It's so itchy! But how to tell whether it's athlete's foot or foot eczema?

Spring and summer are the peak seasons for athlete's foot (tinea pedis) and foot eczema. Because the two are easily confused, patients often cannot tell the difference between athlete's foot and foot eczema.

If the wrong medicine is used because the two are not distinguished in time, it will cause trouble for treatment. Therefore, it is very necessary to understand the difference between athlete's foot and foot eczema.

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1. It is hard to tell the difference between athlete’s foot and foot eczema

Tinea pedis, commonly known as athlete's foot, is a foot skin disease caused by fungal infection of the superficial skin. The areas between the toes, soles, heels and sides of the feet are prone to athlete's foot. After contracting athlete's foot, the skin of the feet will experience symptoms such as peeling, blisters and itching, and it is easy to relapse. Patients with more serious conditions may even experience erosion, exudation and bacterial infection. Athlete's foot often occurs on one side.

Eczema is a common allergic and inflammatory skin disease. The rash is diverse and mostly symmetrically distributed. Patients suffer from unbearable itching and are prone to recurrence, which can easily develop into a chronic skin disease. Eczema can occur on any part of the body throughout the year.

Because some clinical manifestations of athlete's foot and foot eczema are similar, such as severe itching, many patients cannot tell whether they have athlete's foot or foot eczema.

2. The difference between athlete's foot and foot eczema

Although athlete's foot and foot eczema have similarities, there are still major differences between the two.

1. Different causes

Eczema is an inflammatory skin disease, usually caused by allergies, while tinea pedis is caused by a superficial fungal infection of the skin.

2. Different symptoms

Most patients with eczema have allergic constitutions. The rash usually appears as dark red spots, the skin surface is relatively dry, and some skin cracks may occur due to rough feet. Common clinical manifestations of athlete's foot include blisters, scales, and erosions.

3. Different effects of medication

There are also differences in the effects of medication for athlete's foot and foot eczema. For patients with eczema, some hormone ointments have a better therapeutic effect, but they are prone to relapse after stopping the medication; when patients with athlete's foot use hormone ointments, they may have some effect at first, but they will become ineffective after a few days, and may even make the rash worse, causing the rash to spread.

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4. Different infectiousness

Eczema is not contagious, but athlete's foot is highly contagious.

3. How to treat athlete's foot and foot eczema in a targeted manner

Whether it is athlete's foot or foot eczema, symptomatic treatment is required to achieve twice the result with half the effort.

When treating athlete's foot, the goal is to eliminate the pathogens, help the patient relieve the pain caused by the disease, and prevent it from recurring as much as possible. Local treatment is generally used, but systemic treatment or combined treatment may also be used depending on the patient's specific situation.

Local treatment: Currently, the commonly used topical antifungal drugs in clinical practice include imidazole antifungal drugs, acrylamine antifungal drugs and other antifungal drugs. The antibacterial activity of acrylamine antifungal drugs is relatively strong. However, it should be noted that different types of skin lesions require different dosage forms of topical drugs. For example, creams can be used for blister-type, intertriginous erosion-type and scaly keratotic athlete's foot, but when treating intertriginous erosion-type athlete's foot, the local skin needs to be kept dry; blister-type athlete's foot can be treated with non-irritating solutions, while scaly keratotic athlete's foot can be treated with creams, ointments and other dosage forms.

Systemic treatment: mainly used for patients who have poor local treatment efficacy, recurrent disease, or patients with scaly keratotic type and large affected area, as well as those who are unwilling to accept local treatment and have certain systemic diseases (such as diabetes, AIDS, etc.) that lead to low immunity. At present, the commonly used drugs for systemic treatment of athlete's foot are terbinafine and itraconazole.

Combination therapy: Currently, combination therapy is increasingly valued in clinical practice. It generally adopts the method of combining topical medications with oral medications, but the safety of the drugs needs to be considered, and during treatment, attention should also be paid to drug contraindications and drug interactions.

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The treatment of foot eczema is different from that of athlete's foot, because eczema is generally a skin inflammation caused by allergies. When treating foot eczema, the first thing to do is to find out the cause of the patient's illness. It is necessary to understand the patient's medical history, work environment and living habits in detail, and check for allergens.

When treating foot eczema, try to avoid adverse external stimuli, ensure skin cleanliness, carry out anti-allergic treatment, and severe patients require immunomodulatory treatment.

Therefore, patients who cannot distinguish between athlete's foot and foot eczema must go to the hospital for diagnosis and receive regular treatment, and never take medication indiscriminately!

Reviewer: Zhang Shuyuan, Chief Physician, Beijing Huayi Integrated Traditional Chinese and Western Medicine Dermatology Hospital