FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

ATHLETE'S FOOT FUNGUS CAN ATTACK OTHER AREAS OF BODY

Question: Can athlete's foot fungus be found in the neck, scalp and ears areas? What is the best treatment for it?

Answer: We humans are susceptible to a number of conditions that damage our skin, including athlete's foot. Athlete's foot is a general term used by most people to describe any rash on the feet. There are many conditions that can cause a rash, while athlete's foot is a specific rash caused by a fungal infection. And, it is the most common cause of rash on the feet.

Athlete's foot typically involves the skin between the toes, causing it to become dry, scaly and cracked. On some occasions the infection may cause a moist, macerated and peeling rash instead. Though athlete's foot is most common between the toes, it can also affect other parts of the foot. A fine, scaling rash or a series of small blisters along the side of the foot -- at the junction between the thick skin of the sole and the thinner skin on the side of the foot -- is another frequent type of athlete's foot. It can occur, though, anywhere along the sole of the foot. And, to answer your question directly, these kinds of fungal infections may attack the skin of any area of the body.

When other areas of the body are involved, though, other labels are used to describe the infection. Most of these non-foot fungal infections are commonly called "ring-worm," although the rash may not be "ring" shaped and there certainly is no "worm" involved in the process. Tenia capitis is the "doctor label" for a fungal infection of the scalp; Tinea crura is on the groin and Tenia corporis is on the trunk.

There are, actually, several specific types of fungus that can infect skin. The most common ones are transmitted from person to person, but others may be caught from infected animals while a few may be acquired directly from the soil. In all of these types, the infecting fungus is confined to the superficial layers of the skin and does not spread to cause a life-threatening systemic infection in those with an intact immune system. The types of fungus that cause athlete's foot thrive on warm, moist conditions. That is why this infection typically occurs between the 4th and 5th toes. The fungus that infects the skin of the head and neck is usually subtly different in that it thrives where there is less moisture.

Despite the specific fungus that causes a skin infection or the labels we doctors use to describe it, something is needed to eliminate the annoying rash and persistent itch it causes. Many of the non-prescription products that are sold for athlete's foot are very effective. Terbinafine, the generic name for the most recently approved product in this category, is perhaps the most effective of this group. All of these products are effective at treating most fungal skin infections, regardless of the area of the body involved.

The dilemma your question poses is whether or not your rash is actually caused by a fungus. You see, there are other conditions that can initially appear very much like a fungal infection. Consequently, I suggest that you see your family doctor or a dermatologist if your rash fails to promptly clear after using terbinafine for one week. If you do have a fungal infection that terbinafine doesn't clear up, a prescription medicine that is taken by mouth may be necessary to give you relief.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.