Fungal Infections: Candida, Athlete’s Foot, and What Actually Works

Barbara Lalicki November 22, 2025 Health and Wellness 12 Comments

Most people think fungal infections are just annoying rashes or itchy feet. But if you’ve had one, you know they don’t go away on their own. And they don’t just disappear after a few days of cream. Fungal infections are sneaky. They come back. They spread. And if you ignore them, they can turn into something worse - especially if you have diabetes, a weak immune system, or just keep wearing damp socks.

What’s Really Causing Your Itch?

Not all fungal infections are the same. Two of the most common types - athlete’s foot and Candida - are caused by completely different fungi, and they need different treatments.

Athlete’s foot, also called tinea pedis, is caused by dermatophytes. These are fungi that eat keratin - the tough protein in your skin, hair, and nails. That’s why they love your feet. Warm, sweaty shoes? Perfect. Locker rooms, public showers, pool decks? They’re basically fungal hotels. The most common culprit is Trichophyton rubrum. It doesn’t just sit there. It spreads. And if you scratch, you can move it to your hands, groin, or even under your nails.

Candida, on the other hand, is a yeast. Candida albicans is the usual suspect. It lives in your mouth, gut, and vagina naturally - in small amounts. But when your body’s balance gets thrown off - by antibiotics, diabetes, pregnancy, or a weakened immune system - it overgrows. That’s when you get thrush, vaginal yeast infections, or skin folds that turn red and sore. Unlike athlete’s foot, Candida doesn’t need keratin to survive. It can grow on moist, non-keratinized skin too - like between your toes, under your breasts, or in your mouth.

How Do You Know Which One You Have?

It’s easy to mix them up. Both cause itching, redness, and flaking. But here’s how to tell the difference:

Athlete’s foot: Starts between your toes - especially the fourth and fifth. Skin peels, cracks, or turns white and soggy. Sometimes it spreads to the soles of your feet in a "moccasin" pattern - dry, scaly skin that looks like you’ve been wearing rough shoes all winter. Blisters? That’s the less common "vesicular" type.
Candida infection: Bright red, shiny patches. Often with small pustules around the edges. In the groin, it’s called jock itch. In the mouth, it’s white patches that scrape off (thrush). Vaginal yeast infections bring thick, white discharge and intense burning.

One big clue? Athlete’s foot usually doesn’t hurt unless it gets infected with bacteria. Candida infections often burn more than they itch. And if you’ve had a yeast infection before, you’ll recognize the feeling.

What Treatments Actually Work?

Not all antifungal creams are created equal. And not all of them work fast - or at all.

For mild athlete’s foot, over-the-counter creams like clotrimazole or miconazole are fine. But here’s the catch: you have to use them long enough. Most people stop when the itching stops. That’s a mistake. Fungi are still there. That’s why 40% of cases come back within a year.

Studies show that terbinafine (Lamisil) works better. It kills the fungus, not just slows it down. One user on Reddit said their six-month case cleared up in 10 days after clotrimazole failed for weeks. That’s not luck. Terbinafine has a 70-90% cure rate when used correctly.

For stubborn cases - especially if the skin is cracked or thickened - Whitfield’s ointment (a mix of salicylic acid and benzoic acid) helps. It doesn’t kill the fungus directly. Instead, it peels away the dead, infected skin so the antifungal can reach deeper. One study found it cleared 65% of interdigital cases at four weeks, compared to 55% for clotrimazole alone.

Oral meds like terbinafine (250 mg daily for 2-6 weeks) or itraconazole are reserved for severe or recurring cases. They’re more effective because they get into the skin from the inside out. But they’re not for everyone. Liver checks are needed before starting. And they cost more.

For Candida, fluconazole (a single 150 mg pill) often clears up vaginal yeast infections in one dose. Topical creams like clotrimazole work too, but oral treatment is faster and more reliable for recurrent cases. In 2021, the FDA approved ibrexafungerp - the first new class of antifungal in 20 years - for stubborn vaginal yeast infections that didn’t respond to older drugs.

Two cute fungal characters—Trichophyton wrestling a shoe and Candida floating in a skin fold—with antifungal pill nearby.

Why Do These Infections Keep Coming Back?

Because most people treat the symptom, not the cause.

You use the cream. The itching stops. You stop using it. Three weeks later, it’s back. That’s because the fungus is still hiding - in your shoes, under your toenails, in the cracks of your bathroom floor.

Here’s what really works to stop recurrence:

Change your socks daily. Cotton or moisture-wicking blends. No synthetics.
Wear flip-flops in public showers, pools, and gyms.
Let your feet breathe. Avoid tight shoes. Rotate your footwear so they dry out completely between uses.
Use antifungal powder in your shoes and socks. Even after the infection clears. Miconazole powder (2%) is cheap and effective.
Wash your towels, sheets, and socks in hot water. Fungi survive on fabric.
Keep your skin dry. After showering, pat between your toes - don’t rub. Use a hairdryer on cool if needed.

People with diabetes are at higher risk. High blood sugar feeds fungi. And poor circulation means your body can’t fight the infection well. That’s why the CDC’s "My Action Plan" program - which teaches diabetic patients daily foot checks and hygiene - reduced recurrent infections by 35% in clinics that used it.

When Should You See a Doctor?

You don’t need to run to the clinic for a mild rash. But if any of these happen, get help:

Your skin is swollen, hot, or oozing pus - that’s a bacterial infection on top of the fungus. You’ll need antibiotics.
The infection spreads to your nails (they turn yellow, thick, and crumbly). That’s onychomycosis. It needs oral meds.
You have diabetes or a weakened immune system. Even a small foot rash can turn into cellulitis - a dangerous skin infection.
You’ve tried two different antifungals for four weeks with no improvement.
You keep getting yeast infections (four or more a year). That’s not normal. You might have undiagnosed diabetes or another underlying issue.

And don’t ignore nail infections. They’re harder to treat. Topical creams rarely reach deep enough. Oral antifungals are the standard - but they take months. And they’re not always successful. New drugs like olorofim are in trials and show promise for resistant strains, but they’re not available yet.

Chibi doctor using UV shoe sanitizer as a shield while patients march with clean socks and flip-flops.

What’s New in the Fight Against Fungi?

The good news? Science is catching up.

Antifungal resistance is rising. A new strain of athlete’s foot fungus - Trichophyton indotineae - first spotted in India in 2017, has now spread to 28 countries. It doesn’t respond to terbinafine in up to 30% of cases. That’s why the WHO added it to its list of priority fungal pathogens.

Researchers are working on new treatments. Olorofim, a topical drug in Phase II trials, cleared 82% of stubborn athlete’s foot cases in 2023. And scientists are exploring vaccines and combination therapies to outsmart resistant strains.

But until then, the best defense is still simple: keep your skin dry, treat infections fully, and don’t wait until it’s too late.

What Not to Do

There are myths everywhere. Don’t fall for them:

"Hydrogen peroxide or vinegar will cure it." They might sting, but they don’t kill the fungus deep in your skin. And vinegar can irritate broken skin.
"I’ll just use the same cream for my athlete’s foot and my yeast infection." Not always safe. Some creams aren’t formulated for mucous membranes.
"It’s not contagious." It is. You can pick it up from floors, towels, or even your own dirty socks.
"I’ll stop when it looks better." That’s the #1 reason it comes back.

And please - don’t scratch. You’ll spread it. You might break the skin. And then you’re not just dealing with a fungus. You’re dealing with bacteria too.

Can athlete’s foot spread to other parts of the body?

Yes. If you scratch your infected foot and then touch other areas - like your groin, hands, or underarms - you can transfer the fungus. That’s why jock itch and hand fungus often appear alongside athlete’s foot. Always wash your hands after touching the infected area, and avoid sharing towels or shoes.

How long does it take for antifungal cream to work?

You’ll usually feel relief from itching in 2-3 days. But the fungus isn’t gone. Most topical treatments need 2-4 weeks of daily use. Even after the skin looks normal, keep applying for another 1-2 weeks to make sure all the spores are dead. Stopping early is the main reason infections return.

Is athlete’s foot the same as ringworm?

Yes, technically. Both are caused by dermatophytes. Ringworm is just the name for fungal infections on the body, scalp, or nails. Athlete’s foot is ringworm on the feet. The same fungi can cause jock itch or nail infections. It’s all the same family of organisms - just in different places.

Can I use antifungal cream during pregnancy?

Most topical antifungals like clotrimazole and miconazole are considered safe during pregnancy for vaginal yeast infections and skin rashes. Oral fluconazole is usually avoided in the first trimester. Always check with your doctor before using any medication, even over-the-counter ones, while pregnant.

Do I need to throw away my shoes if I have athlete’s foot?

No, but you should treat them. Sprinkle antifungal powder inside each shoe daily for a few weeks. You can also use UV shoe sanitizers, which kill fungi effectively. If your shoes are old, smelly, or made of synthetic materials that trap moisture, consider replacing them. Fungi can live in shoes for months.

Why do some people keep getting yeast infections?

Frequent yeast infections (four or more a year) are a red flag. Common causes include uncontrolled diabetes, antibiotics, hormonal birth control, or a weakened immune system. If you’re getting them often, ask your doctor to test for diabetes or check your vaginal pH. Sometimes, long-term low-dose fluconazole or probiotics help prevent recurrence.

Final Thoughts

Fungal infections aren’t glamorous. They’re messy, persistent, and often embarrassing. But they’re also treatable - if you treat them right. Don’t rush. Don’t skip steps. Don’t ignore the signs. And don’t assume it’s just "a little itch." The same fungus that causes your peeling toes can lead to serious complications if you’re not careful.

Keep your feet dry. Treat infections fully. And if it keeps coming back - see a doctor. It’s not weakness. It’s smart.