Effective Treatments for Athlete's Foot and Managing Exudate

Q: Effective Treatments for Athlete's Foot and Managing Exudate

Hello： For a detailed introduction to athlete's foot, you can refer to the article by Med's Good Friend at https：//www.medpartner.club/tinea-pedis-treatment-prevention/. <br>In summer, it is recommended to apply a thin layer of ointment. <br>If the lesions continue to expand and

Treatment of athlete's foot (tinea pedis) and management of exudate?

Hello Doctor: I have a tendency to sweat excessively from my hands and feet.
I previously had a history of atopic dermatitis over ten years ago, which resolved on its own as I aged.
I also had a history of athlete's foot due to prolonged shoe wear, which was treated successfully with medication, and I have since maintained good foot care without recurrence.
However, in the past six months, due to changes in my lifestyle, I have been spending over 12 hours a day outdoors.
Although I can remove my shoes for a few hours in between, my feet have gotten wet during the rainy season.
Even after drying them and cleaning with medicinal soap two hours later, I developed blister-like skin symptoms that do not itch, so I didn't pay much attention to them.
I continued my usual foot care routine, but the symptoms did not improve.
I mistakenly thought that the prolonged outdoor exposure and increased stress might have lowered my immune system, leading to what I believed was dyshidrotic eczema.
Since the condition was not severe, I self-treated with over-the-counter steroids.
During this time, the foot symptoms fluctuated, but the affected areas alternated between both feet.
After four months, the blisters became erosive, prompting me to consider a fungal infection.
I then sought treatment from a dermatologist, who diagnosed me with tinea pedis (athlete's foot).
Following the doctor's advice, I have been applying a ketoconazole cream 2-3 times a day for the past month, while still needing to wear shoes and socks for extended periods.
Currently, whenever I apply the cream, a significant amount of exudate oozes from the affected area, causing it to stick to my shoes and socks.
If I extend the interval between applications, the exudate decreases, but I still adhere to the doctor's recommendation of applying the cream at least twice a day.
However, the erosive area continues to enlarge, and the doctor has advised me to keep applying the medication.
I would like to know if there are any other proactive treatment options to reduce the exudate issue and effectively treat the athlete's foot.
Thank you.

James, 30~39 year old female. Ask Date: 2023/05/27

Dr. Li Yufen reply Dermatology

Hello: For a detailed introduction to athlete's foot, you can refer to the article by Med's Good Friend at https://www.medpartner.club/tinea-pedis-treatment-prevention/.
In summer, it is recommended to apply a thin layer of ointment.
If the lesions continue to expand and there is significant tissue exudate, consider oral medication treatment simultaneously.
If the skin condition does not improve or worsens, it is advisable to consult a nearby dermatologist for diagnosis and treatment at http://www.derma.org.tw/user_finddoctor.php.
Thank you!

Reply Date: 2023/05/27

More Info

Athlete's foot, or tinea pedis, is a common fungal infection that can cause a range of symptoms, including itching, burning, and the formation of blisters or sores. In your case, it seems that the condition has progressed to a more severe stage, leading to the development of weeping lesions. This can be particularly uncomfortable and may require a more comprehensive treatment approach.

First and foremost, it is essential to continue following your dermatologist's advice regarding the use of antifungal medications, such as ketoconazole. These medications are effective in treating fungal infections, but they may take time to show significant improvement, especially in more severe cases. It is crucial to apply the medication as directed, even if the lesions are weeping or appear to be worsening. The presence of exudate (fluid) can be a sign of inflammation and infection, which may require additional management.

Here are some strategies that may help manage the symptoms and promote healing:
1. Keep the Area Dry: Fungi thrive in moist environments, so it is vital to keep your feet as dry as possible. After washing your feet, ensure they are thoroughly dried, especially between the toes. You might consider using a hairdryer on a low setting to help dry the area.

2. Use Antifungal Powders: In addition to topical antifungal creams, consider using antifungal powders that can help absorb moisture and reduce friction. These can be particularly useful when wearing shoes for extended periods.

3. Footwear Choices: Opt for breathable footwear made from materials that wick moisture away from the skin. Avoid tight-fitting shoes and synthetic materials that can trap moisture. If possible, alternate between different pairs of shoes to allow each pair to dry out completely.

4. Change Socks Frequently: If your feet sweat a lot, consider changing your socks multiple times a day. Look for moisture-wicking socks that can help keep your feet dry.

5. Avoid Steroid Creams: While corticosteroids can reduce inflammation, they may also suppress the local immune response, potentially worsening fungal infections. It is best to avoid using steroid creams unless specifically directed by your healthcare provider.

6. Consider Oral Antifungals: If topical treatments are not effective, your dermatologist may recommend oral antifungal medications. These can be more effective for extensive or resistant infections.

7. Follow Up with Your Dermatologist: Since your condition has persisted and worsened, it is crucial to maintain open communication with your dermatologist. If the current treatment plan is not yielding results, discuss alternative options, including the possibility of a different antifungal medication or additional diagnostic tests to rule out other conditions.

8. Manage Underlying Conditions: Since you mentioned a history of atopic dermatitis and potential immune system concerns, it may be beneficial to address any underlying health issues that could be affecting your skin's ability to heal. This might include stress management techniques, dietary adjustments, or other lifestyle changes.

In summary, while managing athlete's foot can be challenging, especially with the presence of weeping lesions, a combination of proper antifungal treatment, diligent foot care, and lifestyle modifications can help improve your condition. Always consult with your healthcare provider before making any changes to your treatment plan, and ensure that you are receiving the most appropriate care for your specific situation.

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