How to treat itchy toes and athlete's foot?

Athlete's foot brings countless discomforts to patients, among which itchy toes is one of the most common symptoms of athlete's foot. If not treated promptly, patients will inevitably scratch the affected area, which will bring greater risks to patients. Generally speaking, there are three types of treatments for athlete's foot: local treatment, systemic treatment, and traditional Chinese medicine treatment. Patients can choose the treatment that best suits them based on their actual situation!

1. Local treatment

According to the different clinical manifestations of the disease, symptomatic treatment is given:

(1) For patients with dyshidrotic eczema or mild maceration and erosion with a small amount of secretions, soak or wet compress the affected area with 1:6000 or 1:4000 potassium permanganate solution or 3% lead acetate solution every morning and evening for 20 to 30 minutes each time (the blisters can be punctured under sterile conditions), and wipe dry with a sterile cloth after soaking. Then choose the following agents for external application, such as benzoic acid/salicylic acid/iodine/potassium iodide/menthol (compound benzoic acid tincture), Castellan ointment, 5% ichthyol, 3% salicylic acid, 10% sulfur mud, or commercially available medicines, such as 2% clotrimazole cream, terbinafine cream, and bifonazole cream (choose any one), and use highly irritating agents with caution.

(2) For erosive types with more exudate, the above-mentioned potassium permanganate solution or Daribo solution for soaking or wet compress can be used. For those with secondary bacterial infection, 0.1% ethacridine (Livanol) can be added as appropriate. After the exudation stops and the erosion surface is alleviated, the above-mentioned sweat blister mud paste, half-dose of Wyeth tincture or commercially available antifungal cream can be used.

(3) The interdigital type can be treated in the same way as the dyshidrotic eczema type.

(4) For the scaly and keratotic type, the disease course is long and treatment requires patience. Start with tinctures with strong antifungal and exfoliating effects (need stronger penetration), such as compound kelp bark tincture or full dose of benzoic acid/salicylic acid/iodine/potassium iodide/menthol (compound benzoic acid tincture). You can also soak your feet in 10% to 30% acetic acid for 20 to 30 minutes each time. After the hyperkeratosis is significantly reduced, switch to a relatively weaker ointment, such as half a dose of compound benzoic acid ointment or 10% to 20% urea ointment, to consolidate the therapeutic effect and restore normal skin barrier function.

2. Systemic treatment

For patients with poor response to local treatment or extensive skin lesions, short-term oral antifungal drugs such as itraconazole, fluconazole, terbinafine, etc. can be used in combination with treatment, generally 1 to 2 weeks.

3. Traditional Chinese Medicine Treatment

(1) For dyshidrotic eczema or acute blisters with erosion and secretions, it is advisable to use decoction of Rhubarb, Polygonatum sibiricum or Portulaca oleracea, and 5% alum water for wet compresses every morning and evening, or to use decoction of 60g Portulaca oleracea, 20g Phellodendron chinense, and 20g Sophora flavescens for soaking, 2 to 3 times a day, each time for 1 to 2 hours. At night, mix 10% bismuth subgallate (Diamond, bismuth subgallate) and zinc oxide oil and apply it externally. After the inflammation subsides and the rot is completely healed, apply Tuqinpi tincture or Chinese medicinal vinegar every day.

(2) For patients with mild scaly and keratotic type, first use a water-based solution (Xanthium sibiricum 15g, Kochia scoparia 15g, Radix Sophorae Flavescentis 15g, Rhizoma Cynomorii 15g, Fructus Cnidii 15g, Sophora flavescens 15g, Radix Stemonae 15g, Alum 6g, 3000ml of water), boil for 20 minutes, then wait until warm enough to soak for 15-20 minutes, 1-2 times a day. Alternatively, add appropriate amount of vinegar to the foot washing water and soak the feet. Then apply a commercially available tinea pedis ointment.

(3) For those with excessive sweating of the hands and feet, after the local damage is alleviated (no erosion, exudation and obvious keratinized scales), use 5% alum or dried kudzu vine water (30g dried kudzu vine, 15g alum, 1000ml water, decocted in water for washing), or equal amounts of phellodendron and raw sanguisorba officinalis for washing, once a day.

After tinea pedis is cured, you should still apply the medicine 1 to 2 times a week to consolidate the therapeutic effect and prevent recurrence. You should wash your feet frequently (pay special attention to washing between each toe), change your shoes and socks frequently, and keep them dry at all times. People who sweat a lot on their feet can sprinkle some alum powder, methenamine and other powders in their shoes to stop sweating. If the patient also suffers from onychomycosis, they should be treated together.