Eczema and athlete’s foot are two common skin conditions that nail technicians regularly see in the course of servicing clients. Telling the difference between athlete’s foot and eczema is difficult because both conditions can trigger identical symptoms. With either condition, the client may complain of symptoms ranging from thickened, scaly skin with mild redness to red, blistered, and cracked skin that may itch and burn. Even the location of the outbreak doesn’t provide many dues; Eczema is commonly found on the hands and feet; athletes foot most commonly affects the feet, but similar fungal infections can also be found on the hands.

How do you tell the conditions apart? According to Dr. Paul Kechijiam, a New York-based dermatologist and NAILS Magazine’s Nail Doctor, and Dr. Edward Young Jr., a dermatologist in Sherman Oaks. Calif, you don’t. Both doctors say they can’t differentiate the conditions positively without examining skin scrapings under a microscope and doing a culture on the affected area.

Two Different Causes

While athlete's foot and eczema may have identical symptoms, they have very different causes. Eczema is a noninfectious, noncontagious, inflamed skin condition that is related to allergies, irritations, and emotional stress.

Athlete’s foot, on the other hand, is an infectious, contagious, inflamed skin condition that is caused by a fungal infection of the skin. Feet are prone to fungal infections because shoes and socks create a warm, damp, and dark environment that is ideal for fungi to grow.

Both conditions can be acute (appearing suddenly, sub-acute, or chronic (persistent or ongoing). In the acute stages, the skin is often blistered, cracked, and red. The skin may ooze, and most sufferers complain of burning and itching. In the chronic forms, the skin may just remain thickened and scaly, with minimal redness and itching.

The location of the symptoms sometimes provides a few clues in determining what you’re dealing with, but both doctors say they usually must do a culture to determine for certain which condition it is. Eczema usually appears elsewhere on the body, rather than just on the feet,” says Kechijian. “However, if you are allergic to a material in your shoes, then it could appear just on the foot. A clue to athlete’s foot is thick, crumbly nails. But eczema can also affect the nails.”

Young says that affected skin between the toes, especially the fourth and fifth toes, usually indicates athlete’s foot, while cracked and red skin on top of the foot or on top of the toes indicates eczema.

Know When To Say No

Most technicians know they can’t service clients with athlete’s foot because it is contagious, but many service clients with eczema. Whether the condition can be spread to other clients, however, isn’t your only concern. According to Kechijian and Young, clients with either condition should not be serviced during outbreaks.

“You don’t want to do services on people with athlete's foot because athlete’s foot is contagious. And you don’t want to do services on clients with eczema because the skin can overreact to any mild trauma if the client has eczema,” says Young.

The skin acts as a natural protective barrier between the body and outside elements. If this barrier is broken by cracks in the skin, the individual is more susceptible to irritation and infection.

“With both athlete’s foot and eczema, the skin barrier is broken and the skin is more easily irritated. Some of the lotions and other products you use during a service will irritate the skin, even if they normally wouldn’t,” says Young.

Although either condition can recur, you can do services on clients between outbreaks. Advise clients to keep their feet cool and dry and to wear cotton socks to help keep their feet clear of either condition. For his patients who suffer from hand eczema, Kechijian recommends they wear moisturizing creams to keep the skin softened. Clients with hand eczema should also wear gloves to do housework or at any time their hands will be in contact with chemicals or other irritants.

Send Them To A Doctor

If a client has not previously been diagnosed with eczema or athlete’s foot, both Young and Kechijian recommend referring her to a dermatologist so that she gets the correct diagnosis and treatment. Otherwise says Young, she may diagnose herself and treat it in a way that cither makes the condition worse or masks its cause.

Eczema for example, is treated with topical cortisone creams: athlete’s foot is treated with topical antifungal creams. If you apply a cortisone cream to athlete’s foot, the fungal infection will worsen and spread.

Even if the client does correctly guess that she has athlete’s foot and treats it with an over the counter antifungal cream, the condition may not clear and she may end up at the dermatologist’s office anyway “There are many different antifungal medications and some clients will read belter to one than the other,” says Young.

Kechijian agrees: “Say the client uses an antifungal medicine and still the condition doesn’t clear. She goes to see the doctor and he does a scraping but can’t see fungus under the microscope because the medication killed just enough of the infection so that he can’t see it.”

While saving the time and expense of going to the doctor may have an appeal, many over the counter cortisone and antifungal treatments are not strong enough to treat eczema or athlete’s foot successfully. The skin on the palms of the hands and the soles of the feet is very thick, and it usually takes a prescription-strength preparation to penetrate the layers of skin and treat the condition.

Both Young and Kechijian advise technicians not to speculate what the condition is or what has caused it. If a client exhibits patches of thickened, scaly skin, recommend she see a physician first to determine what it is. If she already knows its eczema or athlete's foot, explain that the products you use during the service would only irritate the condition and ask her to reschedule when the outbreak has cleared.