be on a whole different aisle than stuff for other topical rashes. Couldn't hurt to ask a pharmacist what they have in stock, if you want to make sure you've tried all options.

Also, when my cats and I were all suffering from persistent and uncool ringworm, I periodically sprayed fungicide (some OTC athlete's foot aerosol) on a towel draped over my air purifier. I have no idea if it helped, but it didn't make it worse and it certainly made me feel better to think at least some of the spores in the environment were passing through that.

Good luck!
posted by jessicapierce at 6:48 PM on September 19, 2014

There may be other problems, as people have mentioned. But my standard advice in this situation will definitely help, if not completely eliminate your discomfort.
posted by seasparrow at 7:43 PM on September 19, 2014 [1 favorite]

Your primary care doctor can probably handle it.
posted by J. Wilson at 8:46 PM on September 19, 2014

consider applying tea tree oil?
posted by ghostbikes at 9:43 PM on September 19, 2014 [1 favorite]

Yeah you want prescription strength stuff go see a doctor. And go sit with your feet in the sun to get some air and UV rays.
posted by wwax at 9:58 PM on September 19, 2014

As well as seeing a doctor get a boot dryer, they are cheap like $40, and put your shoes on it as soon as you take them off until you go to bed. Drying your shoes like this will make a huge difference in improving the environment you feet live in all day.
posted by fshgrl at 10:01 PM on September 19, 2014

You should see a dermatologist about this (primary care first, though.) I went in to the dermatologist for something similar, and he did his thing and gave me some tubes of some stuff, and had me set up an appointment for two weeks later. At that appointment, he checked everything, and then said, "Now that we got the fungus cleared, this is for the eczema that you've got underlying that." Worked great.
posted by azpenguin at 10:03 PM on September 19, 2014

Doctor, yes. For future reference - in my experience, Lotramin never does diddly, but tolnaftate does.
posted by stormyteal at 11:41 PM on September 19, 2014

I remember as a high school athlete getting an epic case of athlete's foot (and unfortunately, jock itch, ugh) that would just not get better with OTC stuff. My primary care physician prescribed some kind of heavy duty antifungal and it fixed the problem completely in a few days. So I don't think you need to see a specialist.
posted by bennett being thrown at 2:30 AM on September 20, 2014

I've been dealing with a fungal infection for a while now and a general practitioner shouldn't have a problem treating it. I went to an urgent care clinic for mine and got set up with some antifungal pills (fluconazole) and heavy duty prescription strength cream (ketoconazole). A big thing to remember is that even once the visible rash/symptoms go away, you need to keep using whatever treatment you're using for at least a few weeks after or it will most likely just come back.

Something that's been helping me (since the rash spread elsewhere later ugh) is applying Nizoral shampoo, which contains an antifungal and letting it sit on the affected areas for about 15 minutes before I shower. Then applying OTC creams as directed. It's slowly but surely clearing the rash up. You can usually find it with the dandruff shampoos.

You should probably wait until your infection comes more under control and your broken skin heals before trying it though.
posted by Kimmalah at 9:00 AM on September 20, 2014

Definitely see your GP, but as a tip the tablets sold over the counter to treat thrush (fluconazole, sold as "diflucan one" over here) will also treat athlete's foot, ringworm, and the rest. TINMA, always discuss with your pharmacist etc. And ffs make sure you get the tablets not the pessaries, unless you want to make an embarrassing return trip.

Obvs this will only work if you actually have athlete's foot, and it won't fix any underlying eczema or overlying infection, so you should still see your GP to confirm the diagnosis and to rule out anything nasty such as diabetes than might predispose you to foot infections. They can refer you on if needed.
posted by tinkletown at 3:29 PM on September 20, 2014

I've had a persistent case of "athlete's foot fungus" for decades. I've done EVERYTHING: hit it with every anti-fungal on the OTC market, replaced all my socks at once, liberally sprayed shoes, and lately tried a folk remedy of pouring Listerine over my feet in the shower, which was one of the most effective steps I took.

Doctors always uselessly claimed that, since it kept recurring, I wasn't applying the antifungal properly, or some other BS. They wouldn't consider the possibility that this problem was being solved by their textbook answer. Sometimes I want to line them all up and slap the stupid out of them: "You say it doesn't act like my book says it should? It's probably your fault/in your head. That will be $50."

Then, I saw a new doc who listened and said, "If it's not being killed by antifungals, it could be a bacterial infection that mimics Tinea." He recommended antibacterial salves. I hit it with over-the-counter antibiotic cream for a week or so, and while I occasionally get a tingle of itchiness, it's essentially gone.

So, two suggestions: Daily rinses of Listerine, which you can let dry on your feet, and try Neosporin or a similar brand.
posted by IAmBroom at 5:02 AM on September 22, 2014