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Medical Edge Newspaper Column from Mayo Clinic
VIGLANCE NECESSARY TO PREVENT RECURRING ATHLETE’S FOOT
DEAR MAYO CLINIC: My grandson has suffered from athlete’s foot for a few years. He has inflamed areas on the soles and toes of his feet. He has seen three dermatologists, but the treatments have not been successful — the fungus keeps coming back. What else can he do? — Tucson, Ariz.
ANSWER: Athlete’s foot is a common and often recurrent problem. Some people are more prone to it than others and may have more severe symptoms — stinging, itching and burning between the toes and on the sole of the foot.
The diagnosis is made on the clinical examination and by identifying fungus on a skin scraping.
Assuming your grandson has been correctly diagnosed, a number of effective topical treatments are available as ointment, lotion, powder or sprays. The most commonly used prescription medications are clotrimazole (Lotrimin) and terbinafine (Lamisil AT). With topical treatments, it’s important to treat the area involved and the surrounding skin.
In cases where topical treatments don’t work, oral medications can be prescribed. In rare cases, the oral medications have the risk of some serious side effects.
In your grandson’s case, the problem could be that he stops treatment too soon. It could also be reinfection, which is not uncommon because the fungus spreads easily, especially in communal showers, locker rooms and fitness centers. He may need to be more diligent in preventing recurrences. He can try:
— Wearing socks made from cotton, wool or synthetic fibers that wick away moisture, changing them twice a day. Heat and moisture can contribute to recurrences and reinfection.
— Wearing open-toed sandals to help keep his feet dry. He should avoid shoes made from synthetic materials.
— Alternating shoes so each pair has time to dry.
— Using over-the-counter absorbent foot powder containing an antifungal agent.
— Wearing sandals in communal showers to avoid reinfection.
Please urge your grandson to keep trying. Unchecked, athlete’s foot can lead to secondary bacterial infections and skin breakdown.
— Marian McEvoy, M.D., Dermatology, Mayo Clinic Rochester, Minn.
Additional Resources:
Dermatology
Appointment Information
Information on Athlete's Foot
DEAR MAYO CLINIC: I gave my husband a kidney in 1998. At an organ donation support group meeting, someone mentioned we should not have birds, weed gardens or be in close contact with flowers because of the risk of infection. Our transplant coordinator and doctors did not mention this to us. We own two parakeets, so I’m especially concerned. — Las Vegas
ANSWER: There’s no firm data on what activities or animals should be avoided after an organ transplant. Doctors base their recommendations on their experience and educated opinions because it’s not possible to do controlled studies on all causes of infections in transplant patients.
In general, the risk of infection is highest in the first six months to a year after transplant because that is when the patient is taking the highest doses of immunosuppressive medications and recovering from the transplant surgery. Avoiding situations that could cause infections is most important then.
In general, we advise transplant patients to take common-sense precautions to reduce the risk of infections associated with gardens or animals.
Gardening: Dirt contains microorganisms that can cause infection. Transplant recipients should wear shoes, socks, long-sleeved shirts and gloves while gardening. After gardening, or touching plants or soil, hands should be thoroughly washed. Mosquito repellent is suggested because mosquitoes can transmit West Nile virus, which can cause a severe infection in transplant patients.
Pets: Many people receive great comfort from pets; I don’t counsel patients to avoid pets. But transplant recipients should avoid cleaning birdcages and litter boxes. They should also avoid handling reptiles or any animal with diarrhea. After handling animals, transplant recipients should wash their hands thoroughly.
Transplant recipients are at risk for cryptococcosis, a condition that can be acquired from bird droppings. A case of cryptococcosis in a kidney transplant patient has been linked to exposure to a pet cockatoo. A very rare condition, psittacosis, is also transmitted by birds, including parakeets. According to the Centers for Disease Control, fewer than 50 confirmed cases of psittacosis have been reported yearly since 1996.
For kidney donors, the risk of infection associated with gardens or animals isn’t significantly increased in comparison to the normal population.
— Robin Patel, M.D., Transplant Infectious Diseases, Mayo Clinic, Rochester, Minn.
Addional Resources:
Organ Donation
Finding Organ Donors
Organ Donation Myths
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Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.
© 2005 TRIBUNE MEDIA SERVICES, INC.
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