What this protocol covers
Itching and peeling between the toes: how it is treated, for how long, what changes in someone with diabetes, and when it is not a fungal skin infection.
1. What to ask
- Where is it: between the toes, on the sole, the nails?
- Is it itchy, peeling, smelly or cracked? Since when?
- Do they have diabetes, poor circulation or weakened immunity?
- Have they already used something? What and for how long?
- Is there redness that is spreading, heat, pain or fever?
2. Refer if any of these appear
- Diabetes or poor circulation with any lesion on the feet: to the doctor or podiatrist.
- Thickened, yellowish nails or nails coming away: a nail infection is not cured by a cream.
- Spreading redness, heat, pain or fever: there may be a bacterial infection.
- No improvement after 2-4 weeks of correct treatment, or people with weakened immunity.
3. If there are no red flags
Typical lesion between the toes
- A topical antifungal: terbinafine (1-2 weeks) or clotrimazole or miconazole (2-4 weeks), as per each product's leaflet.
- Keep applying it for the full time even if the symptoms go sooner: otherwise it comes back.
So that it does not come back
- Dry well between the toes after showering.
- Cotton socks, breathable shoes and alternating pairs.
- Flip-flops in communal showers and changing rooms, and antifungal powder in shoes if it keeps recurring.
4. Adjust to who will take it
- Diabetes
- Always to the doctor or podiatrist: a foot lesion in someone with diabetes is not managed at the counter alone.
- Pregnancy
- Topical antifungals such as clotrimazole can be used; ask if in any doubt.
- Children
- It is uncommon before puberty: confirm the diagnosis before treating.
- Long-term conditions
- With weakened immunity or poor circulation, a doctor should assess it.
What not to recommend
- A topical corticosteroid on its own: it relieves the itch and makes the fungal infection worse.
- Stopping treatment when the itch goes.
- Treating nails with a cream meant for skin.
What to say at the counter. The cream for the full time even if it stops itching sooner, and dry very well between the toes. If you have diabetes, or your nails are affected, your doctor or a podiatrist should see it.
Pharmacy Pills · conveniodefarmacia.com
Patient sheet: athlete's foot
To print and hand over. It carries only what the patient needs at home.
- Apply the cream for the full time recommended, even if it stops itching sooner.
- Dry well between your toes after showering.
- Wear cotton socks, breathable shoes and flip-flops in communal showers.
- See your doctor or a podiatrist if you have diabetes, if your nails are affected or if it is no better in 2-4 weeks.
Self-assessment
Three questions. When you check your answers you will see the explanation for each one.
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In someone with diabetes, any foot lesion is assessed by the doctor or podiatrist.
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The itch goes before the fungus does; stopping early makes it more likely to return.
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The corticosteroid lowers the skin's local defences and the fungal infection spreads.
Training content. It does not replace the summary of product characteristics or clinical judgement.