Foot Skin Issues: From Athlete's Foot to Peeling Skin

Athlete's foot? Dyshidrotic eczema? Pure desquamation?

In April 2016, the skin between my right foot's middle toe and little toe cracked open to the point where flesh was visible.
After showering, the skin between my toes would turn white and rotten, and there was a small, itchy bump that I could peel off.
My family doctor suggested it might be athlete's foot and prescribed KETOSONE CREAM 20MG/GM.
The skin between my toes healed, but the soles of my feet still had some peeling.
I visited a dermatologist who suspected it was athlete's foot and prescribed Nafdin Cream; during my second visit, they thought it might be peeling skin and prescribed URESON CREAM; during the third visit, no medication was prescribed; and during the fourth visit, another clinic prescribed A-MEI Betamethasone Cream.
After four visits to the dermatologist, my toes and soles continued to peel without improvement, which has been very distressing for me.
The peeling lasts for 1 to 3 days before continuing again, and I rarely have a complete recovery.
This severely affects my daily life, making it difficult to shower, sleep, change clothes, and wear shoes, even impacting my relationships with family.
I would like to ask the doctor: 1.
Can I go to a medical center for further examination? 2.
What testing methods are available? How long do the tests take? Will I need to pay out of pocket? 3.
How should I tell the doctor that I want to undergo testing? 4.
Is bleach and alcohol ineffective against the fungus causing athlete's foot? 5.
After hand-washing socks, will soaking them in boiling water for 10 minutes kill the fungus? 6.
After trimming my toenails, if I wash the scissors twice with hand soap and then wipe them with hydrogen peroxide once, will that kill the fungus? 7.
If my cat covers itself with the blanket that my feet have been on, will the cat have the fungus from athlete's foot? 8.
Is it true that coming into contact with the fungus will lead to infection, or does the environment need to be sufficiently humid for an infection to occur? Thank you for your assistance!

Yīshēng jiù jiù wǒ, 20~29 year old female. Ask Date: 2018/02/20

Dr. Wu Yuxin reply Dermatology

1.
It should not be necessary to go to a medical center.

2-3.
It is important to correlate with clinical symptoms and medical history; there are no specific testing methods.

4.
It is ineffective.

5.
It is possible.

6.
It can be removed, but it may not be completely eradicated.

7.
There is a possibility.

8.
Personal hygiene is more important.

Reply Date: 2018/02/20

More Info

Your concerns about foot skin issues, particularly regarding athlete's foot (tinea pedis) and persistent peeling skin, are quite common and can be quite distressing. Let's address your questions systematically.

1. Further Examination at a Medical Center: Yes, if your symptoms persist despite multiple treatments, it is advisable to seek further evaluation at a medical center. A specialist, such as a dermatologist, can provide a more comprehensive assessment of your condition.

2. Testing Methods: Common diagnostic methods for skin conditions include skin scrapings for fungal cultures, KOH (potassium hydroxide) preparations, and sometimes even biopsies if necessary. The time for results can vary; fungal cultures may take a week or more, while KOH preparations can provide results within a day. Insurance coverage varies, so it’s best to check with your provider regarding costs.

3. Communicating with Your Doctor: When discussing your desire for further testing with your doctor, be clear about your ongoing symptoms, the treatments you've tried, and how they have not resolved your issues. You might say, "I have been experiencing persistent peeling and discomfort despite multiple treatments. I would like to explore further testing to identify the underlying cause."
4. Effectiveness of Bleach and Alcohol: While bleach and alcohol can kill some fungi, they are not recommended for treating athlete's foot. Bleach can irritate the skin and may worsen your condition. Alcohol is also not a reliable antifungal treatment. Over-the-counter antifungal creams or prescription medications are more effective.

5. Sanitizing Socks: Soaking socks in boiling water can help kill some fungi, but it is not a foolproof method. Washing with hot water and a good detergent is generally sufficient. Consider using antifungal laundry additives if you are concerned about contamination.

6. Sterilizing Nail Tools: Cleaning nail clippers with soap and water followed by hydrogen peroxide can help reduce the risk of fungal transmission. However, it’s best to use dedicated sterilizing solutions or alcohol for more effective disinfection.

7. Pets and Fungal Infections: Cats can carry fungi, but they typically do not transmit athlete's foot to humans. However, if your cat has been exposed to contaminated environments, it’s wise to maintain good hygiene and keep your living space clean.

8. Infection Mechanism: Fungal infections like athlete's foot thrive in warm, moist environments. While direct contact with the fungus can lead to infection, the right conditions (humidity, warmth) are often necessary for the fungus to take hold. Maintaining dry feet and using antifungal powders can help prevent infection.

In summary, persistent foot skin issues can be frustrating and impact your quality of life. Seeking further evaluation from a dermatologist is a prudent step. They can provide targeted treatments based on the specific diagnosis. In the meantime, maintaining good foot hygiene, keeping your feet dry, and using antifungal treatments as prescribed can help manage your symptoms. If you have any further questions or concerns, don’t hesitate to reach out to a healthcare professional.

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