Something to Talk About: Athlete’s Foot

The skin on your client’s feet looks dry, red, and cracked. She complains it bothers her because it’s so itchy. You’re confident it’s a treatable case of athlete’s foot, and you know exactly what she needs to do to clear it up. How do you let her know the best way to treat the fungus? The short answer is: You don’t. “Nail professionals are not allowed to diagnose, treat, or prescribe treatment for any unhealthy medical condition,” industry scientist Doug Schoon reminds us. Bearing the legal limitations of our license in mind, let’s imagine how the conversation may look:

Client: Is there a lotion you can recommend for my feet? My skin is so dry it’s cracking.

You: Yes, I can see it’s red and flaking. Have you been to a doctor to check if it’s just dry skin? Sometimes we mistake athlete’s foot and eczema for dry skin. It could be a condition that needs treatment stronger than moisturizer.

Client: No, I haven’t been to the doctor. I’m pretty sure it’s only dry skin though. Isn’t athlete’s foot only between the toes? This is on my whole foot, even the heel.

You: Athlete’s foot is tricky. It has similar symptoms to dry skin: flaky or cracked skin, redness, and itchiness. Sometimes even doctors have a hard time making a diagnosis. Athlete’s foot can be over the entire foot. It’s not limited to just between the toes, though often it does start there. I can’t diagnose the condition or even offer you any advice on how to treat it, but I can say this: You’ve been treating it as if it is dry skin and it hasn’t improved. If you assume it’s athlete’s foot and care for it as such, it won’t cause your dry skin any harm — but it may clear up your skin. If it does clear up, you’ll know it was likely athlete’s foot.

Client: How would I care for it?

You: Here’s the advice I can offer you. It’s basic “best care” practice for the skin on our feet in general. Your best bet is to wash your feet with soap and water twice a day and be meticulous about drying the skin and keeping it dry throughout the day. You can aid this by wearing shoes that fit properly, rather than, say, a heel that will restrict movement in the toes. Wear socks that wick moisture away from the skin and alternate between a couple of pairs of shoes to give the shoes time to dry out.

You’ve been using moisturizer thinking your skin is dry, and it hasn’t improved. Go a couple of weeks without using the moisturizer and keeping your feet dry to see what happens. If it doesn’t clear up within two weeks, give your doctor a call. It’s likely something more complicated than dry skin. After assessing your skin, she may suggest using an over-the-counter antifungal cream, powder, or spray, such as Lotrimin. She may even give you a prescription.

Client: Call my doctor? Isn’t that a bit excessive?

You: Not really. If it’s athlete’s foot, that’s a fungal infection. It can worsen, which is something you’ll want to avoid. Athlete’s foot can spread, which can put your family members and my other clients at risk. Better to know that you are treating your skin for the correct condition than hoping that what you’re doing is effective.